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Hello ladies, lots of good news on here and welcome to the new ladies I've been enjoying everything but wanted to offer Pumpkin a bit more support...The Papp A in itself is not diagnostic and is a single blood test, performed at the beginning of the placenta taking over. The 20 week scan will look at the placenta itself and do the growth measurements so you'll know a lot more then. The positive here is that it's not a problem with baby but maybe (!) with the placenta...if (big if) an IUGR issue then isn't there every likelihood baby will catch up once born and by going for regular scans you will know if baby needs to be born premature. Positive things you could do are: repeat blood test, have a detailed private scan (confirm triple cord umbilical cord, look at the placenta blood flow etc), take blood thinners, check out how your preferred hospital deals with premature births... my local hospital transfers them to another one (I'm planning on going to this more advanced hospital to begin with, takes births from 23 weeks). Breastfeeding may become more important to you. You may be prescribed steroids. well, that's all the thoughts in my head about it, the most important thing is that you won't know until you know, you haven't been diagnosed with anything, so keep doing a wonderful job of looking after yourself (and baby)