Low Papp-A extra weekly scans 29+1

[Fatgrace1]

Hi all, I am on here for some support my daughter has low Papp-A and at her 28 week scan baby was just below lowest centile, they scanning her weekly now I am so worried but don’t want to project onto her. Anyone else had this and needed weekly scans?
many thanks for any replies

I have low Papp A and have been told I will have to have extra scans. I've been told it's usually nothing to worry about, just to take half an aspirin everyday. I was a bit anxious at first, but I've since found out how common it is, so now I'm not too concerned.

She will be looked after very well, considering they are doing weekly scans. Babies from low Papp A mums can sometimes come a little early or be born small, but usually nothing is different. She will be absolutely fine, they are just very over careful these days with everything - it can actually make you worry more

Thanks for your replies, she was meant to be having 28 week scan then 32 week buy now have to do them weekly, she has next scan tomorrow so will know bit more then, she had low Papp in first pregnancy but got to 39 weeks 6lb5oz. But didn’t have this many scans, I think I have googled too much and scared myself xx

I had scans at 20, 30, 34, 36, 38 and 40. Low Papp-a too.

but my baby was average until 28 and then started dropping centiles. She was born at 2nd percentile by induction.

so they are definitely worried about your DD, as her centile is very low.

tell her to keep monitoring baby”s kicks, there is a risk of still birth, and go for an assessment for any reduced movements, even if she’s not sure, it’s better to go and check.

it’s very good they are checking her weekly. They might induce her earlier, or she can have an elective CS if she asks for it, if they consider it’s too risky to wait longer.

I hope she’s been taking 150mg daily aspirin since 12 weeks? Especially as this is her 2nd, the dr would have known to put her on it. If they haven’t it’s good to know and ask for it if she goes for a 3rd baby.

Thank you for your message, we have next scan at 2 today so will know more. She’s been on aspirin since 12 weeks and pregnacare.
will keep you all updated.
really appreciate the replies as going out of my mind with worry, fingers crossed all is ok.

In lots of pregnancies low PAPP-A doesn’t mean growth problems but sometimes it does. It sounds like this may be the case for your daughter.

I had low PAPPA and unfortunately aspirin didn’t help. DS slipped a lot between 28 and 32 weeks. I was put on fortnightly growth scans and fortnightly well-being scans (so he was checked weekly). By 35 weeks it was clear he was going to need early delivery and I had him by C section at 36 weeks. He weighed 4lb 6oz. I was basically the text book version of how it progresses when problems develop.

It was scary but they will monitor your daughter incredibly closely and pick the best time to deliver if the baby does need to come early. I would expect her consultant to warn he she won’t go beyond 37 weeks, but every hospital has different protocols.

She had a scan and they said they were just checking Dopplers and placenta today and baby next Thursday still worried

Your daughter may find the UK IUGR FB page helpful, I certainly did. I did lots of research (both my babies have been IUGR) and this pregnancy I have been taking L’arganine supplements (lots of studies to support this for fetal growth and cord flow), 150mg aspirin at night as it’s better absorbed and upped my protein intake (all approved by my consultant) and so far baby is 50th percentile.

Hi just an update, baby is measuring 3 weeks behind, so going to be a very small baby. Daughter is doing everything in her power to help. She’s having weekly antenatal appointments, Doppler and placenta check scans weekly then growth scans every other week. She’s 31 weeks tomorrow fingers crossed all will be ok. Thanks for all replies I am worried sick

The hospital are monitoring her closely and I am extremely confident the baby will be ok. It sounds like she’ll end up having to deliver early so you can help support her by making sure everything practical is in place, her work know mat leave may start early etc.

It’s hard not to feel scared and overwhelmed, but once you’re in NICU with an IUGR baby you appreciate how common this is. It brings challenges (I’m still struggling with my son’s weight at four months), but for doctors and nurses it’s routine and they do not let things get out of hand.

Thank you for your reply, yes they are definitely keeping eye on her. I have made sure we have extra childcare for her DD. And prepared in case we have early arrival.
its so hard not to worry, constantly asking if baby is moving well etc and reminding her to take aspirin every eve, think I am doing her head in.

Have they considered replacing her aspirin with a blood thinner injection like clexane? Just asking bc now on my 2nd pregnancy they’ll be giving me clexane from 28 weeks.

I had IUGR from 28 weeks and static (no growth) from 36 with my first pregnancy, was induced at 40 (they would have induced earlier but had a wrong scan at 38 that showed growth, then back to no growth at 40, same growth as at 36) and baby was born at 2nd percentile.

While my Papp-a has been normal now, bc of this history, and also I think bc my bmi now is 30 (I was 2 and a bit stones lighter the first time) they now recommend clexane to replace aspirin.

your daughter seems to have a worse IUGR than I had it first time, my DD was average until 28 weeks, so maybe something to consider?

Thanks for your advice, was your baby a healthy weight and ok?
she has scan today only for Dopplers and placenta. Then growth again next Thursday.
will mention the other medication when she’s next at her midwife.

She’s had her scan. Does anyone know what cpr pi means? It’s very low at 8%

• *@Fatgrace1 yes, she was ok, though very skinny, weighed about 2.5kg. She put on weight the following weeks/months. Went on from being on the 2nd percentile to 25th and bit above.

sorry don’t know what that cpr is.

@Fatgrace1
"The CPR is the ratio of the umbilical artery pulsatility index over the middle cerebral artery pulsatility index. A low CPR reflects fetal redistribution and is thought to be indicative of placental insufficiency independent of actual fetal size, and a marker of adverse outcomes"
"Foetal cerebral redistribution or 'brain-sparing' is a diagnosis in foetal medicine. It is characterised by preferential flow of blood towards the brain at the expense of the other vital organs, and it occurs as a haemodynamic adaptation in foetuses which have placental insufficiency."

It's good that they're really on top of scanning and checking your daughter weekly, as you're aware they might have to deliver early due to placental insufficiency. Hope everything goes well for your daughter. 💐