fetal fibronectin test

oregontrailmom

I got a negative test when I went into L&D with lots of contractions at 24+4.  I'm thrilled about that but how much stock should I put into it.  In your experience, how accurate was the FFN?  Can I count on being safe for the next 2 weeks?  

I do have a lot of history with preterm labor. 

peppercorn16

A negative result is very accurate but a positive result is so-so. The fact that you got a negative result means there's only roughly a 1% chance that your body is preparing for labor. I've only had one (it was negative) so far at 25+3 but I'm now 27+4, still preggo!!

mac-n-cheesy

^^this
A negative result is highly accurate (99%+ that you will not go into labor in the next two weeks) however a positive is only somewhat accurate. I had two: one at around 30w and one at 32w both negative and I'm 35w2d and still pregnant despite 6 episodes of PTL.

PaniaO

^^ but FWIW, Kaiser doesn't even do this test anymore because it's not truly accurate enough to put stock in and is 'mostly academic,' according to my doctors.

mac-n-cheesy

I go to Kaiser and had it done 5 weeks and 3 weeks ago. I live in a major city with half a million people but it's not a "teaching" hospital (no residents or interns) so maybe this is a new thing?
I have a medical background and was highly suspicious of a test that is "reliable if it's negative but not necessarily so if it's positive."

PaniaO

lynem29 said:

I go to Kaiser and had it done 5 weeks and 3 weeks ago. I live in a major city with half a million people but it's not a "teaching" hospital (no residents or interns) so maybe this is a new thing?
I have a medical background and was highly suspicious of a test that is "reliable if it's negative but not necessarily so if it's positive."

Interesting. I also live in a major city--in the Bay Area, CA (500,000 people)--and they said no dice, that they don't do it anymore. It seems like a lot of practices are totally different from place to place. (E.g. I got a cerclage at 23 weeks and I've heard others say their doctors said that was too late in the game... Same with bed rest recommendations. My doctors say it's not effective and dangerous.) ETA: my hospital is a teaching hospital (I've been stuck with residents in L&D, unfortunately!).

imsoexcited915

I've had it done before at my high risk office and came back negative. My OB told me she wouldn't have done it because a zillion things can make it falsely positive including the lubricating jelly they use.

mac-n-cheesy

@PaniaO

PaniaO said:

lynem29 said:

I go to Kaiser and had it done 5 weeks and 3 weeks ago. I live in a major city with half a million people but it's not a "teaching" hospital (no residents or interns) so maybe this is a new thing?
I have a medical background and was highly suspicious of a test that is "reliable if it's negative but not necessarily so if it's positive."

Interesting. I also live in a major city--in the Bay Area, CA (500,000 people)--and they said no dice, that they don't do it anymore. It seems like a lot of practices are totally different from place to place. (E.g. I got a cerclage at 23 weeks and I've heard others say their doctors said that was too late in the game... Same with bed rest recommendations. My doctors say it's not effective and dangerous.) ETA: my hospital is a teaching hospital (I've been stuck with residents in L&D, unfortunately!).

While I am in full support of teaching hospitals, I also worked in an ER charting directly for their residents so I was able to see the difference in a doctor who is just starting out and one who has passed all their boards, completed their residency and has a few years under their belt. While OB/GYN (IMHO) edges put ER medicine in terms of how split decisions effect the overall outcome of a patient more often they are very similar in that they are both very high risk specialities for the M.D./D.O. to commit to.
My personal preference is to only be treated by board-certified doctors because I have 5 years under my belt of directly witnessing the second-guessing of decisions that can occur with residents. I get they have to learn as they go along--and somewhere of course--but it's just not for me.
I feel Kaiser as a whole is not terribly consistent in the implementation of policy across the board in the hospitals--even in he same state. My hospital is at most 175 miles from yours and they have completely different views on the Ffn testing as well as cerclagre placement. At 23 weeks my doctor would not have placed a cerclage--and he's the chief of the OB/GYN dept at my hospital. We've also discussed bed rest (as I am 5'8" am down to 122 lbs @ 36w3d, a high risk patient for multiple reasons--including a serious cord abnormality, borderline oligohydraminos, currently on the cusp of IUGR, HG through my entire pregnancy, 6 out of 8 failed NST's/BPP's, and many 5-10hr stays in L&D to stop contractions caused by PTL from weeks 30-35)....and he still hasn't put me on bed rest. Just instructed my DH to stop playing video games and get me whatever I need when I need it and to take over all of the household maintenance (laundry, cooking, cleaning--all of which were all my responsibilities completely...all the while literally putting the entire nursery together myself and doing all the shopping in prep for our LO). So "modified bed rest I guess??!"
Still haven't gained weight and due to the cord abnormality it gets a bit dicey after 37 weeks without all my other problems so we are trying to make it to this coming Thursday or maybe 38 weeks if I miraculously can hold down fluid and food over the next few days.
I feel like teaching hospitals may be ahead of the curve on some things I also feel it's a gamble on who you get in L&D and having as many issues as I have I'd rather be in the hands of my doctor--since he's the chief whenever the on call in L&D finds out he's taking care of me they tend to be overly thorough (which I appreciate).
Anyways, I wish you the best @PaniaO and i hope you get excellent care the day you and your LO get to finally meet in L&D!!

PaniaO

Thank you for sharing your experience, @lynem29. I agree about the problem of relying on residents and I have reflected on my experiences and concluded that I would like to ask for the on-call doctor next time I find myself dealing with awkward students when serious consequences are on the line. If possible. It's been incredible working with my perinatologist after dealing with relatively incompetent (strong word but seriously..!) residents. And, yes, KP is definitely inconsistent--I know Fresno does fFN testing, for example, but when a nurse there suggested I ask about it, they looked at me sideways here. Thankfully, we are still holding on strong at 26 weeks. Still quite a journey ahead. I wish you the best in overcoming your complications. You're so very close!