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October 2014 Moms
Emerald27
member
PAPP-A and (long - sorry) rant :(
Emerald27
member
First, were any of you told at your NT scan that your PAPP-A was low, and if so, how is your provider monitoring your pregnancy differently because of it?
Second, I wasn't around much yesterday because I was seriously having a disastrous meltdown of epic proportions. Which is totally not me. My emotions are insane and I'm having trouble managing my worry.
So I knew I had low PAPP-A (borderline low). It's one of the reasons baby's growth has been monitored via ultrasound monthly since 20 weeks. He was 70th percentile at my 32-week ultrasound, so the MFM told me I didn't need to come back for a 36-week growth check. Well yesterday at my 37-week MW appt, the MW (one I hadn't met yet) walks in and says "so since you have low PAPP-A, we'll be inducing you at 39 weeks." I just about fell off the table! WHAT?! No one told me that I was going to automatically have to be induced based on this diagnosis I received MONTHS ago! I was floored, blindsided, almost couldn't talk...but I managed to somehow relay that this was news to me, was she sure, WHY, and is there any way to monitor me closely instead of inducing...
She said that some moms have AFIs, BPPs, and NSTs twice a week beginning at 38 weeks instead of opting for induction. They also do careful kick counts 3x per day to monitor baby's activity. That is my option for avoiding induction prior to 40 weeks. However, it's not safe to stay pregnant past 40 weeks in my case.
She also said that it was a mistake for my last ultrasound to be canceled, and she called the MFM to see if they could get me in for an ultrasound to check growth and fluid levels right away...which they did. Baby is 7lbs and still 70th percentile. Fluid is great at 15. The MFM confirmed, though, that with low PAPP-A comes a small risk of stillbirth, and that some providers will induce in the last week of pregnancy.
Well, before I switched to the MW practice, my OB had said that he was not worried at all about my low PAPP-A, because it was barely low. The MW who did my transfer interview knew I had low PAPP-A and didn't mention induction. She only told me about the practice policy of inducing 11 days after your due date. The MFM had discharged me from care based on baby's health and growth. As far as I was concerned before yesterday, my pregnancy was healthy and normal!! I am completely confused!
I first was angry that no one had told me any of this and that I might need to be induced, and then I got over that and became TERRIFIED of stillbirth. If I opt for 2x weekly testing, what if something goes wrong? I mean, I would follow the MFM and MW recommendation based on the testing results, and would induce if things weren't looking good, but now I'm so afraid of losing my baby regardless! I couldn't sleep last night at all worrying about him, paying attention to the strength of every kick.
I'm also worried about being induced again at 40 weeks. I mean, I don't feel like this baby is coming early, though if he would that would save me a lot of worry and the induction. I'm strongly considering asking to have my membranes swept at either my 38 or 39 week appt, doing lots of walking, and trying other methods to encourage labor to begin before I hit my due date.
So if you made it this far, thanks for listening. It's a lot to process at once and I'm still going pretty crazy over here. Hoping to find some reassurance in frequent testing and sweet baby kicks.
Second, I wasn't around much yesterday because I was seriously having a disastrous meltdown of epic proportions. Which is totally not me. My emotions are insane and I'm having trouble managing my worry.
So I knew I had low PAPP-A (borderline low). It's one of the reasons baby's growth has been monitored via ultrasound monthly since 20 weeks. He was 70th percentile at my 32-week ultrasound, so the MFM told me I didn't need to come back for a 36-week growth check. Well yesterday at my 37-week MW appt, the MW (one I hadn't met yet) walks in and says "so since you have low PAPP-A, we'll be inducing you at 39 weeks." I just about fell off the table! WHAT?! No one told me that I was going to automatically have to be induced based on this diagnosis I received MONTHS ago! I was floored, blindsided, almost couldn't talk...but I managed to somehow relay that this was news to me, was she sure, WHY, and is there any way to monitor me closely instead of inducing...
