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What Causes Low PAPP-A Levels During Pregnancy?

Posted on Thu, 22 Dec 2016

Question: Hello, im 12 weeks pregnant. I just had my 12 week scan and NT scan. Im neevlis because i was given a 1/700 risk of DS but also have a low PAPP-A MoM. They didnt mention it at the genetics counseling meeting but im reading many things about low PAPP-A being affiliated with DS risk as wel as poor development, preclampsia and stillbirth. Here are my scores:

Free beta HCG: 1.01 MoM
Pappa-a: .43 MoM
AFP: 1.2 MoM
NT: 2.2 m

Please help, thanks.

Answered by Dr. Deepti Verma (16 minutes later)

Brief Answer:
PAPP-A is not below cut off

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
I have reviewed the report.
The MoM of PAPP-A is said to be low when it is less than 0.4
Since it is 0.43 MoM in your case, there is nothing to worry.
Low PAPP-A is associated with placental complications like pre eclampsia, preterm labour and fetal growth restriction.
However, PAPP-A alone is not a good predictor of these complications. Therefore, I will suggest you to get a uterine artery Doppler at 22-24 weeks gestation.
If that is also deranged, then the risk of these complications are definitely high.
In that case, you should be in regular follow up of your OBGYN specialist to detect these complications at the earliest and get appropriate treatment timely.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN
Maternal and fetal medicine specialist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepti Verma (8 minutes later)

Thank you, that was very helpful.

Answered by Dr. Deepti Verma (5 minutes later)

Brief Answer:
Happy to helo

Detailed Answer:
Hi dear,
I am happy to have helped you.
You can get back to me for further queries by asking a direct question to me on the health care magic portal.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepti Verma (2 hours later)

One other question. They offered but didn't recommend the CVS testing. Im 34 and fell into the risk category of a 29 yr old with the 1/700 chance for Down Syndromebut based on these numbers would you recommend the CVS or amnio?

Answered by Dr. Deepti Verma (1 hour later)

Brief Answer:
No prenatal testing required

Detailed Answer:
Hi dear,
No, I do not recommend any prenatal testing in your case.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Prasad