Low PAPP-A

[RaliaMusca]

Hi everyone,

I had a call from my midwife today that my combined screening blood test from my 12 week scan showed I have low PAPP-A.

I've read various conflicting research papers about the significance of PAPP-A levels in predicting adverse pregnancy outcomes.

Having had a missed miscarriage at 13 weeks last time and lots of bleeding due to a subchorionic hematoma in this pregnancy, I am obviously very anxious.

I'm starting 150mg aspirin a day immediately and am already booked in for extra growth scans in the third trimester but I'm so worried something might go wrong.

Any positive stories of anyone who had low PAPP-A? Or anyone else going through the same?

Thanks!

Hiya, I had low PAPP-A and had a healthy baby boy with no issues at all. Got a few more NHS scans to check and was nice to see him more than I would have done otherwise!

I had growth scans towards the end of my pregnancy and took aspirin from 12 weeks. There were no problems and I had a big baby boy weighing 8lbs 7oz :)

Did anyone have low PAPP A and HCG? Mine are both low.

Hey ladies, just found out I have low papp a today, I had a mmc in January so a little nervous about it! My consultant has decided against giving me aspirin... Have any of you gone on to have successful pregnancies without the aspirin? He just said I'll need extra growth scans at the end of pregnancy

There's no strong evidence to suggest aspirin is helpful for the adverse outcomes which MAY be associated with low papp-a but as it's inexpensive & safe to prescribe some trusts recommend it. To reassure you, i've had two healthy & uneventful pregnancies despite two borderline low papp-a results.

Thank you! I was told on another thread that my Papp-a isn't actually low 0.78 so not sure if the consultant worried me for nothing as he definitely said it was low 🤔

In UK the cut off is 0.4. You definitely wouldn't be on a low Papp-a pathway...

@SBR1 yes that's what they told me on the other thread. May change consultant/even hospital (not the best experiences with this hospital!) As he mentioned multiple times that my Papp A was low and I'm certain of the numbers too. He said all other results were normal just not papp a 🤷🏼‍♀️

@SBR1 he's even booking extra growth scans at 32 and 36 weeks for it. Which I won't refuse if I can have them, extra scans to check baby are fab

I had 0.45 for my first pregnancy and got the aspirin. Had something like 0.67 or 0.76 for the 2nd and still got the aspirin but only bc of the 1st pregnancy. Otherwise your and mine result are above the worry line.

I had growth restriction with my first baby, possible bc I started the aspirin late (16 weeks, 75mg / day) or the dose was too low and it didn’t have any effect.

No restrictions with the second, but started it at 12 (or thereabouts) and 150mg, they told me the dose had been updated in the 5 years since my 1st.

You don’t need the aspirin but having the extra checks is good.

It might be on the 'lower side' compared to an absolute ideal? I suspect NHS 'low' number is a cut off threshold for cost effective intervention.
Great to get extra growth scans & that your consultant is being extra cautious in your case.... Sounds like a good thing & I wouldn't be thinking of changing based on this!