Anyone with low PAPP-A?

[Allie84]

Mine was only .27 at my first trimester screen. Bottom 2nd percentile....normal is 1.....and they say it's 'okay' to have it .50 or above.

But below that can indicate problems with the placenta. I'm so worried!! My OB told me not to worry about it and it's controversial if it means much, but my medical journal reading shows me it DOES increase risk.

Risk of IUGR, Pre-E and even stillbirth.

I don't get another look at baby for over 5 weeks at my anatomy scan. It feels like forever when I am so scared about the PAPP-A.

(This result did give me a 1/227 risk for Down Syndrome with my first trimester screen but then I had a NIPT and it came back clear and we're having a girl! SO baby is genetically normal, it's more placental I have to worry about I believe)

 

[Allie84]

No one?

 

[LittleLala]

Hello lovely, I was just coming to the second trimester board to make a post about low Papp-A levels just in case it would help anybody and I saw your post.

I have a lovely little boy who just turned 1 month old. In that pregnancy I had very low Papp-A levels (lower than yours) I was below the first percentile and was so scared.
I was told that the pregnancy was high risk for Down Syndrome (and moderate risk for other trisomies), pre eclampsia, IUGR, and stillbirth. I was also told that most pregnancies with my levels result in a stillbirth by 24 weeks.

I had a NIPT done which came back low risk for DS. It was such a relief. Then I saw a genetic counsellor to talk over whether to get an amniocentesis or not. She said that the risk of miscarriage or infection outweighed the risk for Down syndrome now and so I chose not to get it.

I was taking 150mg of aspirin every night to help prevent pre-e, and to help the blood flow to the placenta. I also had growth scans done every 4 weeks to monitor that baby continued to grow. He was on the small side to begin with but caught up nicely in the third trimester in those scans they measured all of baby but also spent a while doing a uterine scan to ensure that the placenta was still working as it should.

Then at my 36 week scan I was told that due to his femur measuring so behind that we were at risk of Down Syndrome again. It was so far along there was nothing they could do to give me a definitive answer, and I was told that I just had to wait and be patient to find out. I do wish that I had just had an amnio (or cvs) done earlier on, so I would have had peace of mind and had a definitive answer.

It was so stressful. I cried a LOT throughout the pregnancy. I was so scared of so many things.

They induced me (not very early though, at 39 weeks) due to the low PAPP-A levels because they wanted to monitor the baby throughout the birth.

My baby is totally fine. I never got pre-eclampsia, he was a normal birth weight, and does not have Down Syndrome. He spent a little while in the NICU after birth for breathing problems but that was unrelated to my Papp-A levels anyway.
I was also worried that my baby would end up being extra difficult or something due to my stress while I was pregnant (I know that sounds silly, but family kept telling me to relax so that baby would relax) well anyway, he is the chillest, most relaxed baby ever! He sleeps well and is just a total delight.

I hope that I have helped answer some questions for you, and put your mind to ease. If you have any questions, feel free to private message me.
It's a scary thing to be told, and googling it resulted in so much fear and stress for me. I hope this helps you

 

[LadyLovenox]

I also just had low papp-a with my son...it was found at my 20 week scan that he had a two vessel cord, which could have contributed to the low papp-a. They told me I was at risk for iugr, and I had weekly nst and monthly growth scans. I also ended up with gestational diabetes, on top of hypermesis (I threw up every single day for the entire pregnancy, even the day I had him) but he is healthy and was born right on time!

 

[Allie84]

Thank you so much ladies!!! OMG your posts have really helped me.

Google is terrible because usually people are sharing bad stories or worries and never follow up with good stories. I know that's how the internet works but it sucks to research. Also, the medical studies on it are so few that it's hard to know.

MY OB himself says there isn't enough research and all they can do is monitor me.

LittleLala, that does sound stressful and I also worry about my stress levels harming baby!! I was super stressed with my first, and he was/is totally healthy but he is also anxious so maybe it's just my genes, I dunno heh.

LadyLovenox, sounds like you were super well monitored which is great....but oof on the hypermesis!! I am just a few weeks over the terrible MS and I can't imagine.

Thank you so much for sharing.

 

[ebannawuoyohw]

Hi my baby is nearly one now and I had low Papp a.
Mine was actually 0.19! Seriously low... I had to take aspirin and have extra scans. She was small but perfectly fine. I had high blood pressure on the end which is why she may have been small. Don’t worry about it it doesn’t mean anything really I think it’s mainly if the baby is downs ect and that come with the extra complications anyway!

 

[ebannawuoyohw]

Hi my baby is nearly one now and I had low Papp a.
Mine was actually 0.19! Seriously low... I had to take aspirin and have extra scans. She was small but perfectly fine. I had high blood pressure on the end which is why she may have been small. Don’t worry about it it doesn’t mean anything really I think it’s mainly if the baby is downs ect and that come with the extra complications anyway!

 

[vivedi]

My level was 0.29 at 13 weeks. I also had very high beta HCG levels which made me high risk for DS (1 in 33) but I had the Harmony test which came back low risk.

As standard here (Scotland) they don't do any extra monitoring with a low PAPP-A like mine but I also did internet research and it scared me so I asked about additional growth scans as they are recommended by the RCOG.

I have been scheduled for one extra growth scan at 28 weeks and I hope they will keep monitoring me.

I am now 21 weeks pregnant, at my fetal anomaly scan last week, everything looked normal and baby is measuring right on track at about 50% percentile.

I have been on low dosed aspirin (75mg) since I was 12 weeks pregnant as I already had a risk factor for pre-eclampsia (BMI over 35).

I asked about a doppler at my last scan and they said they don't do one for the blood flow from/to placenta that early. So I'll probably have to wait till I'm 28 weeks for that but at least I know that so far our baby is growing well.

So at the moment everything is looking good. Hopefully that won't change.