Last week i had my Nuchal Translucency Scan. The ultrasound showed that the skin fold was within normal limits. Results were as follows:
NT: 1.5
freeBhcg: 1.22 MoM
PAPP-A: 0.25 MoM
The risk for me of Downs Syndrome was 1:153. Yesterday I had CVS and will get the results back today or tomorrow.
My question is: Has anyone had a positive pregnancy outcome after having low PAPP-A scores?
This is an IVF pregnancy, which I have been told, increases the likelihood of having low PAPP-A scores.
I have read a bit about those without chromosomal abnormalities, such as Downs Syndrome, that still have problems throughout the pregnancy with poor fetal growth, and premature birth.
I would really love to hear from anyone who has low PAPP-A and how their pregnancy progressed.
PAPP-A is Pregnancy-associated plasma protein A, and when the score is low, it is a marker for Trisomy 21, interuterine growth restriction, premature delivery and basically is a placenta problem. It cannot really be monitored until after 20 weeks to see if the baby is growing sufficiently.
Big hugs Stellas Mum... This is a scary time and I do understand...
Your PAPP-A is low - and yes it's an indicator. Just like a temperature is an indicator to pneumonia - but you could just get a cold... KWIM???
The ratio between the PappA and HCG is not too bad.
To put it into perspective. My PAPP-A was 3 times yours and my baby was born at 28 weeks with a shot placenta... It is just an indicator. In the absence of any other indicator the likelihood is good that your baby is healthy.
I wish I could give you a hug in person. I feel your pain - please let us know when your CVS comes thru.
Hi Stellas Mum, I certainly know exactly what you are going through as I have recently just gone through the same thing. I'm currently 21 weeks and got very similar results to you at 12 weeks. My results were:
NT: 1.28
freeBHCG: 1.1 MOM
Papp-a: .28MOM
We also elected to have the CSV which came back with everything being good. Given there are no other markers you should be ok as well. My OB has said he has had patients reach 39weeks but other only reaching 28 so it is very individual. I'm having additional growth scans at this stage at 28 and 32 weeks but really all depends of the results.
My 19 week scan showed bubs was growing right on target but OB has said it really isn't until 28 weeks where we can start to tell what might happen as that is when bubs will start to have growth spurts. My 19 weeks did show that bubs has only a single umibilical artery (SUA) (instead of 2), this is linked to kidney problems (but scan showed bubs does have 2 kidneys) and small babies. Given we were already expecting a small baby from the papp-a that is not a big shock. Anyway I don't think the SUA is linked in anyway to the papp-a just lucky (hahah) to get the 2 issues in the one pregnancy.
Anyway can't really help you with the outcome of pregnancy but it is great to hear someone else going through the same thing coz I don't think it is really common.
Further update - had a detailed growth scan yesterday and the baby is growing well, still small but consistent growth, we actually shot up to the 18th% from the 15th a fortnight ago. She is still breech and now I have had 3 people tell me she won't turn. Been seeing a Chiro and she said everything is now positioned well there is no reason from her perspective why the baby can't turn, she says the cord must be short or wrapped around the neck preventing her turning, the Dr doing the ultrasound said she won't turn coz of not enough fluid (fluid levels are ok but he said not enough to help her turn) and my OB said last week he didn't think she would turn.
So c-sect is definitely on the cards however, OB now doesn't know when to do it, last week he said 37wks just to play it safe but now since she is doing so well inside he doesn't want to deliver her too early. He normally does c-sec at 39wks but its still a wait and see game. The longer she stays inside the better.
The weight estimate was 2kg which is great, we actually think she is going to be about the same weight as DD1, she was born at 37wks weighing 2.6kg. We also think this is just a small baby and the SUA and low papp-a is playing no part but it better to be closely monitored and be sure than the other options.
Stellasmum - hope everything is still going well for you.
