A positive fetal fibronectin test in late pregnancy indicates risk of preterm birth within what timeframe, and what are the management implications?

• A. Within 1–3 days; requires immediate delivery
• B. Within 24–48 hours; immediate delivery
• C. No risk and no action needed
• D. Within 7–14 days; may prompt corticosteroids and close monitoring or tocolysis per protocol

Answer: (D)

Fetal fibronectin in the cervicovaginal secretions late in pregnancy signals that the placenta–uterine lining connection may be weakening, so there is an elevated risk of preterm birth in the near future. A positive result specifically points to delivery being likely within about 7–14 days. Because of that shorter window, management aims to prepare for possible preterm birth rather than rushing to delivery. This includes providing interventions that can buy time and protect the baby: administering corticosteroids to accelerate lung maturity if a preterm birth is plausible within days, and using tocolysis per protocol to delay labor when no contraindications exist. Close maternal–fetal monitoring, reassessment, and ensuring NICU readiness are also part of the plan. A negative fFN, by contrast, suggests low short-term risk and supports expectant management.