Very Low Papp-A but normal scans

milkdoctor

Just had my NT scan yesterday and got all the results not what I was hoping for.  I am 35 expecting our first after a very long TTC.  My scans were all normal and they saw a nasal bone my bloodwork showed a very low Papp-a.  The actual value was 0.04mIU/ml or 0.08MoM.  My risk for downs is 1:23.  We spoke about testing etc and the risks.  My doc expressed multiple times that the scans were normal and a nasal bone was seen.  My choices are cvs which worries me b/c of the possible placental attachment issues and this test having a higher miscarriage rate compared to amnio, my next choice is to do another scan in 4 weeks to have the in depth anatomy scan and if any abnormalities are seen to have an amnio at that time.  My hardest problem is speaking to my husband about this.  I am a scientist and look at everything differently.  He looks at it that we have a 5% chance of having a child with downs and he thinks 95% are great odds.  We were offered a genetic counselor but he doesn't feel that will help with anything.  any stories out there would love to hear other experiences and how you are dealing with this.

 Thanks

MJ 

Jgiesbrecht

I guess the best question to ask is how will this information affect the outcome?  Did you have a plan for a situation such as this?  Will more information change your desire to parent?  If the outcome will be the same regardless of the testing process, perhaps that part can be skipped? Otherwise, with your partner, you need to come to a decision about what you both want. It's a tough one, because we don't often discuss these kind of things when we're excited about becoming parents.

 Personally, I would always start with the least invasive test possible.  Less risk to you and to the babe.  Best of luck! Please repost. 

milkdoctor

Our plan is to wait for the scan in 4 weeks and if there are any abnormalities then go for an amnio.

 Staying postive 

Njammer

We had a similar "scare" my papp-a was a .2.  We met with a genetic counsler because our Trisomy 18 was 1:91 and downs was 1:265, just off slightly fromm "normal" but just enough to have me sick to my stomach.  Papp-a when googled is terrifying, and when we scheduled an early level 2 scan I was ready for the high rish obgyn to tell me awful things.  He didn't seem concerend one bit, he told me that I will just have to be monitored more closely and since my early level 2 scans showed no markers, we will get another one in 2 weeks (which is a little after 20 weeks) and from there if things show no markers we will not do any further testing like you.  You might also want to see you are offered a Harmony blood test or I think I have seen something referred to as a Maternti21 (?), They are simple blood tests that yield 99,7% accurancy on trisomies.  We are opting not to do any more if things at 20 weeks look good, but it is something for you to look into. Good luck and keep me posted, these low papp-a seem to be popping up more and more, I think it is something realitively new they are testing for, just one more thing to scare you...keep us updated!