Positive Fetal Fibronectin test - Mothering Forums
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#1 of 22 Old 07-09-2008, 09:37 AM - Thread Starter
 
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So I have posted briefly on this board about my concerns with PTL since I was dilated and soft as of last week. (I am 29 weeks pregnant)I went to take the Fetal Fibronectin test yesterday, and to my surprise it came back positive.

So that meant going to the hospital and being on the monitor for a couple hours. No contractions (thank God), but I am scheduled for an ultrasound today and will have to repeat the FFT in two weeks. In the meantime, I can't do anything but chill out. This seems very surreal to me because I would have never thought that PTL would be a possibility but I guess things work in mysterious ways. They told me that they have seen women with positive FFT go to term, but its like a roller coaster of monitoring...there is a big chance I could more realistically have this baby by 35-36 weeks. As long as she "bakes" for 6 more weeks and can avoid those nasty medications to prevent labor, then I can feel really positive about this. My question is have any of you had to take those medications for PTL? (bethrine, steroids, etc..) what was the outcome with your child?
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#2 of 22 Old 07-09-2008, 09:53 AM
 
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I've had a FFN test every 2 weeks since 22 weeks (I'm 29 weeks now also) but I haven't had to take any medication, so I have no advice there. My perinatologist told me a positive FFN is really only a 50/50 chance (I know you know this already) but our plan was to go ahead and do the steroids for lung maturity just in case, if I had a positive.

It's great that you're not having contractions! Take it easy, rest a lot and I hope you make it many more weeks!
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#3 of 22 Old 07-09-2008, 10:05 AM
 
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I haven't had any experience - but I just wanted to say I'll be keeping you and your little girl in my thoughts

kati , wife to josh , mama to j&d (7.31.07) marion (9.18.08), feeder of nanuq and gracie lou
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#4 of 22 Old 07-09-2008, 11:17 AM
 
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Praying your little darling stays put for a good while longer!!
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#5 of 22 Old 07-09-2008, 11:50 AM
 
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I have no advice just wanted to give a big . Hope that babe stays baking for a while longer.

AP crunchy homeschooling mama to Henning (1/4/03), Connor (7/1/05) and Elijah (9/21/08) Forever holding my 3 lost little ones in my heart.
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#6 of 22 Old 07-09-2008, 12:05 PM
 
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FFN isn't 100% but I'd get the steroids if it was me.

Some of the drugs are nasty, i'd try the lightweight ones first like p17 shots
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#7 of 22 Old 07-09-2008, 12:13 PM
 
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A good friend of mine did ended up holding her baby in for 38 weeks but she also was on complete bedrest because she was having early contractions I think around 31 weeks. They gave her meds to stop them and to mature the lungs if she did deliver early. Her test came back positive at that time.

: DD 8/29/08 and twin boys 11/3/09
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#8 of 22 Old 07-09-2008, 12:59 PM
 
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When I was pregnant with Cale and Dillon, I went into PTL at 25 weeks. I had several shots of terb, was on mag sulfate for almost a week, got the steroids, and was sent home on bedrest with oral terb -- although I didn't take it very often, preferring a glass of wine instead. With my first, I didn't even have an occasional Coke because of the caffeine. Being on all those drugs put things in perspective, and made wine seem like nothing. I'm much more relaxed this pregnancy.

Anyway, my boys held on until a day shy of 37 weeks, and were born perfect -- over 7 pounds each, ready to nurse, and so strong they could hold their heads up from the start! If the medication had any negative effects on them, I certainly haven't noticed -- they've crawled/walked/talked early, are happier babies than my first, healthier, and are on their way to being huge (Dillon's shoe size is almost the same as Griffin's).

I sometimes question whether all of the intervention was necessary, but I'm sure prematurity would have been worse on them then the medication, and do feel I made the best decisions I could have at the time. Incidentally, the medications were not so pleasant for me. After a couple of days on the mag sulfate (which I tolerated relatively well) I was reduced to a weepy, teary mess, and the terb made me anxious and shakey.

Good luck. I'm sorry about your positive test. No fun.

