Low Papp-a: 2 different results

[Elz1406]

Hi everyone

I'm a bit of a loss what to do and thought I'd try putting it out to the hive mind!

So when I was about 11 and a half weeks I had a private nuchal screening (the timing of the NHS one was tricky) which showed up low papp a of about 0.36 MoM.

I tried to pass this info on to be part of my NHS medical record but this turned out to be really difficult to do an in the end gave up and had the NHS one as well thinking that it would turn up the same result anyway.

I had the scan at 13+3 but when I got the results there was nothing about low papp-a. I didn't really know what to do and spoke to my midwife at our appointment. She referred me but then I didn't hear anything for weeks.

I went through the liason team at the hospital just to try and find out what was happening and today had a call to say that my NHS result was normal so I wouldn't be referred. They also sent me the papp a results which gave a corrected MoM of 0.52.

I've reached the end of the road with what I can do about it but I still feel really worried. I don't know which result is more accurate but I'm worried that since nothing will be monitored I'll have no way of knowing if my baby's growth starts to be affected. The only other thing I can is to go and have private scans which obviously don't want to do but I know I'm going to spend the whole pregnancy worrying about it. Am currently 21 weeks so feels like a long way to go.

Does anyone have any helpful thoughts or advice for me? Thanks so much :)

That sounds so confusing! Sorry you’re not getting the reassurance you need.

From 20-something weeks you are monitored in terms of your fundal height (bump) to make sure that it’s growing in line with your personalised graph which is a relatively new thing as before it was a standard across the board measurement which wasn’t individualised. My small baby was not picked up on even though I didn’t have low Papp-a for that pregnancy four years ago (but I do have it this time) as I was “on track” with the average but it was not average for me. It’s much more likely to get picked up now.

Also low Papp-a is a marker, not a diagnosis and they don’t really know what it does to be honest. I think I read when I was researching it that there was a correlation between smaller babies and low Papp-a but not causation and definitely not the case for everyone.

I hope this helps, if not please do reach out to your midwife and maybe they’ll change their mind if it’s causing you continued anxiety x

Thanks so much for taking the time to reply - that's interesting about the fundal height too! I'm definitely going to let my midwife know that I still feel really unsure about it at my next appointment.xx

Sorry you've had conflicting results. It could be that because you were further along for your NHS one your PAPP-A levels had actually increased giving a lower risk result. You could get a private NIPT for peace of mind?

@Elz1406 good plan, hope you get what you need xx

@Elz1406 I would imagine that between 11 weeks and 13 weeks your papp-a would have increased indeed and 0.5 is considered normal (I think anything above 0.4 is considered normal). Papp-a on its own doesn't necessarily mean much. What results overall did you get from the combined test?

I have low papp-a and I'm not having much monitoring. They checked the function of the placenta at the 20 week scan (which they do for everyone) and because it was fine I have no further scans.

Hi everyone

Thanks so much for your replies! My results for the trisomies were low risk so I'm only concerned about the papp a itself. I've decided to go and get the doppler done privately at 24 weeks and take it from there!