If you are pregnant, you may sometimes wonder, 'Will my baby be born prematurely?' This fear is especially heightened when you feel things like minor aches and pains. This is something that many mothers experience. So, today we are going to talk about a special test that will help you know exactly if you are at risk of having a premature baby. We call this the fFN test.
Simply put, what is this fetal fibronectin (fFN)?
Okay, this name may sound a bit complicated, but it's actually quite simple. Imagine your baby is inside a bag full of water. In medical terms, we call this the amniotic sac. This bag needs to be firmly attached to the wall of your uterus. This natural "gum" that helps keep that attachment strong is called fetal fibronectin. This is a type of protein.
It is normal for this fFN protein to be present in vaginal discharge for the first 22 weeks of pregnancy. Also, towards the end of pregnancy, after 35 weeks, as the baby is ready to be born, this fFN protein can be seen again in vaginal discharge.
However, between 22 and 34 weeks , this fFN protein should not be present in the vaginal discharge. If it is present, it means that the "gum" has loosened and the bag containing the baby is starting to separate from the uterine wall. That is a sign that indicates the risk of having a premature baby.
In what cases is this fFN test performed?
This is not a test that is done for every pregnant woman. Your doctor will only recommend this test if he or she suspects that you are at risk of having a premature baby. There are two possible reasons for this.
1. If you are showing symptoms of preterm labor.
2. If you have other factors that increase your risk of having a premature baby.
Let's look at these two points separately.
1. Symptoms of early pregnancy
If you experience one or more of these symptoms before 37 weeks, your doctor may decide to perform an fFN test.
| Symptom | A simple explanation |
|---|---|
| Uterine contractions | My stomach feels like it's hard as a rock, it goes away after a while, then comes back. If this happens more than four times an hour, you should be concerned. |
| Stomach pain or discomfort | I get a stomachache, just like during menstruation. |
| Spinal cord injury | A strange, persistent pain in the lower back. It doesn't go away even when I change positions. |
| Changes in vaginal discharge | A discharge from the vagina that is watery, mucus-like, or has a little blood in it. It's like we're going through a 'show'. |
| Signs of cervical dilation | This is confirmed by a test performed by a doctor. |
| Pressure in the pelvic area | A feeling in the lower abdomen that feels like the baby is pushing down. |
| Water bag rupture `(PPROM)` | The amniotic sac ruptures prematurely, causing a watery fluid to flow through the vagina. |
The most important thing is that if you notice a symptom like this, don't ignore it as something minor, but inform your doctor immediately .
2. Other factors that increase the risk of having a premature baby
Sometimes you may not have any symptoms. But if you have the following risk factors, your doctor may order this fFN test.
- Having delivered the baby prematurely in a previous pregnancy.
- Having had any surgery on your uterus or cervix.
- Lifestyle factors such as smoking during pregnancy and being underweight before pregnancy.
- Short cervix: This is something that can be detected through a scan.
- The time between two pregnancies is very short (e.g. less than 6 months).
How should I prepare before the test?
This is very important. Because, for the test result to be accurate, you must follow these things. Avoid the following things for 24 hours before taking the test.
- Avoid having sex.
- Do not insert anything into the vagina. For example, do not use lubricants, soaps, suppositories, or douches.
- Avoid having a routine pelvic examination or a transvaginal ultrasound.
- Avoid doing anything that might interfere with the vagina, cervix, or uterus in any other way.
If you do these things, the test result may be falsely positive . This means that you may get a false positive result even if you are not actually at risk. Also, if you have moderate or heavy vaginal bleeding, your doctor will not do this test. This can also change the result.
How is the fFN test done? Does it hurt?
Don't be afraid of this test. It's very simple and painless. It feels just like a Pap smear.
Your doctor will insert a long, thin cotton swab into your vagina and take a small sample of the fluid from your cervix. The sample will then be sent to a laboratory to be tested for the presence of the fFN protein.
What do the test results say?
The result comes in two types: Positive or Negative . It is very important for you to know exactly what these two mean.
| Result | What does this mean? | What happens next? |
|---|---|---|
| Positive | The fFN protein is present in your vaginal discharge. This means that there is a risk of conceiving within the next week or two . | The doctor will prepare you for an early delivery. He will give you medicine to help your baby's lungs develop, medicine to reduce uterine contractions, and he will monitor you closely. |
| Negative | There is no fFN protein in your vaginal discharge. This means that the risk of conceiving within the next two weeks is very low . This is a very reassuring result. | You will be told to go home. If your symptoms persist, you may be asked to take another test in a week or two. |
The important thing here is that a positive result does not mean that you will definitely have an early baby. It just means that the risk is higher, so we need to be more careful.
What does the doctor do if the result is positive?
Don't panic if you get a positive result. It means your doctor will take immediate steps to provide you and your baby with the best treatment possible. This is usually done by:
- Corticosteroid injections to help the baby's lungs mature: The biggest problem for premature babies is that their lungs are not fully developed. These injections help the baby's lungs develop quickly and help prevent respiratory distress syndrome (RDS) that can occur after birth.
- Giving tocolytics to stop or reduce uterine contractions: If you are having pain, meaning your uterus is contracting, these medications can help stop or reduce it. This can give us a few more days to keep the baby in the womb. This will also help the steroid injections work.
- Giving antibiotics: In some cases, especially if your water breaks or you have a group B strep infection, antibiotics are given to prevent the spread of infection to the baby.
How accurate is this test?
This is a very important question.
- Negative results are very accurate: If the fFN test comes back negative, you can be 99% sure that you will not conceive within the next two weeks. So this is a very reassuring and reliable result.
- Positive results are not very accurate: Many mothers who get a positive result have delivered their babies at the full term. So don't be afraid of a positive result. It just means that there is a risk, so we need to be extra careful.
It usually takes 24 to 48 hours to get results. Talk to your doctor about this and be aware of it in advance.
Take-Home Message
- Fetal fibronectin (fFN) is a "natural glue" that sticks the gestational sac to the uterus. The fFN test looks for this in vaginal fluid.
- This test is only done between weeks 22 and 34 if you have symptoms of preterm labor or other risk factors.
- If the test result comes back negative , it means that the risk of conceiving within the next two weeks is very low. This is a great relief.
- If the result is positive , it means that the risk is higher. But it does not necessarily mean that you will have an early baby. Your doctor will carefully monitor you and your baby and start the necessary treatment.
- It is essential to avoid sexual intercourse and inserting anything into the vagina for 24 hours before the test to obtain an accurate result.
- Talk to your doctor without hesitation about any discomfort, fear, or doubt you may have during your pregnancy.
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