12w scan don't need combined test

[Carebear99]

Hi all
I had the nipt last week and all was well. I've got my 12w scan tomorrow and I understand at part of the combined screening they also test papp a, anything else? Can I just tell them to the papp a test and anything else but the combined test? I don't want the combined test as I don't need it and it may come up with a high risk result falsely.

I just told them I had already had the NIPT and they just did a lovely long scan instead, nothing was mentioned about PAPP-A 😐 will have to ask the consultant when I see her next week :)

The Papp-A is part of the screening so you can’t have one without the other. If you don’t want screening you just have the scan and they’ll still look at the Nuchal Translucency (NT) and measure that as a raised NT can be an indicator or other things like cardiac conditions not just chromosomal. You can still have screening if you really wanted to know about the PAPP-A and just if you had a high chance result you wouldn’t need any other investigation as you’ve already had a NIPT. NIPT is now offered to all women that have a high chance result on the NHS so effectively you would just skip needing that.

I was in the exact same dilemma, had NIPT and was told I could have the combined screening but could not choose to just have PAPP-A. I had always been set on not having the combined test for the same reasons as you, I thought I would feel anxious if a high risk result came back, despite having had low risk NIPT (after all, there is still a 1% chance of false negative with NIPT, it’s not infallible by any stretch of the imagination).
I ended up deciding to have the combined screening anyway because a low PAPP-A seemed quite important to know about since it seems to directly change the management of the pregnancy (aspirin, extra growth scans or both).
I don’t know how I’d have reacted if it was a high risk result or if I’d have remained reassured by the NIPT. Luckily it was all low risk. Not saying my decision was correct but it’s worth thinking about carefully as you can’t have PAPP-A done after 14 weeks so not something you can change your mind on later.
Let us know how you get on

It also occurred to me that I might be able to get a PAPP-A level done at a private clinic - but couldn’t find one near me. I wonder if places like the fetal medicine centre in london might though.