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Low Papp-A level... induction?

cscrandallcscrandall member
in High-Risk Pregnancy

Hi ladies - The results of my NT screening reflected an extremely low level of Papp-A.  When we received that news, we opted to get the MaterniT21 test, which thankfully indicated that everything looked fine and the chances of our peanut having downs, etc. was practically non-existent.  

I'm currently 33w3d.  My OB has told me all along that one of the biggest concerns with low Papp-A is growth restriction in the 3rd tri.  So far, she's measuring big, and we are very pleased.  I've had u/s at every doctor's appt this entire pregnancy (approximately every 2-3 weeks) to make sure things are still on track.  At my last appointment, my OB said that she would like for me to be induced between 38-39 weeks.  Apparently another risk of low Papp-A is an increased risk of still birth the closer to 40 weeks you get.  Obviously this made my head start spinning. 

Anyone dealing with a similar situation or know anything about it?  I trust my OB and if she wants to induce me then I'm going to go with her advice. But I also want our little one to "cook" in my belly as long as possible.  TIA! 

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Re: Low Papp-A level... induction?

  • Mwilt127Mwilt127
    I'm in the same situation just a few weeks ahead of you. I'll be 36 weeks tomorrow. I've had monthly growth ultrasounds, and baby has continued to grow at a great rate. Our last appointment with our perinatologist was yesterday, and baby was already measuring over 7 pounds and is in the 85 percentile. I'm very thankful, but I've been worried sick since 13 weeks.

    In the 3rd trimester, I've also had weekly biophysical profiles. Baby has passed all of those so far, so no one seems too worried right now about placenta issues.

    My OB hasn't mentioned wanting to induce early because of low PAPPA, but I'm a repeat csection so I'm already set to deliver at 39 weeks and that's been the plan all along. Our perinatologist did mention the increased risk of still birth a few months ago. He didn't seem overly concerned and acted as if we would likely have other warning signs if we needed to worry about that. He said a moving baby is a happy and healthy baby so to just make sure I'm always feeling the movements as expected.

    If I wasn't already scheduled to deliver at 39 weeks and my OB or perinatologist suggested an early delivery, I would have done it. As long as they don't want to go too early, delivery outweighs the potential risks IMO.

    Good luck to you. I'm glad we've both made it this far in our pregnancies after the initial scares!
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