This article comes to us from Full Term™, the Fetal Fibronectin Test. Utilized by hospitals and healthcare providers in office settings, this non-invasive test helps to identify the possibility of premature birth by detecting the presence of a protein known as fetal fibronectin. Read this informative article by Dr. Naylor to learn more about this test.
FDA-Approved Test Helps Women and Doctors Manage High-Risk Pregnancies
By: Dr. Scott Naylor
While the goal for pregnancy is for every baby to be born healthy and at full term, the reality is that premature birth, also known as preterm delivery, is one of the most serious obstetric problems and is the number one cause of death for newborns in the United States. Defined as delivery earlier than 37 completed weeks of gestation, preterm birth affects 1 in 8 babies born in the United States.
Premature babies have a higher incidence of lifelong health and developmental challenges, including cerebral palsy, mental retardation, chronic lung disease, and vision and hearing loss.
Given the potential grave consequences of prematurity, there is a pressing need to identify patients at increased risk to help physicians prepare for a potential preterm birth.
A new study published in the current issue of the American Journal of Obstetrics and Gynecology found the use of fetal fibronectin (fFN) testing and cervical length testing between 22 and 32 weeks gestation more accurately identified asymptomatic women pregnant with twins who are at the highest risk of premature delivery. The fFN test is an FDA-approved, noninvasive test that provides high-risk women and their physicians with valuable information about the likelihood of premature birth.
Experts have identified certain factors that put some women at increased risk for delivering early. They include women who have had a previous preterm birth, women who are pregnant with multiples and women with certain uterine or cervical abnormalities.
The fFN test, similar to a Pap test, can be performed quickly and easily in a doctor’s office and measures the amount of fetal fibronectin—the “glue” that holds the baby in the womb—in the vagina. There are no side effects to either mom or baby, and the test can be repeated every two weeks until 35 weeks of pregnancy.
In a typical pregnancy, fetal fibronectin should be almost undetectable from weeks 22 to 35. In fact, if the test is negative (i.e. the “glue is not leaking”) a woman has a 99 percent chance of not delivering in the next 14 days. Because of this powerful degree of reassurance, this can help avoid over treatment with drugs and other medical interventions such as bed rest or hospital admission. Additionally, the reassurance of a negative test result allows women to continue their normal routines, such as working, traveling, caring for other children and socializing with friends and family.
A positive result, on the other hand, is perhaps one of the single strongest independent predictors of preterm birth. Narrowing this delivery window can help doctors better manage pregnancies and work to keep babies in the womb as long as possible. In the case of a positive test result, doctors may prescribe treatments like bed rest, drugs to relax the uterus or corticosteroids to enhance the development of the baby’s lungs. For patients who are found to be at high risk for preterm birth, every extra day in the womb makes a difference and is equivalent to 3 fewer days spent in the neonatal intensive care unit. Women for whom preterm birth is inevitable will greatly benefit from the early warning, allowing them to be close to a hospital with specialized services for premature babies.
As a perinatologist who cares for high-risk pregnant patients, I use the Fetal Fibronectin test frequently in my office for women with signs or symptoms of preterm labor, women who have had a previous preterm birth or patients who are pregnant with multiples. The test provides me with important information which helps us to avoid over treating our patients and to plan accordingly for each woman’s pregnancy. Kathleen’s story below is an example of a situation in which the test has helped give a worried mother-to-be peace of mind.
Kathleen’s Story: A happy ending
Every woman has her own unique experiences during pregnancy and some of them can be frightening. Doctors are constantly working to quell their fears and work toward the best possible outcomes. The story of Kathleen from Hermosa Beach California is no exception.
Kathleen was thrilled when she learned she was pregnant for the second time. After a normal pregnancy and the easy birth of her first born, Brandon, Kathleen and her fiancé were looking forward to bringing another child into the world. However, Kathleen recalls her emotions turning to fear when she started experiencing contractions and labor pains while in her 28th week of pregnancy.
Kathleen grew anxious thinking about the possibility of delivering a premature baby. Our office offers fetal fibronectin testing, and I suggested it to Kathleen. We were all pleased when all of Kathleen’s tests came back negative providing her with the comfort of knowing she would not go into labor within the next two weeks. For Kathleen and her fiancé, the reassurance was exactly what they needed to ease their worries during subsequent contractions. The negative results also allowed Kathleen to maintain her regular activity level, and the freedom to care for her four-year-old child at home.
Kathleen says she’s glad the test was available and she strongly recommends it. She says it is a blessing to have a better sense of when to expect (or not expect) your baby to arrive, so everyone involved can better manage the pregnancy.
To find a physician near you who offers this test please visit http://www.fullterm.net/.
Dr. Scott Naylor is Board-Certified Maternal-Fetal Medicine Specialist at Pacific Perinatal Center in Torrance, California.
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Babies 411 is an on-line information and resource center for parents. This site has been developed by a neonatal intensive care nurse with the sole purpose of promoting the health, safety, an well-being of all babies.
Author : Diba Tillery RN, BSN, IBCLC, CPST
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