Low PAPP-A

Low PAPP-A leaflet.

You have been given this leaflet because your recent combined screening blood test has shown that you have low PAPP-A levels. Please read this information carefully and if you have any further questions you should contact the Antenatal screening team on 01905 768945.

What is PAPP-A?

PAPP-A is a protein produced by the placenta (afterbirth). It is one of the hormones that are measured during the 12-week combined screening test.

Low PAPP-A can be associated with Down’s syndrome, Edward’s syndrome & Patau’s syndrome. If your baby had an increased chance for these chromosome differences one of the screening midwives would already have made contact with you to discuss your results.  

Research tells us that in some women with low PAPP-A the placenta may not work as well as it should so they may be affected by:

• Low birth weight babies 
• Raised blood pressure and protein in the urine, known as pre-eclampsia

If you have low PAPP-A we want to reassure you that the chance of complications is small and the majority of pregnancies will progress without problem. 

What will this mean for my pregnancy?  

You will now be offered an appointment with a Consultant Obstetrician and you will be sent an appointment to see them after your detailed scan, usually between 22-24 weeks. This will give you the opportunity to ask questions and discuss the plan of care for the rest of your pregnancy which will include the option of extra growth scans.  

In the meantime, we will write to your GP to inform them and also ask them to offer you a prescription for 150mg of aspirin to take once a day until delivery. This is because aspirin can support the way the placenta works and reduce the chance of complications.

Low-dose aspirin is not known to be harmful during pregnancy and there is no evidence to suggest it increases the risk of bleeding during pregnancy. We recommend taking aspirin in the evening with or after food. You will also be invited for a scan at around 20 – 22 weeks to look at the blood flow to the placenta from your uterus (uterine artery Doppler). 

We will continue to check your blood pressure and urine at all your routine antenatal appointments. This is so any changes can be identified at an early stage.  

If you would like to speak a member of the Antenatal Screening team further please call 01905 768945.

Further information

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999. 

Patient experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made.

There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly.

If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS

Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times

The PALS telephone lines are open Monday to Friday from 8.30am to 4pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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