Bridee,
I must say, I breathe a sigh of relief when I read these good emails! So glad she is doing well, 2kg is great. How did your ceasar go last time? I'm just starting to think about the birth now, the way I look at it, the ceasar seems to be pretty much risk free for the baby? What are your thoughts on the matter?
Well my little bub must be growing I suppose, my stomach has ballooned over the past 4 days! She has been lying transverse, but on the weekend I felt this huge movement and she must have gone feet down, but has since moved back to transverse. I cant wait to have the scan next week, fingers very tightly crossed that everything is going well.
Keep me updated on the progress, its getting so close for you now!
Emma
To answer the original Q my mum had a risk of 1:50 with my brother who is here and perfectly healthy and "normal"... Well, as normal as 18 year old boys can be! So although the numbers may be low sometimes they are just that, low numbers and nothing more.
Ryders Mum, it's all very well to say take the chance, but I think these things need to be looked into and research carefully, and Mummy of bub needs to be comlpetely 100% sure of her choice and comfortable with it. At the end of the day it is possible to misscarry a perfectly healthy baby from an amnio, and it's not a "chance" that should be taken lightly.
Stellasmum- c-section isn't risk free for the baby complications can occur but if bub is breech the majority of Dr will do a c-sect. I would prefer to have a natural birth but I think my body has decided breech is the way to go. My c-sect went really well last time I recovered really quickly - the midwives in hosp were insisting on take pain meds when I really didn't need them. So hopefully the same occurs this time. But the major downfall with c-sect is the recovery time, you really aren't meant to do much for 6 wks which is difficult with a baby, particularly when I have another as well. My DH is great and takes at least a month off work to help but with a natural birth the recovery just isn't that long.
Good luck for scan next week, I'll be looking forward to hear how it goes.
Stellas mum - how are you, how did you scan go? Well my news the baby will be arriving on Monday. Had a growth scan yesterday and the results suggest the baby hasn't grown in the 2 weeks since the prior growth scan and signs the placenta isn't functioning as it should, then went for monitoring which we have been doing weeks for the past month and it took 1.5 hours to get her to move around and her heart beat was on the low side so with all this combined it was decided baby needs to be delivered. At one stage it could have been today but thankfully she moved a bit and that was enough for Dr to say Monday is ok. I have to go in on Saturday for further monitoring so hoping that is ok for us to last till Monday.
I did actually make a midnight trip into the hospital last night coz I hadn't felt movements for nearly 12hours, they were so lovely at the hospital. Turns out everything was fine and in fact the monitoring was far better than in the afternoon, the hearbeat had returned to around 150-160 and apparently I was having some 'tighenings'.
So anyway looks like low papp-a has caught up with us, it was only last week we were saying it looks like this is just a small baby but now there seems to be evidence it is the low papp-a that is causing the smallness. The weight estimate is 2kg so hopefully she does surpass this estimate. On Monday I will be 37weeks so technically she will be full term but the size of about a 34weeker. But maturity wise she should be fine.
Just checking in to see how things are going with your Holly. My Holly is going pretty well, she has put on good weight and now weighs 4kg at 6 weeks so she has put on 1.3 kgs since she was born. She is so placid and is just gorgeous! Hope all is going well with your Holly. What has she been doing? How many weeks old is she now? Hope you are all doing well.
How funny you posted this I was just thinking of you. My Holly is doing really well. She is however, in a brace for hip dysplasia but DD1 also had hip dysplasia so it is no big deal for us. Holly's isn't as bad as DD1 so hoping she won't be in the brace for too long (hoping for only 6wks but if it is longer that's ok - far better now than when she is older).
Holly is putting on good weight - she's in the 25th% percentile. Sleeps over night anywhere from 6-10hrs but generally about 8.
Life can be challenging with 2 at times but DD1 just loves her sister so haven't had to deal with any jealously issues.
Low PAPP-A Results after Nuchal Translucency Scan
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This is a scary time and I do understand... 
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