PAPP-A (Pregnancy associated plasma protein-A) is a protein produced by the placenta. It is needed for the implantation process and to maintain a healthy placenta (afterbirth). PAPP-A is a marker measured as part of the combined pregnancy screening blood test which is offered around 11-14 weeks of pregnancy.
Low levels of PAPP-A (0.415 MoM and below) are sometimes associated with:
• A lower birth weight baby
• Preterm birth
• Pre-eclampsia – high blood pressure (hypertension) and protein in your urine (proteinuria)
• Mid trimester miscarriage
If you receive news that you have low PAPP-A levels it only means that there is a small risk of the above. Please be assured that you will receive close surveillance with shared care between your midwife and obstetrician.
If you are found to have low PAPP-A levels in your blood you will have already been contacted by a Screening Midwife and you will be offered a Uterine Artery Doppler scan at the time of your detailed scan. Extra ultrasound scans in the third trimester of your pregnancy will then be offered. The timings of these will depend on the result of your Uterine Artery Doppler scan.
Ultrasound scans will monitor your baby’s wellbeing by taking measurements for growth, placental blood flow and the amount of amniotic fluid around your baby.
If there are any concerns around your baby’s growth or wellbeing this will be referred to a consultant to discuss any further management and planning. If it is detected at less than 16 weeks it would be beneficial for you to commence aspirin (150mg at night) until the delivery of your baby.
If you smoke it is very important that you stop as it can affect placental function and your baby’s growth. Please contact your community midwife who can refer you to smoking cessation or you can refer yourself direct though the smoking cessation helpline found on the internet.
If you have any queries or concerns please contact the Screening Midwife (01253 953639) or a member of your community midwifery team (01253 953622). 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. For those babies that are found to be small you will have the reassurance of close monitoring with the midwifery team and obstetricians in our Maternity Unit.
