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Q. My PAPP-A result is below average. Will my child have any complications?

Answered by
Dr. Balakrishnan. R
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 27, 2022

Hi doctor,

I had my nuchal translucency scan and double marker blood tests taken a few days ago. I am worried because my NT scan reports are normal, but my double marker test report shows a high risk for trisomy 21. All reports are attached for your guidance and suggestions.

Kindly help.

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# Hi,

Welcome to icliniq.com.

I hope you are doing well. I read your query, and I can understand your concern.

From your history and reports (attachments removed to protect patient's identity), I gather that you are 33 years old, which is a low-risk age, and there are no other risk factors. Previously you have had a full-term baby by cesarean section, but a fetal demise within a few days after birth, associated with cardiac abnormality.

All soft tissue markers are normal, but PAPP-A (pregnancy associated plasma protein-A) is below average.

I cannot give you false hope that everything is normal. Reports suggest a risk of Down's syndrome and risk of hypertension towards the delivery and risk of growth restrictions towards the delivery date.

But do not lose hope. These tests are not confirmatory. You can go ahead with more precise tests like NIPT (noninvasive prenatal testing), testing fetal tissue from your blood sample. If this is negative, you can relax. Or else, you can have amniocentesis, which is, fluid around the baby is tested. This test is 100% confirmatory.

This test that you have already done is a screening test. Many times, we get a false-positive result. Just pray for a normal confirmatory test.

All the best.

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