• 16th June 2023

What is PAPP-A?

pappa-a information

What is PAPP-A?

What is PAPP-A? 225 225 Original Window to the Womb

Here at The Window To The Womb, the Original in Nottingham, we often have ladies that come for a scan with us that have been advised that they have ‘low PAPP-A’.

It usually just means they will obtain additional scans later on in their pregnancy and usually is nothing to worry about.

Here’s some helpful information from NHS England to help us understand.

pappa-a information

What really is PAPP-A?

Pregnancy Associated Plasma Protein-A (PAPP-A) is a hormone that is made by the placenta (afterbirth) in pregnancy. It is measured as part of the combined screening blood test.

What does Low PAPP-A mean?

Low levels of PAPP-A (when it is less than 0.4 MoM in pregnancy) may be associated with:

  • A lower birth weight baby as your placenta may not work as well
  • An increased chance of having an early birth
  • A slight increased chance of developing pre-eclampsia or miscarriage.

At every appointment with either your midwife, you will be offered to have your blood pressure measured and your urine checked for protein. You will also be offered regular ultrasound scans in order to monitor your baby’s wellbeing by taking measurements of your baby’s growth, your baby’s placental blood flow and the amount of amniotic fluid around your baby. The appointments for your scans will be sent through the post. You should also remain aware of your baby’s movements and follow the advice your midwife will give you at your 16 week appointment.  This is of course not part of your Gender Scan, but you can consult with us about this at anytime.  We are here to ensure your pregnancy moves along as naturally and beautifully as possible.

Receiving the news that you have low PAPP-A levels may cause anxiety but please be assured that the majority of babies will have normal growth and the pregnancy will progress without problem.

What will happen now?

Your antenatal care will be with your midwife, and you will be offered an appointment with a consultant obstetrician in the antenatal clinic to discuss further management and planning. If you have had an anatomy scan at 20 weeks then a customised growth chart will have been added to your hand held records so the growth of your baby throughout pregnancy can be monitored. You will continue to see your community midwife for your routine appointments but they will not measure your abdomen if you are having regular scans to monitor your baby’s growth and wellbeing.

If there are no concerns about the baby’s growth, then the scans will be at 3 weekly intervals between 28 weeks until the birth of your baby. However if there are any concerns about the baby’s growth or well-being, you will be asked to attend the Antenatal Day Unit (ADU) to be seen by a midwife and doctor.

Because of the associated risks with low PAPP-A, it is recommended that labour is induced around your due date. However you will have a full discussion of the process of induction of labour including risks and benefits before any decision is made.

You will also be able to have a discussion with the doctor and midwife about monitoring your baby in labour, as it is recommended that women who have low PAPP-A have continuous heart rate monitoring of their baby in labour. This method of monitoring isn’t available on the Fatima Allam Birth Unit or at home, and is only available on Labour Ward. We do have facilities to enable you to labour and birth in water using telemetry monitoring (a wireless, waterproof system) and this can be discussed with the doctor or midwife.

Who can I speak with if I need further information?

You can speak to your midwife at your 16 week appointment or your consultant after your anatomy scan if you have further questions.

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