Fetal Fibronectin Test

Early labor can be terrifying. You wonder if it is just practice contractions, or if your baby or babies are really coming. And if they are really early, that can be awful, just wondering if everything will be okay.

One of my best friends asked me if I had ever heard of the Fetal Fibronectin Test. I had heard a few things, but I didn’t hear enough to warrent researching it. But, since she brought it up, I figured it was a pretty neat topic and set out to research right away.

There are a lot of articles on it. And, it is a really cool test, especially if you are experiencing labor symptoms and it is before 34 weeks.

fFN can’t tell you for sure if you are in labor, but it can tell you for sure if you aren’t. I know that saying is kind of vague, but let me explain a little more.

This test is useful, since it is hard to tell if a woman is truly in preterm labor based on symptoms and a pelvic exam.

A negative result means it is highly unlikely to give birth in the next week or two, so your caregiver can hold off on treatments that are unnecessary. These treatments include meds that stall preterm labor, antibiotics for group B strep, corticosteroids (to mature lungs of baby). These medicines are great if you are in early labor, but if you aren’t, you may not be able to take them again when you are truly in labor. A negative also helps you avoid or postpone bedrest or hospitalization, neither of which is very effective at preventing preterm birth and labor, but it is still recommended.

A positive result is not as useful. It means you are at a higher risk to have a preterm labor, but it doesn’t mean you will, so treatments may be done that aren’t necessary.

If you are having symptoms of preterm labor, in addition to this test, your doctor may order an ultrasound to see if your cervix is thinggin, which is what happens during labor.

This test is done at your caregiver’s office:
-Inserts speculum
-Takes samples of cervical and vaginal secretions
-This is pretty much the same feeling as during a pap smear.
NOTE: If you have had sex or used lubricants in the 24 hours before the test, please let your caregiver know. It can give a false positive, and that is never good.
-The lab analyzes the sample and measure the amount of fetal fibronectin (fFN).
= this is a protein that serves as a ‘glue’. It attaches the fetal sac to the uterine lining.
= found in small amounts between 22-34 weeks, since it is not disintegrating
= if larger amounts are found, it may mean that the glue is disintegrating ahead of schedule because of contractions or an injury to the membranes.
= if this happens, risk of premature labor is more likely

Anyone who is having symptoms of labor before 34 weeks should go in and get the test done
Some doctors say that all high risk patients should do it, but it is not proven to help at all, since it isn’t very accurate if you get a positive result.
If you get a negative, but still experience symptoms, some doctors will test every two weeks until 34 weeks just to make sure.

The results tell you
-if you are having symptoms:
Regularly, there is a 4% chance of delivering within two weeks. A negative results shows that you have a 1% chance of delivering. If you get a positive, the risk is increased of pre-35 weeks labor to 16% in the next 2 weeks.
-if you are NOT having symptoms:
If you have had a previous preterm birth, but no symptoms in this pregnancy, you can test, but less useful results are found if you are not having symptoms. IE: If it is positive, you won’t be treated since you aren’t in labor yet. In general, high-risk women without symptoms have a 1 in 3 chance of delivery before 37 weeks.
Among women with previous preterm birth, but no symptoms, fewer than 10% with negative test result at 24 will go on to deliver before 35 weeks, compared with 60% of women with a positive result.

The research on this is pretty shaky. If you get a negative result, that’s completely certain. But if you get a positive, you may be worrying and on bed rest for weeks and you wouldn’t have gone into labor in the first place.
It is a lot of unnecessary worrying that a pregnant woman shouldn’t have to do, especially if she wasn’t in labor to begin with.
But on the other hand, if she is in labor or at a more increased risk because she is about to start labor, treatments are the best option.
I think the best thing you can do is to trust your body. Stay healthy, exercise (if your doctor says it’s ok), get lots of rest, drink lots of fluids, and try to stay positive. With all the advances in medicine, a baby can survive if born as early as 21 weeks. It isn’t the ideal, but it happens.
And, although I am not that positive about doctors and such, trust your caregiver. Early labor is scary. So many things can go wrong, and their insight is invaluable. Listen to their advice, and research things for yourself just to double check.
Every woman is different. I have heard of a woman pregnant with triplets that went overdue. And people carrying just one baby go really early. You never know what is going to happen, but is having an unnecessary procedure that might not tell you anything but give more worry truly worth it?

3 Responses

  1. Interesting topic. I had never heard of that before. I am grateful for the treatments available to women and babies who might come early, but I agree that trusting your body, though difficult at times, is best.

  2. i had a FFn test 5 days ago that came back positive. Have had lots of false labour the past 2 weeks and was in and out of the hospital for 3 days. I feel that the test has added more fear to my worry and hasn't been the greatest. I agree trust your body these test can make it more stressful for us and in the end cause more problems.My cervix hasn't changed and i still have false labour pains. I'm over 31 wks along if the baby comes there is nothing we can do put pray that it will be healthy.Not all test are reliable, we know our body's better than anyone and i feel that is the best indicator.

  3. I went into the hospital with really strong contractions, low back pain that didnt let up. They have me meds to stop the pains but they didnt. Did a exam and said the cervix was opening. They did the test and it was negative, so they just sent me home, still in pain. I have been having these pains for almost a weeks now, everytime I go to the bathroom I have some mucusy stuff when I wipe. I am still very worried and feel like just because i had a negative test the doctor seems too relaxed about it. The contractions are really strong still, this is my 5 baby and I have never had this issue. Im worried one true labor starts it only take minutes for me to deliver. So I really dont like the test, feel even more worried.

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