I’ve said it before, and I’ll say it again, Mrs Lighty loved being newly pregnant. It was a time of such highs and such hope, culminating in seeing a perfect Baby Lighty on the monitor at the 12 week scan.
But the first trimester was swiftly followed by the results of the first trimester blood tests. And that’s when a lot of that hope turned to worry.
You see, as part of the screening for Downs Syndrome, it was picked up that Mrs Lighty – or Baby Lighty, or the placenta, or someone – had low levels of the pregnancy hormone Papp A. I’ll never forget cheerily returning the call of the midwife, thinking it was going to be a regular change to an appointment, or something else equally as mundane, to be told that they’d picked something up on the blood tests that potentially wasn’t good. Low Papp A.
She was quick to point out that my risk of Downs Syndrome was low, but my head was still spinning. So much so that when I put the phone down, I phoned the midwife back a few minutes later to ask her to go through it all again.
And then the Googling began. And it continued pretty much for the next six months.
Not that it ever got me very far. You’d be forgiven for not knowing, or even not having heard, of low Papp A and what it does. I certainly hadn’t. And Googling didn’t shed a whole load of light, either.
There is a ridiculously little amount of information out there on low Papp A. There’s nothing at all on the official NHS pages. And yet the midwife told me that it’s extremely common?! To this day, I’ve only ever heard of one other low Papp A pregnancy, and that’s having read a lot of blogs, being a member of a baby Facebook group, and having had a lot of pregnant friends. From the Googling I did do, I have gathered that PAPPA or Papp A stands for Pregnancy Associated Plasma Protein A, and it can either be a marker for chromosome disorders (although my tests did not show any abnormal results on this front) or that there may be issues with the placenta, which can result in fetal growth restriction, increased risk of pre-eclampsia, placenta abruption, and a higher risk of premature or still birth. Really scary stuff, when I look back now.
I am fortunate, however, to have had these risks picked up early through the 12 week blood tests and to have been looked after extremely well by the wonderful NHS staff. Almost immediately after the blood test results were in, at a 15 week consultant’s appointment, I was directed to take a baby aspirin every morning to aid blood flow through the placenta. The midwives and doctors alike reassured me over and over again from that point forward not to worry. They said that probably the worst that would happen would be that Baby Lighty would be born on the small side. My main community midwife even told me that my labour was likely to be shorter because of it – every cloud, and all that!
At 23 weeks I had to undergo additional scans, both internal and external, to check the placental blood flow, Baby Lighty’s growth and his heartbeat.I took the fact that the scans were happening on Father-in-Law Lighty’s birthday as a good omen. Fortunately all appeared to be well, and we were lucky enough to get to see our little baby again, all be it from behind – his stubborn streak was already showing and he wouldn’t turn round in my tum to say hello to us!
I also had my bump measured as usual by my community midwife at each appointment. At about 28 weeks, my bump started to measure slightly too small – two weeks too small consistently – but as my bump also continued to grow at this rate throughout the rest of my pregnancy, she wasn’t too concerned.
I had also been referred for regular consultant appointments due to the condition and my pregnancy was classed as ‘high risk’. However, at 36 weeks, the consultant decided that all was well and finally signed my pregnancy off as low risk. It was now just going to be a waiting game until Baby Lighty’s arrival – that’s when we’d really be able to tell if all was well.
But alas, where the Lighty’s are concerned, nothing is ever that straightforward!
No, the last few weeks of my pregnancy were not that straightforward at all. Having had perfect blood pressure the whole way through my pregnancy, at 37 weeks, full term, it decided to suddenly start creeping up. Not dangerously high, but enough that because of the low Papp A, it was decided that I should go to triage for blood tests to rule out pre-eclampsia. Which I duly did. Then a few days later I phoned my midwife to say that my migraines were getting worse and more frequent, and so I was sent to triage again. At that point the doctors decided that I would need my blood pressure to be measured every few days. I had so many hospital appointments and blood tests and blood pressure checks in those last few weeks that it’s all a bit of a blur now. Oh and the migraines got worse. And worse. And worse. To the point where the one that I had a few days before Baby Lighty was born was the worst of my life. In a 39 weeks pregnant fit of diva-ism, I even told Mr Lighty that if I looked like I was going to die in the night from this migraine, he was to save the baby. I’m not even exaggerating when I say that it was worse than giving birth a few days later. I never want to experience pain like that again!
So the waiting game had turned into the worry game. I was fortunate that having waited so long to get pregnant, I was determined to enjoy being pregnant, so I never wanted to hurry Baby Lighty along, and never felt particularly uncomfy, even right at the end; probably because my bump was relatively small. But when it got to the point where the community midwife wouldn’t even perform a routine sweep because she thought it was too risky and sent me to the hospital for the fouth time that week for yet more monitoring, I wanted to cry. I didn’t want this longed-for pregnancy any more, I wanted my longed-for baby to be safely in my arms instead.
And he must’ve listened, because that night Baby Lighty decided to put an end to a pregnancy of worry, and made his appearance 14 hours later, with the most straightforward delivery in the world, just to contradict my difficult pregnancy.
But that worry was worth it. Oh how it was worth it! Despite being on the small side at 6lbs 8.5oz, he was just as perfect as we’d hoped he would be. And he continues to be so today.
Which is why, even though I can’t really shed any further light than is already out there on low Papp A, I decided to write this post. I just want to offer a happy ending to the low Papp A story. If you’ve been diagnosed with it, it is naturally a worry, but please be reassured that I was so well looked after, and I have a healthy – and very happy, judging by his many super-cute smiles – baby at the end of it all. The Lightys’ mysterious low Papp A ended well, and I hope that many other mothers and babies with low Papp A will also be able to say the same.
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