2010 Group Project 5

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Fetal Fibronectin


Fetal Fibronectin

The Fetal Fibronectin (fFN) test measures the amount of secretions of fFN from a woman's vagina and cervix. This technique is used to determine the likelihood of a premature birth occurring. Fetal fibronectin is a protein based plasma that acts as a form of glue attaching the amniotic sac to the uterine wall. Fetal fibronectin is commonly present between 22 to 35 weeks of pregnancy. It is released into the upper vagina towards the onset of labour. If the test finds fFN between this period, the woman will have a chance of going into labour. Hence, if there is no fFN found, it is most likely that they woman will not going into pre-term labour. Therefore, this test allows the woman to see if they are at risk or not.

About pre-term births

History of Fetal Fibronectin


Test Results

Targeted woman


The FFN remains relatively very low levels throughout the first 22 weeks of gestation.The following dramatically increase of the concentration that reaches 50 ng/mL or over from 22nd week onwards associates with the increase of the incidence of preterm labor before week 37th of gastation.[1] According to a study carried out in a teaching hospital, the presence of fetal fibronectin in the cervicovaginal secretions of preterm birth symptomatic women indicates a significant risk for subsequent preterm birth while the absence of fetal fibronectin in this group of woman is a very strong indication that subsequent preterm birth is unlikely to occur.[2] The findings are ,the preterm birth (before 37 weeks of gestation) rate in the population studied was 19.1%. Fetal fibronectin predicted preterm birth with sensitivity of 63%, specificity of 95.6%, positive predictive value of 77.3%, and negative predictive value of 91.6%. A negative test accurately excluded (97.9%) the chance of subsequent birth during the three weeks interval following sampling.[2]A study with objective to determine the accuracy with which cervico-vaginal fetal fibronectin predicts preterm delivery using systematic quantitative overview of the available literature ,concludes that fetal fibronectin test is the most accurate in predicting spontaneous preterm birth within 7 to 10 days after the test of symptomatic woman before advanced cervical dilatation. A total of 26 876 women involved in the study and among asymptomatic women the best summary likelihood ratio for positive results was 4.01 , 95% confidence interval 2.93 to 5.49 for predicting birth before 34 weeks' gestation, with corresponding summary likelihood ratio for negative results of 0.78. Among symptomatic women the best summary likelihood ratio for positive results was 5.42 for predicting birth within 7-10 days of testing, with corresponding ratio for negative results of 0.25.

Although the test has been commonly used in labour and delivery units to help in the management of preterm labour asymptomatic woman, yet it is not an official screening method to be used of pregnant woman in general, as there is not sufficient evidence to recommend its use as a screening method.Fetal fibronectin test, if combined with clinical findings, has a potentially important role in clinical management of women with symptoms suggestive of preterm labour.[2] Since this review found an association between knowledge of FFN results and a lower incidence of preterm birth before 37 weeks, further research should be encouraged.[3]


Infants that born preterm are mainly associated with high chances of mortality and getting health and development problems as they grow up.Complications associated include acute respiratory, gastrointestinal, immunologic, central nervous system problems, hearing, and vision defects, longer-term motor, cognitive, visual, hearing, behavioral, social-emotional, health, and growth problems. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems.[4]



The current treatment has been focused on inhibiting uterine wall contractions. These interventions do not reduce the incidence of preterm birth but they do delay delivery long enough to allow the administration of antenatal steroids and transfer of the mother and fetus to a hospital where they may receive appropriate care. These interventions have reduced the rates of perinatal mortality and morbidity.[4] According to a study carried out in New Zealand with the objective to compare the treatment received by both fFN positive and fFN negative woman. Women with a positive fFN were more likely to receive antenatal corticosteroids (96.4 vs 4.7%),and tocolysis (71.4 vs 2.4%) and to be admitted antenatally (96.4 vs 54.4%). In short, women with a positive fFN result received different treatment to those with a negative fFN. [5]

Further Research



  1. Akush Ginekol (Sofiia). 2010;49(2):39-42. Bulgarian.
  2. 2.0 2.1 2.2 <pubmed>8688390</pubmed>
  3. <pubmed>18843732</pubmed>
  4. 4.0 4.1 Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes; Behrman RE, Butler AS, editors.Washington (DC): National Academies Press (US);2007
  5. <pubmed>16953860</pubmed>

2010 ANAT2341 Group Projects

Project 1 - Ultrasound | Project 2 - Chorionic villus sampling | Project 3 - Amniocentesis | Group Project 4 - Percutaneous Umbilical Cord Blood Sampling | Project 5 - Fetal Fibronectin | Project 6 - Maternal serum alpha-fetoprotein | Group Assessment Criteria

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Cite this page: Hill, M.A. (2021, July 26) Embryology 2010 Group Project 5. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/2010_Group_Project_5

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© Dr Mark Hill 2021, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G