* Jaime
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#9 of 22 Old 07-09-2008, 01:00 PM - Thread Starter
 
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I really appreciate all the encouragement. My first priority is the baby so if she needs some help I am open to it. I have heard so many mixed responses so I guess there is never a set plan when this occurs. I am hearing alot from women who got the steroids with just a positive fetal fibronectin test alone. I wonder why my doc is holding out...we'll see
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#10 of 22 Old 07-09-2008, 01:42 PM
 
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I had a baby at 33 weeks and prior to her birth I had both terbutaline and steroid shots. I had a negative FFN with her, but many other complications and ended up with my water breaking. I would do the steroid shots without question, they have very few side effects and I believe they were the single biggest factor in the fact that my tiny 4 pound baby was breathing on her own right from birth. The medications are a longer story and I'm not sure what I would do now faced with the same choices. One thing is that I would have asked about procardia, it is supposed to be more effective but with fewer side effects.

Hope your little one stays put for quite a while!
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#11 of 22 Old 07-09-2008, 02:59 PM
 
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I read up on the fFN test, and it seems that if it's negative, it's more accurate than if it's positive. Basically, if it's negative, you probably won't go into labor within the next two weeks. If it's positive, you MIGHT go into labor and you might not. It just means you're at a higher risk of preterm delivery. Where you've been having symptoms of PTL, obviously they'll want to keep a close eye on you, but less medication is better for you and the baby as far as side effects go. I had some PTL with DD1, and had to take terbutaline to stop contractions. That is some nasty stuff, made my heart race and gave me the shakes. I also got the steroid shots while pg with her, I started dilating (while in the hospital) at 30 weeks and they wanted to give them to me just in case. I don't recall any side effects for myself, and she doesn't seem to have any. If you're not contracting and they keep their fingers out of you, I wouldn't see a need for the steroid shots or anything to stop labor (since you're not IN labor). It turns out I just dilate early, I went to 6cm before being induced via AROM with DD1, and 7 cm before going into labor naturally at 41 weeks with DD2. Personally, I'd tell them no more cervical checks, since it's not a good indicator of when you'll go into labor anyway (as I previously proved for myself).

Mom to DD#1 8/04, nursed 43 months, DD#2 8/06, nursed 21 months and DD#3 9/08, still nursing strong
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#12 of 22 Old 07-10-2008, 02:26 PM
 
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good luck and keep us posted!

just to add another anecdote to the mix... I have two close friends who were hospitalized with PTL over the last two years. both took all the meds possible, including steroids for baby's lungs (twice, in one person's case).

things got under control and normal pregnancies resumed in both cases. one woman delivered on her due date, and the other wound up going almost two weeks overdue! both babies (now children) are amazingly healthy and perfect!
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#13 of 22 Old 07-11-2008, 01:16 AM
 
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I did the steroid shots with this pregnancy. They thought they were going to have to deliver me at 26 weeks because I have almost all of the signs of pre-E (bloodwork comes back okay so it's the only thing stopping them from delivering right now) and had it with my daughter. Instead, they put me on bed rest but I've been dealing with the pre-E and PTL drama too.
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#14 of 22 Old 07-11-2008, 09:22 AM
 
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Ugh Lexi, I can't imagine dealing with bedrest and a child under 1. You poor thing!

Mom to DD#1 8/04, nursed 43 months, DD#2 8/06, nursed 21 months and DD#3 9/08, still nursing strong
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#15 of 22 Old 07-11-2008, 01:40 PM
 
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Good luck!

I have to do the test every 14 days now. I don't really understand why they insist on it, but it's just a swap and not a full vaginal examination so I don't object. I had some preterm labor since early June, late June I had to go to the ER and they gave me Terbutaline which stopped it at least (every 4 minutes, as strong as regular labor). I now have the pills in case they come back, but so far I was lucky.
I talked to my sister in Europe about the test (she's a doctor in research) and she doesn't like it - not really accurate. She is pregnant also so she talked to her obgyn about it and we don't really use that test at all in Europe. We rather resort to ultrasounds of the cervix to measure its length and whether it's opening as predictor for preterm labor. I wonder though if that test is kind of expensive and hence used.... ????
My obgyn did order a cervix ultrasound (takes about 20 seconds to get that measurement) however the ultrasound place claims they dont do that after 30 weeks (why???). Still waiting for a call... Frustrating...
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#16 of 22 Old 07-11-2008, 02:39 PM
 
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Quote:
Originally Posted by nia82 View Post
She is pregnant also so she talked to her obgyn about it and we don't really use that test at all in Europe. We rather resort to ultrasounds of the cervix to measure its length and whether it's opening as predictor for preterm labor. I wonder though if that test is kind of expensive and hence used.... ????
It is very expensive, and I can't really figure out why. My insurance has been billed $740.00 for every fibronectin test, and they only pay $32.40 and I owe nothing. If the test can be done for that much, I don't understand why the lab tries to charge almost 23 times that amount.

