[chickadee]

Has anyone had low free beta hCG results? I got a call today with the results from my first trimester combined screening, and they told me that the markers for Downs and other trisomies came back normal (low risk), but that my free beta hCG levels are low. Apparently they like for them to be at least 0.4 (I can't remember the unit), and mine are only at 0.3. I wasn't expecting the call when the genetic counselor reached me, and I had to go to a meeting a few minutes later and so didn't have a lot of time to speak to her, and so will call her back tomorrow with questions... but what she told me is that the result means there is a 1% risk of problems with the baby's growth. I don't really understand that. What kind of problems? Why would we be concerned if it were only 1% - wouldn't that be a low risk? The doctor had warned me that some of my results could be abnormal (because we lost the twin but the placenta is still there, so the numbers could be impacted), and the genetic counselor said that *could* be the reason for these results... but she didn't seem convinced of that. She didn't say that they would be doing any additional bloodwork, just that they'll be doing more frequent ultrasounds to monitor the baby's growth (every 4 weeks through 32, and then every week after that). I've had a lot of ultrasounds already and the baby's growth has been consistent so far... so I'm hoping that the result is abnormal just because of the twin loss. One more thing to worry about though, ugh.

Has anyone had this result before? What do you know about it, and how did things go with the pregnancy?

[sarah*]

I am confused, i have never even heard of a free beta hCG! im also confused why they would be confused over the 1%? i hope you get some answers!

[Mom2twolittlemen]

Hmmm I personally am not sure how upset I'd be over 1% chance. They have to tell you so maybe that's why they made it a concern?

[Ravado]

I have no idea, but I hope they can clear it up when you call today. 1% does not seem like something to be overly concerned about but I really don't know anything about it.

[sparkle04]

1% does not seem like something to be alarmed about but the fact that they felt the need to call and tell you will obviously make you worry!!! I think i would just call back and get more details!!

[foosdiva]

I'm not exactly sure what that is. Last week at my appointment they were concerned my HCG levels were too high. Is that the same thing? There was a 10 minutes period when she couldn't find the baby on an abdominal u/s where she scared the sh*t out of me. High levels can apparently mean something is wrong with baby or twins.

She couldn't have just done the u/s without scaring the crap out of me. I was bawling b/c I thought I was losing the baby.

I hate it when they give us scarey information we could have done w/o hearing.

[Rebelmommy]

I have never heard of this, but hope you get some definitive answers to your questions soon! Don't Dr.'s understand that preggo women are already stressed and consumed with the what if possibilities? Why do they have to give us just enough information to freak us out, can't they just lay it all out right then and there and break it down into simple realistic terms for us? ((HUGS))

I've never heard of this either and I don't see why they are worrying about HCG at 12 weeks? That just seems weird to me.

[martilynne]

I don't really know much about it. The first time I had the first trimester combined screening, my PAPP-A was super low. I did a lot of google searching and I couldn't really find much info at all. I ended up seeing a peri for the remainder of my pregnancy because of it.

[wishing]

I have never heard of that particular test.

My daughter was a twin and I lost her twin during pregnancy but it didn't affect the results.

My son was a triplet but I lost one and went on to carry twins. The dr did say it could affect the results but it didn't seem to although the dr might have interperated them before telling me.

[martilynne]

free beta hCG and the hCG levels they check in early pregnancy are two different things.

The NT scan as most people refer to it is actually the first trimester combined screening. Along with the u/s to measure the neck fold they take a few drops of blood to test your levels of free-beta hCG and PAPP-A. Different combinations of these levels put you at higher or lower risk for the baby having Trisomy 21 or Trisomies 13 or 18.

That is my unprofessional explanation, I hope it made sense.

[chickadee]

Thank you for the good thoughts, and I'm kind of glad that I wasn't the only one who was totally confused!! I couldn't find very much online when I googled, so I was really lost. I called the genetic counselor today and spoke with her for nearly 30 minutes, lol, and she was great and gave me a much better understanding of what the abnormal result means. The upshot is that I'm not particularly worried given what she told me today. The more complete info is below, though, in case anyone else comes across this issue with their screening!

As martilynne said, PAPP-A and free beta hCG are what are tested along with the NT measurments to make up the combined first trimester screening. Those three pieces of information together determine risk levels for Downs and the other trisomies. My combined results are normal/low/fine. However, the PAPP-A and free beta hCG levels, when taken on their own, have some statistical association with growth issues in the pregnancy. When both are low it's more of a concern, or if one is very low it's more of a concern. One of mine (just the free beta hCG) is lowER, but not extremely low. With the level that they detected, there is some statistical association with growth issues. However, the predictive value given my test result (the % of women with this result who end up having growth issues with the pregnancy) is less than 1%.

The "growth issues" essentially mean the baby measuring small for gestational age late in the pregnancy (after 28, 30, 32 weeks - that time frame) due to placental insufficiency. She said that when this occurs, it's typically first managed by dietary supplementation (usually protein supplements). If that doesn't seem to help or the growth seems substantially impacted, they may consider inducing early (say at 37 weeks, provided the lungs are developed, etc.) - as the issue is completely one of placental insufficiency and so would not continue to be an issue after birth.

The counselor said she has seen this result many times (and many women have had both free beta hCG and PAPP-A levels be low), and it has very seldom resulted in any issues later in the pregnancy. They just know that there is some association, and so they play it safe by doing more ultrasounds later in pregnancy so that they can catch any growth issues ASAP and manage them appropriately.

I'm glad to have gotten all the info (I always feel better just *knowing* what's happening and what the potential issues are), and with a predictive value of less than 1% I'm really not going to worry about it at all.

[pinkpopsicles]

Glad you were able to get some clarification!