II. Indication
- Preterm Labor Evaluation
III. 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
- Presence >20 weeks gestation suggests Preterm Labor
IV. Contraindications: False Positive fibronectin risks
- Vaginal exam within prior 24 hours
- Sexual intercourse within prior 48 hours
- Moderate Vaginal Bleeding
V. 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 [PubMed]
- Positive fibronectin
- Once positive, no longer useful for monitoring
- Low Specificity for preterm delivery
VI. 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 [PubMed]