A positive fetal fibronectin test in late pregnancy indicates risk of preterm birth within 7–14 days; which action is appropriate?

A positive fetal fibronectin test in late pregnancy indicates risk of preterm birth within 7–14 days; which action is appropriate?

• A. Corticosteroid administration and close monitoring or tocolysis per protocol
• B. Immediate delivery is recommended
• C. No action needed
• D. Discharge home

Answer: (A)

A positive fetal fibronectin in late pregnancy signals that preterm birth is likely within a short window, typically 7–14 days, and the fetus may be at risk for complications if delivery occurs now. The goal is to protect the fetal lungs and give time for interventions to be effective, rather than rushing to delivery or sending the patient home. Therefore, the appropriate action is to administer corticosteroids to accelerate fetal lung maturity and to monitor the mother and fetus closely, using tocolysis if indicated by protocol to delay labor and buy time for the steroids to work. This approach aims to improve neonatal outcomes by reducing respiratory complications and allowing for continued assessment and stabilization. Immediate delivery would not be the default response to a positive FFN, since the test indicates risk but not necessarily a need for birth right away. Discharging home would also be inappropriate because the pregnancy is at risk for imminent preterm birth and requires close supervision and possible interventions.

A positive fetal fibronectin in late pregnancy signals that preterm birth is likely within a short window, typically 7–14 days, and the fetus may be at risk for complications if delivery occurs now. The goal is to protect the fetal lungs and give time for interventions to be effective, rather than rushing to delivery or sending the patient home.

Therefore, the appropriate action is to administer corticosteroids to accelerate fetal lung maturity and to monitor the mother and fetus closely, using tocolysis if indicated by protocol to delay labor and buy time for the steroids to work. This approach aims to improve neonatal outcomes by reducing respiratory complications and allowing for continued assessment and stabilization.

Immediate delivery would not be the default response to a positive FFN, since the test indicates risk but not necessarily a need for birth right away. Discharging home would also be inappropriate because the pregnancy is at risk for imminent preterm birth and requires close supervision and possible interventions.