LOW PAPP-A IN PREGNANCY





Sandy Jade Ridpath



Thursday we received our screening results for our baby, we were so pleased that it said low risk for Down’s syndrome and Edwards syndrome.


We spent the evening looking at Spencer’s baby journal and trying to figure out if we were having a boy or a girl. We tried the skull theory and the nub theory....to be honest we were crap at both but had so much fun trying, looking at the new baby’s scan against Spencer’s scan, looking at their little noses and trying to see resemblances or differences. Right now we are on cloud 9!


Today I woke up and got Spencer ready for a birthday party, as we came down the stairs some post had arrived, a letter lay on the floor with a hand written address...addressed to me. I opened it thinking it was my next midwife appointment or something to do with work. As I opened the letter and read my heart sank “following your recent screening, the test has shown that you have low Papp A”.


Low Papp A?...what the hell is that? so maybe I need to take more vitamins?


I read on “this has been found to be associated with smaller babies later in pregnancy”. Small, how small? I read on.


Regular growth scans? consultants? in 3 months time!? why that long? surely they would want to monitor me now! whats going on?


I had to leave to get to the party, my husband was out. I called him on the way and explained the letter, he told me not to worry and to enjoy the party.


I tried to put it to the back of my mind and thought surely if it was serious they would have called me, not just sent a letter?





On the way home I called my husband, he had read the letter and researched low Papp A in pregnancy, he told me not to google it and that he would show me an NHS leaflet once I was home. We decided we would call the number on the letter and my midwife for more information, we had so many questions


I read the leaflet once I was home that explained Papp A is a hormone in your blood when you are pregnant and to have low Papp A you are more susceptible to; having a smaller baby due to reduced growth after 28 weeks, premature birth, preclemcia and are at slightly higher risk of miscarriage after 20 weeks.


My heart sank. Pregnancy is such a miracle, to get through to full term and have a healthy baby at the end is such an incredible thing, I think so many people take it for granted. I still can’t get over the fact a human is created by two microscopic cells that a woman’s body then homes, feeds and nurtures until the baby is ready for the world. It is an incredible and unbelievable process in which only Mother Nature seems to have a say. Being told that at 12 weeks your baby could already be having to fight an extra fight is scary. My son Spencer was 4 weeks premature and he was smaller, born at 5lbs 13oz, but he was perfect. He was ready for the world. I think the dates may have just got mixed up. But being told your baby could have growth issues, knowing baby could come early sent me into a whirlwind.


What if the baby doesn’t develop properly? what if my placenta isn’t giving the baby the nutrients needed but we don’t know that until 28 weeks? what if the baby has other issues because of the placenta not doing it’s job? what if I have to leave the baby in the hospital in an incubator and come home, without them? leave them all alone. At 20 weeks you seem to relax slightly about loosing the baby, you are at half way point, although as a mother it’s always in the back of your mind, I now felt like I would be on edge the whole time.


I know to many this may seem silly, no one has said anything is wrong, many parents receive devastating news and this is just a maybe, your baby could be small. But I went into panic mode. I read everything I could, every article, followed every low Papp A # to read stories of others. I found most mothers did not go full term, most babies were small but all ok just needed a bit of help. I read about emergency inductions and C sections as the baby wasn’t growing. I read about babies who were born at 24-26 weeks and had life long health issues. I drove myself crazy.


My midwife was amazing and was honest, she told me it’s not unheard of but also not common. She explained the tests and growth scans, she explained what they look for and advised me she has had other mothers that have gone full term with perfectly healthy babies. We discussed the possibility of me having it with Spencer hence why he was early and on the small side, it may have just not been picked up or borderline. She didn’t sugar coat it. When I asked questions about the placenta not doing it’s job and it effecting baby she advised me that this was very possible, from brain damage to still birth. But she assured me this is why extra monitoring is in place and absolute worse case. She explained I need to be in tune with baby’s movements and not hesitate for one second if I feel something is off.


I am now at 22weeks, I feel lots of movement daily, I am starting to prepare for baby just in case. I want my hospital bag packed and ready by 28weeks and enough supplies just in case. This might sound over the top but it’s my way of dealing with it and feeling like I’m doing something. I can’t just sit back and expect to go to 40weeks. We had our 20week scan where baby is growing as they should, all measurements are matching up and all organs looking good. I’m so happy and relieved.


We see our first consultant in 3 weeks, I’m looking forward to asking more questions and knowing that they are doing everything they can to make sure baby and I are safe. I’ve relaxed more as I’ve stopped reading all the stories and getting myself in a frenzy of “what ifs”. The baby will come when it comes.....knowing all my frantic worrying I will go to 40weeks with a 9lbs baby and that will be a real shock!