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Fetal fibronectin (FFN) is a high-molecular-weight glycoprotein that can be found in fetal connective tissue, placenta, and amniotic fluid. FFN is measurable in cervicovaginal secretions early in pregnancy and at term, but is rarely detectable between 21 and 37 weeks gestation in normal pregnancies that are delivered at term. Its detection during this time period is associated with preterm labor/delivery. Since the symptoms of preterm labor are often vague, an accurate diagnosis of preterm labor is often difficult to make. According to the American College of Obstetrics and Gynecology (ACOG), "Fetal fibronectin testing may be useful in women with symptoms of preterm labor to identify those with negative values and a reduced risk of preterm birth, thereby avoiding unnecessary intervention."*

The following were among the resources reviewed and considered in developing this policy. By reviewing and considering the resources, CareFirst does not in any way endorse the contents thereof nor assume any liability or responsibility in connection therewith. The opinions and conclusions of the authors of these resources are their own, and may or may not be in agreement with those of CareFirst.

American College of Obstetrics and Gynecology (2003). Management of Preterm Labor, ACOG Practice Bulletin Number 43, May 2003.

Blue Cross and Blue Shield Association. (2000, August 18). Fetal Fibronectin Enzyme Immunoassay (Medical Policy 2.04.03). Chicago: Author.

Blue Cross and Blue Shield Association. (1998, November 16). Fetal Fibronectin Enzyme Immunoassay (Medical Policy 2.04.03). Chicago: Author.

Blue Cross and Blue Shield Association. (1997, August). TEC assessment: Fetal Fibronectin Enzyme Immunoassay. Technology Evaluation Center Assessments, 12(16), 1-40.

Goldenberg, R.L., Klebanoff, M., Carey, J.C., MacPherson, C., Leveno, K.J., Moawad, A.H., Sibai, B., Heine, R.P., Ernest, J.M., Dombrowski, M.P., Miodovnik, M., Wapner, R.J., Iams, J.D., Langer, O., O'Sullivan, M.J. & Roberts, J.M. (2000). American Journal of Obstetrics and Gynecology, 183(2), 469-75.

Iams, J.D., Goldenberg, R.L., Mercer, B.M., Moawad, A.H., Meis, P.J., Das, A.F., Caritas, S.N., Miodovnik, M., Menard, M.K., Thurnau, G.R., Dombrowski, M.P. & Roberts, J.H. The preterm prediction study: can low risk women destined for spontaneous preterm birth be identified? American Journal of Obstetrics and Gynecology, 184(4), 652-5.

Lu, G.C., Goldenberg, R.L., Cliver, S.P., Kreaden, U.S., Andrews, W.W. (2001). Vaginal fetal fibronectin levels and spontaneous preterm birth in symptomatic women. Obstetrics and Gynecology, 97(2), 225-8.

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