She said that some moms have AFIs, BPPs, and NSTs twice a week beginning at 38 weeks instead of opting for induction. They also do careful kick counts 3x per day to monitor baby's activity. That is my option for avoiding induction prior to 40 weeks. However, it's not safe to stay pregnant past 40 weeks in my case.
She also said that it was a mistake for my last ultrasound to be canceled, and she called the MFM to see if they could get me in for an ultrasound to check growth and fluid levels right away...which they did. Baby is 7lbs and still 70th percentile. Fluid is great at 15. The MFM confirmed, though, that with low PAPP-A comes a small risk of stillbirth, and that some providers will induce in the last week of pregnancy.
Well, before I switched to the MW practice, my OB had said that he was not worried at all about my low PAPP-A, because it was barely low. The MW who did my transfer interview knew I had low PAPP-A and didn't mention induction. She only told me about the practice policy of inducing 11 days after your due date. The MFM had discharged me from care based on baby's health and growth. As far as I was concerned before yesterday, my pregnancy was healthy and normal!! I am completely confused!
I first was angry that no one had told me any of this and that I might need to be induced, and then I got over that and became TERRIFIED of stillbirth. If I opt for 2x weekly testing, what if something goes wrong? I mean, I would follow the MFM and MW recommendation based on the testing results, and would induce if things weren't looking good, but now I'm so afraid of losing my baby regardless! I couldn't sleep last night at all worrying about him, paying attention to the strength of every kick.
I'm also worried about being induced again at 40 weeks. I mean, I don't feel like this baby is coming early, though if he would that would save me a lot of worry and the induction. I'm strongly considering asking to have my membranes swept at either my 38 or 39 week appt, doing lots of walking, and trying other methods to encourage labor to begin before I hit my due date.
So if you made it this far, thanks for listening. It's a lot to process at once and I'm still going pretty crazy over here. Hoping to find some reassurance in frequent testing and sweet baby kicks.
This discussion has been closed.
Re: PAPP-A and (long - sorry) rant :(
...to membrane sweep and become a marathon walker...
I think my favorite is the coffee steam to the lady bits.
Thank you for sharing
I agree with @kfitzguerra. Keep doing what you're doing.
It may not hurt to talk to the MFM and your OB about this, see what they say.
I'm sorry you're stuck going through this... that really sucks!
My Ovulation Chart Simple Link: My Ovulation Chart
I had low PAPP-A last pregnancy, and again this pregnancy. Because of that, I am considered high risk. I had to have 2 growth ultrasounds (32 and 36 weeks). I also have to start 2 times a week NSTs at 35 weeks. I did all this last time as well.
I was NEVER told I'd be induced. In fact, I was not induced. My water broke at 39 weeks, 4 days. DS was born at 7 pounds, 14 ounces and 20" long. He was a csection, but that's due to decels in his HR with contractions, NOTHING to do with the low PAPP-A.
This time I'm hoping for a VBAC.
All that said, I'd talk with your Dr/MW and do the NSTs. It makes no sense to induce early if your baby is growing adequately. (IMO, not a medical expert by any means)
GL!
my happy boy
I hope baby decides to come on his own (or with a little help) so you can avoid all this worry.
Ah okay. I mean... I'm high risk as well, so I get the AFIs and NSTs twice weekly, and they haven't mentioned anything about an induction based on what they've seen. Obviously I have a different ailment, but we share a similar risk. If you are worried about the days in between, I keep an eye on her movements a lot. But I like the NSTs for a weekly "status report." I have no idea if I'm helping. :-/
------------------------------
You're definitely helping!! Thank you.
Me- 36 DH- 40 ***TTC since 1/13
BFP #1 - 4/3/13 *** EDD 12/13/13 ***M/C 4/12/13 @5wks 1 day
BFP#2 - 1/29/14 ***EDD 10/11/14
It's a GIRL!!!