High hcg and low PappA

[AshFar]

Hi Moms
I recently had my first-trimester combined screening (double marker). My results are:

• β-hCG: 76.60 ng/mL → MoM ≈ 2.36 (elevated)
• PAPP-A: 0.22–0.44 MoM (low)
• NT scan: normal (1.5 mm)
• Maternal age: 32

My doctor said my Down syndrome risk is 1:85, so they suggested amniocentesis.

I also have other symptoms of possible early preeclampsia, including persistent headache

Has anyone experienced similar double marker results .How did your pregnancy progress, and what steps did your doctor take?

I’d really appreciate any reassurance, experiences, or advice.

Thanks!

Surely go for the NIPT test first, before an amnio? Unless you're waiting for the results on that? Especially as your NT measurement was normal.

Also they should have started you on 150mg aspirin due to the pre eclampsia risk.

I had previous miscarriages, so my doctor started me on aspirin and progesterone from the first day my pregnancy was confirmed, and now my aspirin dose has been increased.

I’ve had previous miscarriages, so my doctor started me on aspirin and progesterone from the first day my pregnancy was confirmed, and the aspirin dose has now been increased. After my combined screening came back with a higher risk, I told my doctor I would prefer to do NIPT, but she explained that NIPT is still a probability test (about 99% accurate), while amniocentesis gives a 100% definitive answer.

Okay, then it's up to you - sorry, I don't have experience with amnios but hopefully someone else will be along to give more info/advice!

Hi OP, with my last pregnancy I had a 1:28 chance of Down Syndrome from the combined screening. I had low papp-a, normal NT and I was 39 at the time. I decided to get NIPT instead of amniocentesis as I didn't want an invasive test. I knew NIPT was not diagnostic but statistically it is incredibly accurate (and much more so than the combined test the NHS starts with!). I did feel the screening midwives were trying to (gently) push me towards amniocentesis too but I didn't think combined screening score was high enough to warrant it - it translated to a 3.5% chance of DS, or 96.5% no DS, which is actually pretty low!! It took a lot of soul searching but was the right decision for us. NIPT came back clear which was good enough for me and DS2 was born completely healthy. Do what feels right for you and your pregnancy, it's your decision. Good luck OP x

Hi OP, with my last pregnancy I had a 1:28 chance of Down Syndrome from the combined screening. I had low papp-a, normal NT and I was 39 at the time. I decided to get NIPT instead of amniocentesis as I didn't want an invasive test. I knew NIPT was not diagnostic but statistically it is incredibly accurate (and much more so than the combined test the NHS starts with!). I did feel the screening midwives were trying to (gently) push me towards amniocentesis too but I didn't think combined screening score was high enough to warrant it - it translated to a 3.5% chance of DS, or 96.5% no DS, which is actually pretty low!! It took a lot of soul searching but was the right decision for us. NIPT came back clear which was good enough for me and DS2 was born completely healthy. Do what feels right for you and your pregnancy, it's your decision. Good luck OP x

Not quite the same, but In my current pregnancy I have low PAPP-A, normal NT and partly because of my age (45) the combined test gave me a 1 in 2 chance of Edward’s/Patau’s.

My NIPT gave me a less than 1 in 10,000 chance, and rather than going straight to amnio, fetal medicine gave us really detailed anomaly scans at 16, 18 and 20 weeks. From the first scan the consultant was very, very reassuring - we still had the option of an amnio if we wanted one, but between the NIPT and the scans we felt reassured.