Is my doctor wrong?
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January 16th, 2013, 05:07 PM
Join Date: Jan 2013
I am 28 years old and 14 weeks pregnant with my second. My first child is a healthy 20 month old and my pregnancy with her was uncomplicated. For this pregnancy, my first trimester screen results were:
NT: 2.9mm (otherwise baby looked perfectly normal)
PAPP-A: 0.81 MoM (40 percentile)
Free Beta HCG: 1.33 MoM (70 percentile)
I am awaiting the results of the MaterniT21 test. I am praying the results come back soon and baby is normal chromosomally.
However, today at my doctor's appointment, my doctor told me that even if baby is normal chromosomally, I will be considered high risk. She specifically said that my low PAPP-A and high free HCG are associated with preeclampsia, IUGR, low birth weight, etc. So she wants me to get one NST and one BPP every week from week 32 through delivery to check on baby!
I am fine with extra monitoring if it is warranted, but all the studies I've come across mention the 5th percentile (or maybe even the 10th percentile) as the cut-off value for low PAPP-A and the 95th percentile for free HCG. I couldn't find any studies that demonstrate that percentiles of 40 and 70 are any indication for alarm. Even for values that do meet the cut-off levels, the predictive value of poor pregnancy outcome is still weak.
So what do you think? Do you have any experience with this? Is my doctor being extra, extra conservative? Or is she off the mark and not praciticing evidence-based medicine?
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