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Fetal fibronectin, cervicovaginal secretions, semi-quantitative

CPT4 code

Name of the Procedure:

Fetal Fibronectin Test, Cervicovaginal Secretions, Semi-Quantitative

Summary

The fetal fibronectin test is a prenatal procedure used to measure the presence of fetal fibronectin — a protein that's typically found between the fetal membranes and the mother's uterine lining. The presence of this protein in cervical and vaginal secretions can indicate an increased risk of preterm labor.

Purpose

The fetal fibronectin test is primarily used to assess the risk of preterm birth in pregnant women. By detecting fetal fibronectin, healthcare providers can determine the likelihood of the mother going into labor prematurely and take necessary precautions to manage or prevent preterm birth.

Indications

  • Pregnant women experiencing symptoms of preterm labor, such as uterine contractions or cervical dilation.
  • Women with a history of preterm birth.
  • Twin or multiple pregnancies, which are at higher risk for preterm labor.
  • Any conditions or anomalies noted during routine prenatal check-ups that could indicate risk of early labor.

Preparation

  • Patients are usually advised not to engage in sexual intercourse, use douches, or insert anything into the vagina for at least 24 hours before the test.
  • No fasting or special diets are required.
  • Routine prenatal assessments and physical examinations will be performed.

Procedure Description

  1. The patient lies on an examination table as a standard pelvic exam is performed.
  2. A sterile speculum is inserted into the vagina to allow for visibility and access to the cervix.
  3. A small swab is gently used to collect a sample of cervical and vaginal secretions.
  4. The swab is then placed in a designated tube and sent to a lab for analysis.
  5. The semi-quantitative test measures the levels of fetal fibronectin in the sample to determine the risk of preterm labor.

Duration

The procedure typically takes about 10 to 15 minutes.

Setting

The test is usually performed in an outpatient clinic or a hospital setting, such as a prenatal care center or an obstetrician's office.

Personnel

The procedure is usually conducted by an obstetrician or a trained nurse specializing in prenatal care.

Risks and Complications

  • Mild discomfort or pressure during the collection of the sample.
  • Rarely, light spotting or irritation may occur post-procedure.
  • False positives or false negatives are possible, leading to unnecessary concern or false reassurance.

Benefits

  • Early detection and management of preterm labor risk.
  • Allows healthcare providers to initiate preventive measures, such as administering medications to delay labor or enhancing fetal lung maturity.
  • Provides reassurance to mothers at risk when results are negative.

Recovery

  • The patient can resume normal activities immediately after the procedure.
  • No specific post-procedure care is required.
  • Follow-up appointments as per the healthcare provider’s schedule.

Alternatives

  • Regular monitoring through routine prenatal visits and ultrasound scans.
  • Cervical length measurement via transvaginal ultrasound.
  • Each alternative has its own pros and cons and should be discussed with a healthcare provider.

Patient Experience

  • The patient may feel mild discomfort or pressure similar to a routine pelvic exam.
  • Pain is minimal, and no anesthesia is required.
  • The procedure is quick, and the patient can continue with their daily activities immediately afterward.

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