http://www.fpnotebook.com/
Fetal Fibronectin
Aka: Fetal Fibronectin
- Indication
- Preterm Labor Evaluation
- Mechanism
- Extracellular glycoprotein glues cell together
- Found between many cell types
- Binds placenta to Decidua
- Normally present in vagina in early pregnancy
- Not normally found in vagina after 20 weeks gestation
- Presense >20 weeks gestation suggests Preterm Labor
- Technique
- Do not obtain sample within 24 hours of vaginal exam
- Digital vaginal exam increases false positive rate
- Interpretation
- Negative fibronectin is reassuring for 2 weeks
- If no cervical change, <10% preterm delivery risk
- Iams (2002) N Engl J Med 346:250-5
- Positive fibronectin
- Once positive, no longer useful for monitoring
- Low Specificity for preterm delivery
- Efficacy
- Does not affect gestational age at delivery
- Does not affect rate of inpatient admissions
- Does not affect frequency of medical interventions
- Lowe (2004) Am J Obstet Gynecol 190:358-62