Thursday, December 13, 2007

A few answers

In the previous post, I has asked if anyone knew how the Papp-A numbers might affect my placenta. And I've discovered that when in doubt you should definitely ask the internet!

Oh and to those of you on the planet who think that prenatal diagnosis numbers are all about ending a pregnancy, read on. It's also predicting IUGR, or FGR (pick your term, same thing) and miscarriages, and stillbirths, and preeclampsia. And if you can predict those things at twelve weeks, then maybe you can change drug treatments or get monitored differently, or save a baby that otherwise might not have made it.

About my numbers, one doctor told me it was fine....and technically he's right, since it is, sort of, but I get pretty nervous about these things, so I like more exact numbers. The genetics counselor said it was a bit low, but she really only deals with genetics & chromosomes and not bad placentas on healthy babies so much, so she really wasn't able to tell me much.

So, Rachel sent me a link to an article in a comment and explained that in this ratio 1 is the mean, and so .66 is low. Fortunately, not very low, just slightly. (Sometimes I've seen 0 be the mean, in other non-science areas so this is clearer! Also, the way they calculate the Mom number and the reason they use it instead of raw numbers is because they take into account maternal weight, so on the raw numbers (IU/litres) for my last post, they only apply to women who are around 130-135 pounds. Circulating blood hormone levels look different on small vs. larger women.) Yes, I'm skinny, but I'm pretty flabby and short; I wonder if height or muscle vs. fat ratio affects it? Hmmmmm....

Compared to Georgia, in 2004 who had a Papp-A of .50 MoMs, .66 MoMs this time around doesn't seem so much better, but apparently it is. "Women with PAPP-A 0.50 MoM also had significantly higher rates of FGR (RR = 3.30) and spontaneous miscarriage (RR = 3.78)." So, she was definitely in the low range potential for miscarriage. And this baby isn't.

The worst results though are reserved for those who fall into the bottom 5%. And that doesn't even start until .415, and the woman at genetics said they don't see serious problems until it goes as low as .30, so I tend to think---maybe I can get away with this. And as Wabi has reminded me, it's only a possibility of miscarriage, my risk has gone up slightly, but that's not for sure, and full 14 week anatomical scan we are having tomorrow morning will tell me a lot more about my placenta and the blood flow to it.

I'm definitely going to keep injecting the heparin though, and taking the progesterone and baby aspirin. I didn't do it last time, and now I now I have some numbers to show it's helping. Proof enough for me.

They'll have to pry that needle out of my cold dead hand to stop me from shooting up.


  1. As long as the answer is right, and provides you with comfort and not a math headache, it's all good. right?

  2. I'm dizzy but happy for you. Good luck tomorrow.

  3. I love when the science makes you happy, not sad!

    I'm glad you are feeling more hopeful and that you will get more reassurance at the next scan.

    Hang in there A!

  4. "maybe I can get away with this"
    you crack me up, and I certainly hope you do get away with it.
    you got a new girl at genetics?

  5. I'm glad you found answers, because I was shrugging. The placenta has been my no.1 worry (rather than actual genetic defects - probably because the last one was genetically normal). But I think holding off on the testing was right in our case (I'm on meds as it is). It's a real trick to get the "right" amount of info.