Helping prepare for a potential preterm birth: FDA-approved test helps women and doctors manage high-risk pregnancies

Published 5:04 pm Wednesday, November 28, 2007

Board-Certified Maternal Fetal Medicine Specialist at Ochsner Health System in New Orleans

While the goal is for every baby to be born healthy and at full term, the reality is premature birth, also known as preterm birth, is the number one obstetric problem and the number one cause of death for newborns in the United States. Defined medically as childbirth occurring earlier than 37 completed weeks of gestation, preterm birth affects 1 in 8 babies born in the United States.

Premature babies have a higher incidence of lifelong health and developmental challenges, including cerebral palsy, mental retardation, chronic lung disease, and vision and hearing loss.

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Given the potential grave consequences of prematurity, there is a pressing need to identify patients at increased risk to help physicians prepare for a potential preterm birth.

Experts have identified certain factors that put some women at increased risk for delivering early. They include women who have had a previous preterm birth, women who are pregnant with multiples and women with certain uterine or cervical abnormalities. FullTerm™, The Fetal Fibronectin Test is an FDA-approved, noninvasive test that provides high-risk women and their physicians with valuable information about the likelihood of premature birth.

The test can be performed in a doctor’s office (similar to a Pap smear test) and measures the amount of fetal fibronectin—the “glue” that holds the baby in the womb—in the vagina. There are no side effects to either mom or baby, and the test can be repeated every two weeks until 35 weeks of pregnancy. During weeks 22 to 35, fetal fibronectin should be almost undetectable.

If the test is negative, a woman has a 99 percent chance of not delivering in the next 14 days. This means women can avoid over treatment with drugs and other medical interventions such as bed rest or hospital admission. Additionally, the reassurance of a negative test result allows women to continue their normal routines, such as working, traveling, caring for other children and socializing with friends and family.

A positive result is the single strongest independent predictor of preterm birth at less than 32 weeks. Narrowing the delivery window can help doctors better manage pregnancies and work to keep babies in the womb as long as possible. Doctors may prescribe treatments like bed rest, drugs or corticosteroids. Every extra day in the womb helps a baby’s organs grow. Women for whom preterm birth is inevitable benefit from the early warning, which allows them to travel closer to a hospital with specialized services for premature babies.

Danielle’s Story

When Danielle Porche learned she was pregnant with her first child, she was ecstatic. The pregnancy was moving along smoothly until she began having contractions at just 24 weeks. Danielle visited her doctor who found she had begun dilating; she was immediately admitted to the hospital and placed on magnesium to stop her contractions.

Danielle was overcome with the fear that her baby would come too soon. After being hospitalized for several weeks, her doctor allowed her to go home, but said she needed to stay on strict bed rest.

Danielle vowed to be the best bed-rester possible; she even moved around her house in a supine wheelchair fearing the slightest deviation from her doctor’s orders’ would cause preterm labor. Thankfully, Danielle’s huge sacrifices paid-off. She gave birth to Ryan, a health baby boy, at 37 weeks.

When Danielle found out she was pregnant for the second time, she hoped that she would not have to go through another pregnancy on strict bed rest. Even worse was the thought she’d be hospitalized again. How would she manage this time with little Ryan at home? When Danielle began having contractions and dilating at week 23, she prepared herself for the worst.

Danielle had recently switched to my care and I suggested that given her history she have FullTerm, The Fetal Fibronectin Test. I explained that the fetal fibronectin test can help detect the likelihood of preterm birth. The test determines the presence of fetal fibronectin, or the glue that holds the baby in the womb. When present between weeks 22 – 35, a woman is at elevated risk for delivering early. A negative result indicates a 99 percent chance that labor will not begin for at least two weeks.

Danielle began having the test every two weeks. After each negative test result, Danielle called her husband and they would celebrate being “out of the woods for two more weeks.”

Knowing that his patient had a greater than 99 percent chance of NOT going into labor within the next 14 days, her physician was able to avoid hospitalizing her. And, while Danielle was still told to take it easy, she was able to watch after her son Ryan in the comfort of their home. This treatment regime worked out perfectly; Danielle gave birth to a healthy baby girl, Madison, at 38 weeks.

Danielle admits that before she was pregnant she knew that prematurity was a possibility, but she had no clue how devastating and emotional it could be until she thought it might happen to her children. Danielle and her husband are happy to share their story so that others in their position know there is a test available that offers valuable information about the likelihood of premature birth.

Women interested in additional information on FullTerm, The Fetal Fibronectin Test are invited to visit HYPERLINK “” to learn more.