First Trimester Screening-help, not great #s

Question

I am 12 weeks today and went in for my detailed u/s and to receive the results from my first trimester blood work.  I am hoping someone can help me decipher these results???

The NT measurement was 1.4.
The PAPP-A MoM was 0.58.  (This is what is scaring me to death.)
The HCG was around -.56 (I THINK...can't remember because at the time they brushed off the #).

Overall - combined with my age and the fact I've had one m/c due to Trisomy 13 -  my odds are 1:238 for DS and something like 1:2300 for Trisomy 18.

I am extremely worried about the fact that:  odds for DS were worse than 1:250 which is the cutoff at some clinics, and that the PAPP-A # is so low..I've read low PAPP-A is associated with poor pregnancy outcomes, including late miscarriage, stillbirth, low birth weight, etc. etc.

I've been searching all over the Internet for a chart that shows just how low (what percentile) my HCG and PAPP-A levels are. 

Any help?  I'm so sad.  Waiting for a call back from my OB/GYN but I might have to wait until my appt. 3 weeks from now! :(

Uenvythis · Answer

oh ok i see this is old
gl

adgal · Answer

Hey there.

Have been thinking about you.  So good to hear from you and know all is well. Congrats on being so close, and please keep in touch!  XOXO

Allip77 · Answer

Congratulations!  I ended up doing the amnio at my doctor's recommendation and everything was fine.  Due in about 5 weeks:)  Good luck with everything and take care.

April162010 · Answer

great news!.......
I had 1% of chance of my child (as per the blood test) to have T18. i didnt do the amnio and since it was 1% only i took the risk.( 1 in 50 chance)

Jacob was born 1 week ago and he is a perfect child!.... super healthy and too gorgeous.

I had so many  bad moments thinking because of this test and i was so scare since I am 42y/o. this doctors should be more careful the kind of stress they put you through.


tx adgal..tx tiger!

god bless you all

Allip77 · Answer

That baby is one lucky little one to have you as his mommy!  Odds are he will be a healthy baby, too!  Best of luck to you.

April162010 · Answer

Hi , I got my test an ultrasound last week @ 18 weeks

glucose: 118 ;.... is good number
trisomy 18  I supposed to have 1 in 100 and my test come back 1 in 50  but i did the ultrasound the dame day thy took the test and the u/s was perfect. so i dont really get it.

I still dont go for the amnio, if my baby is healthy i dont want to have any chance to miscarriage but....
 if the baby for some reason at the end has trisomy 18 and then i will give him the opportunity to come to the world and hugg him and kiss him and to tell him how much i love him while in my arms and then God will open his heaven door for him.  

good luck to everybody... i wish a healthy baby to everyone

Allip77 · Answer

So glad to hear that!  Congrats!  (We decided to schedule the second round of blood work for 15 weeks and u/s for 16 weeks.  If not good, then we'll go ahead and do amnio at 16 weeks..but maybe we'll feel good with the numbers and skip it.).  Good luck with the rest of your pregnancy - enjoy!

April162010 · Answer

Hi allip, I am 42y/o and i was feeling like you when i got my numbers ( went crazy) thanks to Adgal and tiger they explained to me and i felt much better.

this clinic recomend me the amnio but i denied it and i just went for an u/s  @ 18 weeks to check the baby and he is doing perfectly fine.

wish you luck in everything

Allip77 · Answer

Thanks, Amanda! I'm not quite in my second trimester- a few days away:) - but very close. I wish you the best of luck, too. I was sorry to read about your m/c and then that it was incomplete. I hope you get past that quickly and onto getting pregnant again very soon!!!!!

adgal · Answer

I'm so glad your feeling better.  The internet can be such a blessing when we are looking for info, but it can scare the heck out of us too.  I know you already know this, but I drove myself insane trying to interpret test results and even HCG doubling times on my own.  I have sworn that I will not research next time.  Way to many sleepless nights..lol.

Happy Holidays to you too!!!  And congrats on being in that second trimester!!! Such a big milestone!!!!

Allip77 · Answer

Thank you both for your input and encouragement!  I just got off the phone with another genetic counselor at the office which gave me my results (a different one than I met originally) and he told me my results are normal!  He said .58 is not low; below 3.8 or so is low.  He gave me the analogy of people's heights...the average woman is, say, 5'5 but not every woman is 5'5 and when you see a woman who is 5'0 you say she's shorter than average but there's nothing at all wrong with her.  He said there's nothing at all wrong with my number = it's completely within the normal range.  He also said my hcg is normal but that you wouldn't really worry with a low hcg because that's a good thing.  I have no idea - and he didn't either - why the other person indicated my #s were low, but I'm just going to let it go.  Quit researching, like you two said, and start enjoying my pregnancy!!  Happy Holidays to all.

happynifer · Answer

those numbers look pretty darn good to me.  that's well less than 0.25% there s any chromosomal abnormalities that they test for.  combined with a normal 12 week scan, i'd relax and enjoy your pregnancy.
you will have the option of having an amnio done, or just waiting until your anatomy scan at 18-20 weeks to make sure development is proceeding as expected.
we tested 1:112 for downs and opted to not do the amnio (i have ad 3 m/c) and just follow her on US instead.  since i am 36, my insurance covered all of the scans with the perinatologist.  by 18 weeks she was 80th percentile in size and her echo and other organ screens have all been perfect.
so try to relax, stop surfing the internet to see what may go wrong and discuss an amnio with your provider and your partner if you want definitive answers

lilly0 · Answer

I have no idee what u talking about... 

Sorry

adgal · Answer

Hi there.  Just a couple of comments on your post.  First off, that is an excellent NF measurement..well within normal. Secondly, odds of DS being 1:238 are excellent odds.  Put that into perspective...your baby has a 237:238 odds of being typical.  And lastly...it is not so much the Papp a and HCG they look for, it is the ratio between the two. The higher the ratio, the higher the odds.  So yours are pretty good.  

As for low papp a...the information I have read is that very low papp a has been associated with complications in pregnancy, but it certainly not a strong indicator that that will be the case.  

When you read up on normal papp a levels, you can see that it is very complicated.  Age, smoking, etc. can all play a part in your papp a numbers.  It really isn't something you should be trying to interpret on your own...I think you will just drive yourself nuts with it.  Please be careful when it comes to self diagnosing, or looking for a problem where there probably isn't one.  I don't mean that harshly, its just that I have spent hours doing the very same thing and worried myself over so many things that turned out to be nothing. I guess the best advice I can give you is to stop googling, and talk to your Dr.

I am sure all will be fine.  Take care!!