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My first trimester screen indicated I have a very low PAPP-A level (.24 MOM) and high HCG level. This put me at a 1:12 risk of Downs Syndrome. The results of my CVS indicated no Downs Syndrome, Trisomy 18 or 13. I have read that having a very low PAPP-A level can lead to placental problems such as IUGR, stillbirth, eclampsia and gestational diabetes to name a few.
Has anyone had any experience with low levels of PAPP-A?
"Anyway, not to belabor the point, but to make a long story short, the simple answer to our reader’s question is that low PAPP-A levels are not only associated with certain fetal chromosomal abnormalities, but also with an increased risk for a poor pregnancy outcome. BUT, despite this association, the positive predictive value of a low PAPP-A for one of these outcomes is still relatively low. That means the chance of one of these events is higher with a low PAPP-A, but you shouldn’t panic at the outset that something bad is going to happen.
Several things our reader's providers could do that might help elucidate her actual risk for problems throughout her pregnancy include the following: 1) A screen for MSAFP at 16 weeks (ask your doctor to explain this); 2) a ‘targeted’ ultrasound to carefully evaluate the baby’s anatomy and growth; 3) Doppler flow velocimetry of the uterine arteries at the time of the ‘targeted’ ultrasound to look for increased resistance to maternal-placental perfusion (indicative of an abnormality of placentation); 4) Serial assessment of fetal growth, and; 5) Doppler flow studies on the fetal umbilical cord and middle cerebral arteries to look for evidence of increased resistance to fetal-placental perfusion (again, indicative of abnormal placental vascularization) and fetal blood flow redistribution (suggestive of preservation of the brain at the expense of perfusion of less ‘essential’ organs), respectively. None of these will accurately predict outcome, but if they are abnormal, can justify more intensive antepartum fetal surveillance so that chances of delivering a healthy baby, regardless of the gestational age, are improved."
I hope this helps!
Thank you Vicki for my awesome siggy!!
Last edited by rebeccabaltimore and more; July 27th, 2009 at 05:25 PM.