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Current Perspectives on the Use of Fetal Fibronectin Testing in Preterm Labor Diagnosis and Management

fFN testing is most valuable as a tool to help identify which women are at low risk for spontaneous preterm birth among those that present with symptoms of PTL. Unfortunately, much of the recent literature seeks to expand the use of fFN testing to identify which women will ultimately deliver preterm (at less than 37 weeks’ gestation) as a primary outcome, an outcome the fFN test was not designed to assess under its FDA indications. Thus, the lack of strict adherence to diagnostic and treatment protocols, as well as the expansion of the use of fFN beyond its core assessment strength, has resulted in literature-based evidence that has confounded our understanding of the proper role of fFN testing.…

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 Fetal Fibronectin: The Benefits of a High Negative Predictive Value in Management of Preterm Labor

In summary, the available evidence verifies the cost savings and utility of a diagnostic protocol which includes fFN for identifying patients who have symptoms of PTL but are likely experiencing false labor. The test is easy to administer, non-invasive, and has no related side effects. The NPV of fFN is high, with a negative test associated with a <1% chance of giving birth within the next two weeks. The test itself is objective, and its benefits with respect to costs and decreased healthcare utilization are well-documented.

 This Test Could Help Moms At Risk For Preterm Labor

About 99.2 percent of "women with symptoms of preterm birth who have a negative fetal fibronectin test result will not deliver their baby within the next 14 d. A negative fFN test result indicates there is less than a 1 percent chance of the patient giving birth in the next 14 days, giving both the patient and her physician the confidence that discharge is appropriate.

Articles of Interest

Fetal fibronectin testing for reducing the risk of preterm birth

The evidence from this review suggests that management based on knowledge of FFN results may reduce preterm birth before 37 weeks. However, our confidence in this result is limited as the evidence was found to be of low quality. Effects on other substantive outcomes are uncertain due to serious concerns in study design, inconsistency, and imprecision of effect estimates. No trials were identified on asymptomatic women, or multiple gestations.

Fetal Fibronectin Testing in Threatened Preterm Labor

Fetal fibronectin testing is performed in many clinics, emergency departments, and hospitals across the country, but it is still unclear how testing impacts clinical outcomes. Further studies need to be performed with clearly specified intervention protocols to determine perinatal outcomes with fetal fibronectin testing.

Foetal Fibronectin Test: Predicting Preterm Labor

A positive result (fFN ≥50 ng/mL) suggests an increased risk of spontaneous preterm delivery, often within 7-14 days. It indicates the "glue" bonding the amniotic sac to the uterus may be weakening. A negative result (fFN <50 ng/mL) indicates a low likelihood of preterm birth in the near term. It provides reassurance and helps avoid unnecessary treatments or hospitalisations.

Management of Threatened and Active Preterm Labour

Fetal fibronectin is one of several commercially available vaginal biomarker tests for the prediction of preterm birth in women presenting with symptoms of PTL. To date fFN is the most extensively tested with data on predictive value in several thousand symptomatic women.

Potential of Fetal Fibronectin Testing to Prevent Preterm Birth

Fetal fibronectin testing may reduce preterm birth, although the evidence is not strong enough to recommend regular testing. Knowing the results of fetal fibronectin testing does not lead to a reduction in secondary outcomes such as preterm birth before 34 weeks' gestation, admission to the neonatal intensive care unit, or perinatal death.

Using Fetal Fibronectin Test to Reduce Hospital Admissions with Diagnosis of Preterm Labor: An Economic Evaluation Study

This was the first study to analyze the cost of FFN implementation to triage women with threatened preterm labor on reducing hospital admissions in a tertiary hospital in the United Arab Emirates (UAE). Its usage was simple, fast and does not require extra skills with high negative predictive values. However, the cost reduction was evident but not that large.

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Rapid fFN

Rapid fFN® testing can help rule out imminent preterm birth and deliver peace of mind.