NT Scan- low Papp-a and HCG


#1

We had our NT scan last week at 12 weeks. The nuchal thickness measured perfectly (1.0), but we got a call a few days later that the papp-a and free hcg levels were low. They still put us in a low risk category for chromosomal issues, but after consulting Dr. Google (terrible idea, I know), I am finding that low levels on the 12 week blood work can correlate with placental failure, stillbirth, miscarriage, pre-eclampsia, and IUGR. I don’t see my OB for another week so in the meantime I get to stress about all of these things.

Has anyone had experience with low levels of papp-a and free hcg on their first trimester screen, and if so, what did your OB do differently, if anything?


#2

That’s just like me, almost exactly. They went on to do a placenta study on me @ 22 weeks and they also found a poor artery doppler reading to the placenta and a two vessel cord. I was warned about all the increased risks, just like you mentioned in your post. All those scarey things. I was being monitored every week (that often because of my previous loss), put on baby aspirin but other than that is was just a wait a see game. I also had a loss in my prior pregnancy due to a poor placenta but I am happy to report that things are very smooth sailing for me at 30 weeks. Baby is right at the 50th percentile for growth and the placenta looks great. Low pap and HCG levels CAN mean something is up but it can also mean NOTHING. They don’t really know.

My doctor described it like, smoking increases your chances of cancer but that by no means says you will get it. You are at higher risk but still risks are low.
I would ask for a placenta study around 22 weeks and for growth monitoring every two weeks, if possible. When they see the shape and size of the placenta and monitor baby’s growth that will give you more important information. If you do have a compromised placenta you should consider steroids at 24-29 weeks to help lungs develop in case of an early delivery. You should also be extra aware of preeclampsia symptoms.
Literally having just gone through all this I would suggest that you don’t get ahead of your self. Try your best to enjoy your pregnancy while still being on top of all this. I admit I was a bit obsessed with my news and in hide sight now that babe seems to be fine I wish I had cooled my jets and just was able to not stress so much about it. There really is nothing you can do. The placenta and babe are on their course. No exercises, diet, body position can change that now.
I wish you the very very best with this and would love to know how you are doing. :grouphug:

[quote=musicgal]We had our NT scan last week at 12 weeks. The nuchal thickness measured perfectly (1.0), but we got a call a few days later that the papp-a and free hcg levels were low. They still put us in a low risk category for chromosomal issues, but after consulting Dr. Google (terrible idea, I know), I am finding that low levels on the 12 week blood work can correlate with placental failure, stillbirth, miscarriage, pre-eclampsia, and IUGR. I don’t see my OB for another week so in the meantime I get to stress about all of these things.

Has anyone had experience with low levels of papp-a and free hcg on their first trimester screen, and if so, what did your OB do differently, if anything?[/quote]


#3

Thanks Toronto! Congrats on getting to 30 weeks! Right now that seems like an eternity away for me. I am trying not to stress about this news, since hopefully, like you said, it will turn out to be nothing. I will definitely ask my OB about the extra monitoring for growth.


#4

I had low papp a levels and high HCG, was told the same thing as you, higher risk for placental issues late in pregnancy. I had lots of biophysical profiles done during the 3rd trimester. It was every two weeks starting at 30ish weeks I think.

Anywho, no ill effects or issues. I made it to my scheduled c-section date at 39 weeks and delivered a healthy baby boy who is now 11 weeks old.