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July 2016 Moms
Lyra2727
member
Really worried with very low PAPP-A at First Trimester Screening (0.19 MoM)
Lyra2727
member
Hi everyone,
I've been so stressed since last Wednesday 12/30/15 after my first trimester screening results. The NT measurements were great (1.15 MoM, 1.5mm) and everything appeared normal during the ultrasound but the blood work was poor putting me at high risk. My PAPP-A was at 0.19 MoM (so low!) and the hcg was at 0.42 MoM (low but not too bad or they did not stress that one as much).
My age does not help either, just turned 39 on December 27. I opted for the Panorama (NIPT) test for further screening since accuracy rates for that test are far better. I should have results within the next 7 days or so. This is my first pregnancy.
I have done extensive reading over the past few days and these are the bullet points of what I have understood so far:
- The first trimester screening test is notorious for false positives, and that % only goes up with age. I guess that is a good thing, as most say to take it with a grain of salt. Easier said than done when a 1:19 ratio is given to you
- PAPP-A is quite controversial with quite loose correlations related to placental issues in the 3rd trimester, pre-eclampsia, premature labor, etc. Scary stuff but there are plenty of women who have given birth to healthy babies even though they had low PAPP-A levels.
- I should feel good about the NT measurement, which is *said* to have a stronger correlation with chromosomal and heart abnormalities. Still, plenty of cases whereby women with thicker measurements had healthy babies. Good!
- Down Syndrome is usually correlated with a low PAPP-A AND a high hcg measurement. This was not the case for me. And yet again, plenty of cases whereby women with this pattern screened negative with subsequent testing.
- 1:19 is still not that bad in the grand scheme of things. More than 94.5% chance that things will turn out fine. Yeah ok, tell that to my anxiety levels that cannot be reasoned with
Bottom line: nobody knows nothing! And things are inconclusive. And while I can take comfort in my NT measurement, I will be stressed out till I get the Panorama results. What is worse is the anticipation, the waiting and the "not knowing". Had I been more aware about the ridiculous ratio of false positives for the first trimester screening, I would have opted for the Panorama test much earlier in order to have those much more reliable resutls prior to the first trimester screening and eliminate this anxiety and waiting game.
That's my story. Would love to hear any thoughts and similar stories. Going to take the mutt for a walk now and try to decompress. Past few days have been hellish.
Be well all 
Re: Really worried with very low PAPP-A at First Trimester Screening (0.19 MoM)
One thing to remember: even though everyone calls them "false positives" they are not. What you had was purely a screening that gives overall ratio/odds. And as you said, your current odds are not actually that bad. So I wouldn't rule out and call the first tri screening ridiculous -- they just tell you if something *might* be wrong so you can pursue further testing, which you are doing.
I had this issue last pregnancy with my very healthy DD. My ultrasound showed a 3.2 measurement. I was so upset, and the wait was agonizing. I had to wait about 5 days for the MaterniT21 test. They called and I learned all was well.
Good luck, keep us updated, and TRY to stop googling in the meantime!
Sending lots of thoughts and prayers. Please keep us updated?