Low Papp A

[WhyamInotvomiting]

I am 14 weeks pregnant with DC3 and have just had my combined screening results back. They were all low risk, however it was noted that I have low papp A. I am to start aspirin daily and have been referred for consultant-led care, extra scans etc.

Whilst I wait for an appointment with the consultant, would be interested in anyone else's experience of this?

I am finding the information available online and from my hospital not very in-depth which is fuelling my anxiety more. For example, it all says 'most' babies are fine but it increases your risks of loss, small for gestational age, pre-eclampsia etc but I can't find the actual estimates for the amount of increased risk if that makes sense? Like, does 'most' babies are fine mean 55% of them, or 95% of them? Is the increased risk of an SGA baby a risk increase of 5% more, or 50% more, or what? If anyone knows where I can find better information regarding risks that would be appreciated too.

Finally, has anyone had low papp A with no other antenatal complications and went on to still have a midwife-led birth and/or birth without continuous fetal monitoring from the outset?

There is not much information because it's a fairly unknown area as far as I understand. The majority with low papp a will have no issues, it does depend on how low though. My first baby I had 0.4 mom - no issues had a 7lb 10oz baby at home. Second time I had 0.24mom and that baby was smaller at 6lb 5oz and she had reduced growth at 39 weeks. Arguably the papp a could have been responsible but I had other factors too not present first time. But she was born perfectly healthy and has more than caught up to where her brother was 1 month on. I'm not exactly answering your question and you will find more stories from people who weren't impacted than were- have a look at the low papp a Facebook group for some positive stories.

Hello, just been through this. I was told to start taking aspirin as soon as low Papp-A was identified. Just been for an artery Doppler scan and have now been moved to low risk for pre-eclampsia which I had been worried about. I'm having a couple of growth scans to monitor growth due to low Papp-A potentially indicating link for growth but despite being on the smaller at 20 weeks she's caught up at 24 and tracking fine. I know it's hard when there's little information available not to worry (been there). I can't give you figures but it doesn't necessarily indicate a problem.

Thanks, I've joined the Facebook group and found that really helpful more just to see more information about real life possibilities than anything else. My papp-A is 0.29 so low but not extremely low/below 1st centile, which is some comfort too. I just feel the wait for my 20 week scan and UAD scan is excruciating now as I'm so nervous about them but it could be up to about 7 weeks away depending when they do them.

It's easy for people to say don't worry when you naturally will. The main thing is that it's been identified and they will keep an eye and once you've had the next scans you'll have more information to work with if there are any concerns from this they will be able to support you.

A professional had mentioned that unless under 0,2 the doctors will not be worried. I had 0,34. My midwife said it’s fairly common and rather normal to have it at such volumes.
You will have to give urine at every midwife appointment. I am now 22 weeks in and having my consultant meeting next Wednesday. Everything has been pretty normal so far. I was not very worried about preeclampsia because my natural blood pressure is low, last time it was checked it was still good and I’ve not had any protein in my wee. From what I read it’s like 9 out of 10 ladies with low Papp-A go on to have a completely normal pregnancy.