Okay thought I would add my 5 cents from my experience thus far for what its worth. we have a papp-a of .28 and a combined risk due to age etc of a 1 in 2 risk for downs and 1 in 16 for trisomy 18/13 so extremely high risk factors...needless to say many sleepless nights and turmoiled days ensued. We chose to have a CVS done last week and the early FISH result says no downs or trisomy 18/13...so yay for us on that score.
We have since met with our specialist obstetrician today and had a very long chat about all the possible implications of the low papp-a and what we can do to minimise the risk of issues later in the pregnancy. Now our specialist is the Head of Fetal Medicine at Monash Medical Centre so has dealt with these sorts of issues before and she came up with some interesting new research in this area that you may like to ponder.
Basically all this papp-a research has only been around for the last few years so research into the full implications is also quite new and not a lot is available, but what is coming to light is that a combined therapy of clexane (blood thinners) and low dose aspirin can be beneficial in helping to maximise the function of the placenta. After discussing this in great detail we have decided to to go down this track to give our baby the best possible odds.....we will be on 40mg of clexane a day and one low dose aspirin per day.
I feel so much better knowing there is something we can do to give our baby the best possible chance and just thought I'd share what we had learnt today. I think is also why flowerchild is recommending you see a fetal medicine specialist as really a normal obstetrician does not in all honesty have the training, knowledge or experience to deal with such complex issues.
Something she also mentioned which I found quite interesting is that the placenta has two main growths spurts, one has already occurred, one happens from 15-18 weeks and it is vital that you maximise the placenta's potential during these high growth phases to keep it going through the rest of the pregnancy.... that really cemented our decision to go the treatment route especially over the next few weeks of vital placental growth.
All food for thought....hope my experience adds to the discussion in some way.....
Mel I am glad you came & shared your experience - thankyou...
As you probably know I was on the regime you mentioned but for an autoimmune condition that caused multiple deaths for my unborn babies. I too have read this research and found it interesting. My fetal medicine obstetrician also uses a similar regime on some high risk women.
It makes sense doesn't it? When placental function is not optimal it has to work harder - thinning both the maternal supply and the placental supply (asprin crosses the placenta) aims to make the placental job easier.
Know Mel that the regime you are on is used frequently by high risk women - you will become adept at injecting yourself and your tummy will be battered for a few months - but in the end it will be worth it all!
I just cant reiterate more loudly what Mel said about a specialist. It is imperative. I have had lots of personal and professional experience with this and I have to say this is a time you need the big guns! Some obstetricians are quite unsure about this type of issue and only those very studied in the area are truly helpful (of course some will happily call in the big guns!)...
Good luck Mel - if you need any "pointers" let me know... (scuse the pun )
hun....I have had type 1 diabetes for 30years and have calculated I have already doen somewhere in the vicinity of 25,000 -30,000 injections...a few more is soooo not an issue.....LOL!!! I am also on Gavin Sack's protocol for immune based miscarriages/nk cell issues as I think you were so am already on clexane just a lower dose....
I just want to add - a low PAPP-A is thought to occur when implantation of the placenta is a bit iffy... Most often the placental position etc appears fine - but remembering that the formation of the placenta - just like that of the fetus is an intricate miracle!
A bit lke building a house - if the foundations are not strong it can make the house a little less stable. One house may be fine and stand 200 years - another may need extra fortification so that it stays strong. REally that is what the low PAPP-A is saying... You might need a little help here, then again you might not!
This is the business of babies - most of the time all goes well - but it's all an unknown - Faith in the outcome and strength in the process is important...
Yup have been on 25mgs pred...am weaning off now...down to 15 at the moment....in a strange twist of irony the prednisone has balanced out the first trimester lows that most type 1's get so the net increase in insulin dose has been zero....which is awesome...At the moment with me weaning off the pred and still being in that window of hypos I am actually taking less than pre pregnancy insulin doses.....this will swing the other way in the next month or so...but so far so good!!!
Squid you will still get a rebate from Medicare - many many many people without private health access a private fetal medicine specialist. Also if you are on a low income and once your expenses exceed $500 you will get 85% of your out of pocket expenses back.
It is worth one appointment that you will get a rebate for - the more knowledge you have the better informed decisions you can make...
Hun, even as a public patient you can request a referral to the fetal medicine unit at the closest large hospital to you.......they are all medicare funded........
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I remember now about your Diabetes... Sorry my love...
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