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What Do These Following Lab Reports Indicate?

Posted on Thu, 15 Dec 2016

Question: Hello doctor,

I am really worried. I have IVF pregnancy and now I am 12.4 weeks pregnant. As suggested by doctor I got my Dounle marker test done.pls refer the attacjed reports.
Its negative but above age risk.
My age : 27 years

My doctor has recomended 4d scan after 4 weeks that is when I will be 16 weeks pregnant.
Pls reply.

My readings are:

Free beta hcg: 135.00 ng/mL
Pappa: 1.53 mIU/mL
Corr. MOM's
Papp-A : 0.52
Free beta hcg - 2.98

Comments in report: In view of biochemical risk above age risk but below cut off risk 1:250, it is advisable to do higg level USG or confirmatory test under clinical guidance.

Also,
My Trisomy 21 is negative
Trisomy 13/18 is negative

But above age risk

Further readings: trisomy 21+ NT - risk is 1:514
Trisomy 13/18 - risk is 1: 1: 10000
Age risk : 1: 843

Pls reply.

Answered by Dr. Deepti Verma (57 minutes later)

Brief Answer:
No need to panic

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
I have reviewed the report.
The corrected MoM values of PAPP-A and beta hCG values are definitely deranged, however the calculated risk of chromosomal anomalies is low.
In this situation, nothing active needs to be done at this time.
However, a detailed anomaly ultrasound should be done at 18 weeks to rule out any major congenital anomalies.
You should get regular blood pressure check up as these markers can be deranged in hypertension of pregnancy also.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN
Maternal and fetal medicine specialist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepti Verma (15 minutes later)

Thank you very much doctor for your prompt reply.

My baby will not have any risk of down syndrome , right?

And will 4D scan help to rule out whether any problem is there or not???

Or ultrasound will help to rule out any problem at 16 weeks?

Also Doctor, can I do something to have all readings normal??

Hi doctor,

Can you pls reply for my above worries?

Answered by Dr. Deepti Verma (15 hours later)

Brief Answer:
Nothing can be done to alter parameters

Detailed Answer:
Hi dear,
Yes, there is no risk of Down syndrome in your baby.
Nothing can be done to make the serum values normal.
You need not worry.
A 4 D ultrasound will detect any major congenital anomaly. It can be done anywhere between 16-20 weeks.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. REMY KOSHY

Follow up: Dr. Deepti Verma (3 hours later)

Thanks a lot doctor. One last query.Are my free beta HCG levels high & is Pappa normal.
I could not find normal ranges for both. Can you please tell me.

Answered by Dr. Deepti Verma (2 hours later)

Brief Answer:
MoM cut offs

Detailed Answer:
Hi dear,
Your free beta hCG levels are high and PAPP-A levels are low. The reference values are the MoM cut off for both.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Deepti Verma (14 minutes later)

Thanks alot doctor!

Can such high hcg levels & low pappa levels lead to any problem to my baby?

Answered by Dr. Deepti Verma (3 hours later)

Brief Answer:
Various problems

Detailed Answer:
Hi dear,
Deranged levels of hCG and PAPP-A can lead to growth restriction in baby, preterm labour, hypertension in pregnancy.
Your treating doctor will detect these conditions by appropriate examination and investigations.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepti Verma (31 minutes later)

Thanks doctor for your timely reply.

Answered by Dr. Deepti Verma (23 minutes later)

Brief Answer:
Happy to help

Detailed Answer:
Hi dear,
I am happy to have helped you.
You can get back to me anytime by asking a direct question to me on the healthcare magic portal.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Vaishalee Punj