Fetal fibronectin

Fetal fibronectin (fFN) is a fibronectin protein produced by fetal cells. It is found at the interface of the chorion and the decidua (between the fetal sac and the uterine lining). In a normal case, fFN is found at low levels in cervicovaginal secretions.[1]

It can be thought of as an adhesive or "biological glue" that binds the fetal sac to the uterine lining.[2]

Screening test
Fetal fibronectin
Purposetest of pre-term birth

Fetal fibronectin "leaks" into the vagina if a preterm delivery is likely to occur and can be measured in a screening test.[3]

Testing will produce a negative or a positive result. When the fFN test is positive, the result is an excellent predictor of preterm labor risk. A negative result means that there is little possibility of preterm labor within the next 7 to 10 days, and the test can be repeated weekly for women who remain at high risk. A negative fetal fibronectin says that a patient has less than 5% chance of giving birth in the next two weeks. A positive result is a less reliable indicator that a woman will go into preterm labor.[4] A systematic review of the medical literature found that fetal fibronectin is a good predictor of spontaneous preterm birth before cervical dilation.[5] The test may be run on patients between 22 and 34 weeks gestation.

The test is easily performed and is usually painless. A specimen is collected from the patient using a vaginal swab. The swab is placed in a transport tube and sent to a laboratory for testing. Most labs can easily produce a result in less than one hour.

At or after 22 weeks of gestation, fFN levels greater than or equal to 50 ng/mL are associated with an increased risk of spontaneous preterm birth.[1]

A false positive fetal fibronectin result can occur if the test is performed after digital examination of the cervix or after having had intercourse. It is important that the swab be taken before a digital vaginal exam is performed.

See also

References
  1. Berghella, Vincenzo; Saccone, Gabriele (29 July 2019). "Fetal fibronectin testing for reducing the risk of preterm birth". The Cochrane Database of Systematic Reviews. 2019 (7): CD006843. doi:10.1002/14651858.CD006843.pub3. ISSN 1469-493X. PMC 6663121. PMID 31356681.
  2. Mayo Clinic Staff. Accessed 3/19/2016. http://www.mayoclinic.org/tests-procedures/fetal-fibronectin/basics/definition/prc-20014483
  3. Lockwood CJ, Senyei AE, Dische MR, et al. (1991). "Fetal fibronectin in cervical and vaginal secretions as a predictor of preterm delivery". N. Engl. J. Med. 325 (10): 669–74. doi:10.1056/NEJM199109053251001. PMID 1870640.
  4. Farquharson D, Skoll A. Fetal fibronectin. BCRCP Perspectives, Winter 2004. Available at: http://www.rcp.gov.bc.ca/whatsnew_pdfs/fibronectin.pdf. Accessed on: December 25, 2007. Archived September 20, 2007, at the Wayback Machine
  5. Honest H, Bachmann LM, Gupta JK, Kleijnen J, Khan KS (2002). "Accuracy of cervicovaginal fetal fibronectin test in predicting risk of spontaneous preterm birth: systematic review". BMJ. 325 (7359): 301. doi:10.1136/bmj.325.7359.301. PMC 117763. PMID 12169504.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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