Did you have low Papp-A? Loss mentioned.

MrsJeffsWife2B

Hi Ladies, visitor from the other side (I have twin 6 month olds and a 4.5 year old)

Sadly, incredibly unbelievably sadly my sister lost her baby at 40 weeks.

She had a low papp-a at her triple screen around 13 weeks and was supposed to be a "watched" pregnancy because low papp-a can be associated with Pre-e, IUGR, or even stillbirth. And yet, incredibly she had not even had an NST! Her last full scan was about 2 months before her due date. My opinion is that her OB/MFM were incredibly negligent to let her go to term without at LEAST monitoring her like a hawk. She said her OB never even measured her fundal height (he is actually a very well known OB to the stars, not some crack pot which makes this all even more unbelievable).

The baby was only 6lbs at 40+ weeks - the same as when she had her last major growth scan in January so it would seem that IUGR or placental insufficiency were at play, though we won't know for certain until after the autopsy.

My question for you if you had low Papp-A is how closely are you being watched in the 3rd Tri? Are you getting weekly NSTs or growth scans? Has your OB mentioned the possibility of inducing before 40 weeks due to increased risk of stillbirth? 

I'm just trying to get a sense of what the standard of care SHOULD have been.

And lastly, if you had low Papp-A and are NOT getting extra monitoring, please make sure you are getting the kind of vigilant care you should be getting. (See this study http://jama.jamanetwork.com/article.aspx?articleid=199766)

Thank you.