Low PAPP-A - experience?

[jinis]

The screening results from the 12 weeks combined test have just come back & I was notified of low PAPP-A (0.39).

This resulted in no changes to the protocol, as I had already been referred to a high-risk pregnancy care due to it being an IVF DE pregnancy (so 150mg aspirin daily, serial growth scans from 28 weeks & not allowed to carry full term) - I'm 14+3 today and otherwise healthy.

I'd appreciate if you could share your experience of how your pregnancies went with low PAPP-A.

Thanks lovelies as ever xx

[JA-fnuk Partner]

Hope you get some replies to your post form others who have experienced this condition The positive thing is they are aware of it and you will be closely monitored during the pregnancy and have already started taking the low dose of aspirin .You will have your blood pressure and weight + urine checked regularly + growth scans from 28 wks For support take a look at our website fertilitynetworkuk.org UK-Wide Support groups " Pregnancy & Beyond Groups "

Take care

Janet-Partner

[jinis in reply to JA-fnuk]

Thank you Janet xx

[Lolalules]

Hiya, I had low papp-a in my pregnancy after a successful FET. It doesn’t necessarily mean too much until you have the blood flow scan - following this they then either 1) continue you with regular scans (blood flow comes up as slower than average), or 2) just one more scan plus additional midwife appts (blood flow fine but baby lower centile) or 3) just one additional check in (all looks fine). For all three options you’ll be offered induction. In my blood flow scan, my daughter was small but blood flow ok so i had regular midwife appts to monitor blood pressure and if bump wasn’t measuring the right size i was sent for scans.

My daughter remained small throughout pregnancy (below 10th centile) but then rose above 10th in weeks 38+ and was born a healthy 7lbs12 at 41 weeks. From the research I did this is quite a common outcome especially if your levels were closer to the test limit (I think i was 0.28). Low papp-a is quite common, it’s also not tested in all countries, but mainly just means you’ll be monitored more (reassuring after IVF!) and will be offered regular midwife appts to check blood pressure. Try not to panic! I recommend joining peanut as there’s a low papp-a group on there with lots of reassuring positive stories x

[jinis in reply to Lolalules]

Thanks lovely - this is very helpful. I'm so glad your little one arrived safely 💛 V interesting regarding the growth spur towards the end too!

When did you have the blood flow scan? xx

[Lolalules in reply to jinis]

Thank you! Yeah i did modify my diet too and made sure i ate little and often and high protein… i ate overnight oats with protein yoghurt before i got out of bed everyday (and was a great habit to have once BF and little one is here!) and had fruit and nuts on me all the time. I definitely think it helped! I had the blood flow scan at 28 weeks i think.

My friend in Germany told me that they don’t test it there. Apparently it’s just because the downs/edwards test they do here measures papp-a against hcg to see if there’s a risk of those conditions and then they saw a trend of low papp-a with low birth weight/small babies etc. the test is cheaper whereas in Germany they offer harmony as standard so they don’t even measure papp-a and it’s not conclusive enough that they’re concerned to measure it. If that helps! X

[IVFat40]

I also had a low papp-a test result with my son (I was 42), it really worried me at the time but from what I can tell it didn't seem to have any negative effect at all, my son grew well throughout the pregnancy and was a healthy weight at birth. He did arrive 2 weeks early, but was healthy and I've no reason to think that was linked to the papp-a. It's hard because I found the medical professionals didn't really seem to know much about it, so I felt a bit left to wonder and worry. But the important thing is, my son was absolutely fine 😊

[IVFat40 in reply to IVFat40]

I'd also add I took steroids during my first trimester and always wondered if that could somehow have effected the papp-a test result? No evidence for that though just a thought!

[jinis in reply to IVFat40]

Thank you - so glad to hear it didn't affect your little one's growth 💛

I felt the same in that I was told this over the phone but not much more information. So really appreciate you sharing your experience xx

[Kate-92]

hello, I am also in the same situation although I am unsure of what my levels are until my 16 wk midwife app on Monday. I too am having an IVF pregnancy so at this stage my protocol hasn’t changed either x hope all goes well for you 💞

[jinis in reply to Kate-92]

Hey lovely - congratulations on your pregnancy 💛 How are you feeling? I've still got a bit until my 16wk appointment, but I've heard they usually review the results from the combined screening at this appointment, so I hope you'll find more information about it tomorrow.

Thank you, and hope everything goes smoothly for you too xx

[Kate-92 in reply to jinis]

Aaah thank you & also congratulations to you too 💫 I still find it really strange when someone says congratulations to me - it feels so surreal !

I feel good, symptoms have lessened but still there - mainly headaches, sleepy, needing to wee loads 😂 and the odd bout of nausea but I am SO anxious about everything - always find myself down google rabbit holes ! How about you ?

x

[jinis in reply to Kate-92]

Thank you 💛

Same here - nausea started easing up around 12/13 weeks and I have a bit more energy. Still very sleepy and have a daily nap when I'm working from home😅 Bloating has been pretty intense to the point I don't know if I'm starting to have a small bump or just bloated!

And yes Dr Google has been on duty 24/7 - what I've found difficult is that there is no easy way of finding out if the bub is okay. No reason to believe otherwise but so hard not to think of the worst... but trying to stay optimistic/positive because I also want to enjoy this process 🥰

[Kate-92 in reply to jinis]

It’s hard isn’t it - we have had quite a few additional scans & paid for a private NIPT after the screening results just for piece of mind (my piece of mind 😂) But like you said we just need to stay positive and enjoy being pregnant x I feel like that is getting easier as each mile stone passes - I just can’t wait to feel some movement. I think I’ve felt little flutters over the past week, but no idea if it’s me or baby…

I’ve started working from home a bit more so I can lie in longer 😂 and I am sure at 14 weeks there is a little bump too 💞 I’m struggling to hide mine at work now and I’m trying to keep it under wraps until we have told our family in a couple of weeks x

[jinis in reply to Kate-92]

That's so exciting about feeling flutters (I'm sure it'd the baby) 🥰 May I know which one you used for a NIPT test? It's been on my mind and there are so many choices of private clinics...! xx

[Kate-92 in reply to jinis]

We went with a local baby scanning clinic (I am in the north west) who offered NIPT from various labs, so regardless of where you go - the blood is always tested in the same place (which is good to know & trust) We opted for Prenatalsafe, their lab is in Guildford - some are still abroad and I wanted quick turn around. It was £355 which is standard no matter where you have it done - we weren’t eligible on the NHS because we were low risk but because of the low Papp-a / my age (38) I just wanted extra reassurance x we got results in 3 working days 🙏🏼 in my opinion it was worth every penny for me, but isn’t necessary for everyone x