Is my doctor wrong?

jdsm514

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?

jdsm514

Teacher Clark:

Since your doctor has the medical degree and we don't, I would defer to your dr. That doesn't mean you can't get a second opinion though. Is there really anything wrong with extra monitoring for your baby? FWIW my pregnancy with DD was completely problem free and this one is just one big issue after the next. One healthy pregnancy does not mean the next one will be the same.

I am likely going to get a second opinion from another doctor. I'm curious to see if any of the ladies here have had a similar experience. I'm fine with extra monitoring if it is backed by research. I am wondering if any other doctors out there would suggest all this extra monitoring for percentiles of 40 and 70, when everything I could find online suggest increased risk at 5 and 95 percentiles.

caden1206

I don't have much experience with the things you are going through, but it sounds like you need a second opinion for yourself. I think that your doctor is being proactive and if this is not what you want then you should express that.Good luck and prayers that everything turns out ok and you have the pregnancy you desire.