My cervix is checked weekly by ultrasound, but we still have the FFN test to help predict preterm labor. My insurance covers 100% of labs (the ONLY good thing about my insurance) and I like the reassurance, so I haven't questioned it. My understanding is that a negative FFN is very reliable, but a positive is not an indicator that labor is necessarily imminent.
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#17 of 22 Old 07-11-2008, 11:06 PM - Thread Starter
 
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I think its so ridiculous because if the test comes back positive, and its not accurate with a positive result then why even do the test?? It makes life a little stressful especially if you don't know what the outcome is going to be. The more I read about this test, the more frustrated I become. Ok, I re-test in one week and then what if its positive again?....they aren't going to give me steroids or bethrine unless I am contracting so really whats the point of me taking this test. Its like I have 5-6 weeks to be slightly paranoid...:
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#18 of 22 Old 07-11-2008, 11:49 PM
 
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HinesMaMa, I can really understand the frustration with your situation. If they're not going to do anything about a positive test, why have them? My peri would give steroids with a positive FFN, so that is different.

Have you asked your healthcare provider why they bother?
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#19 of 22 Old 07-12-2008, 12:47 AM
 
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Most likely they aren't doing anything about the positive result because you aren't having any other symptoms currently. If you had contractions and a positive test, then it sounds like they would start talking about medications.

It does sound a bit frustrating, but it also sounds like they are trying to be cautious and not give you medications you don't need. I hope it doesn't cause you too much stress, and you can always decline the test if you think it best. In my opinion, I think it probably good to have the information just in case, and since it isn't very invasive I would probably keep having the test done.
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#20 of 22 Old 07-12-2008, 06:36 PM - Thread Starter
 
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Did they put you on any type of bedrest in the meantime?

The OB backing the midwives ordered the ultrasound too. I haven't heard back yet from the doc about it, eventhough the tech said it looked good. The bedrest part is killing me because its not real clear cut what I can and can't do....still no contractions. Just alot of pressure and crampiness.


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Originally Posted by nia82 View Post
Good luck!

I have to do the test every 14 days now. I don't really understand why they insist on it, but it's just a swap and not a full vaginal examination so I don't object. I had some preterm labor since early June, late June I had to go to the ER and they gave me Terbutaline which stopped it at least (every 4 minutes, as strong as regular labor). I now have the pills in case they come back, but so far I was lucky.
I talked to my sister in Europe about the test (she's a doctor in research) and she doesn't like it - not really accurate. She is pregnant also so she talked to her obgyn about it and we don't really use that test at all in Europe. We rather resort to ultrasounds of the cervix to measure its length and whether it's opening as predictor for preterm labor. I wonder though if that test is kind of expensive and hence used.... ????
My obgyn did order a cervix ultrasound (takes about 20 seconds to get that measurement) however the ultrasound place claims they dont do that after 30 weeks (why???). Still waiting for a call... Frustrating...
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#21 of 22 Old 07-13-2008, 03:21 AM
 
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Ugh Lexi, I can't imagine dealing with bedrest and a child under 1. You poor thing!
Thanks... it's a huge pain but luckily, my DH is a teacher and is off for the summer.
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#22 of 22 Old 07-15-2008, 12:52 PM
 
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I had a negative ffn at 30 and 32 weeks (I'm almost 34 now). When I went to the hospital at 30 weeks, I was having contractions every 3 min and they gave me a shot of terbutaline and steroids even before the ffn results came back because I was also 70% effaced. The terbutaline did slow down my contractions considerably and made them less intense (they really weren't painful to start with, but afterwards they were barely noticeable and shorter). That seemed to reduce my contractions for about 1.5 weeks and then they were back to usual. But once my test came back negative, they haven't given me terb again. So in my case, if it was positive they'd definitely be giving me more terb and probably require some level of bed rest. At this point they just told me no exercise or sex till 36 weeks.

So it's different than your situation and it sucks that your ffn was positive but it's great that you're not having contractions. If you were, I'm sure they'd be aggressive about stopping them. I know the steroids are *very* safe. I am also fairly comfortable about terbutaline, but I know it doesn't work as well for everyone as it did for me. There are several other drugs they can try if it doesn't help. They did monitor me for a while after the terbutaline and my heartrate was up for maybe 5 min, but it did not appear to affect the baby's heartrate at all. But again, if you're not having contractions, it's not needed.
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