Anyone have any positive stories about a +ve fibronectin test for TBM?

[TinkerBellesMum]

(In case you missed it) Last weekend I went into hospital with what I thought were just BH, but as it had been going on for three hours I decided it was best to get them checked out (I've had two premature natural labours at 20 and 31 weeks so this is the plan for this pregnancy). Hospital was happy everything was OK, cervix closed so they sent me into the waiting room to wait for the fibronectin results. It came back positive and a scan revealed baby was in position. I was started on the drugs to stop labour and given steroids. Through the drugs I still got contractions and they increased when they were due (when I was on tablets) or when it run out (when I was on a drip). 48 hours after the tablets were started they withdrew all medication to see what would happen, 48 hours later I was still having contractions at a rate of 3-4 an hour but they weren't doing much so I was allowed home. A week after they were stopped they're still coming at the same frequency, sometimes they're uncomfortable sometimes they're rather painful.

Being me and not just leaving anything on the outside of my knowledge, I wanted to know what fibronectin is. I did some Googling yesterday and found out it is the glue that holds everything to the uterus (basically) in the second trimester there shouldn't be any on the outside of the cervix and in the third only when the baby is due. When it's outside it means that the glue is breaking down, it takes about 3 weeks to break down and as you don't usually know when it first appeared the baby could come anytime in the next three weeks.

I know the drugs for stopping labour do so by relaxing the uterus, so I don't think they're "anti-fibronectin" not sure that's the best description. So now I'm worrying that this baby could be here within the next 10 days and I'm hoping someone on MN has a positive story to help me! Have you had a positive result and went on to carry your baby longer?

[DraculaNeedsArteries]

Hi TBM

I did lurk on your thread last week as I had a pair of 27wkers.

I personally don't know anyone that has had a +ver Feotal fibronectin result personally.

The consultant (a top ranking in teh country for premature stuff; major centre for premature research) I saw in my second pregnancy certainly said that a +ve FF was a very strong indicator if impending labour (a -ve result is less predictive).

You are right - your drugs would have been beta agonists (I suspect) - they are muscle relaxants - stopping the uterus from contracting. BUT it doesn't matter that they have done anything to teh fibronectin. You don't need to repair the fibronectin to keep baby in...there will still be enough for that. AFAIK the fibronectin is used to tell the Drs that the body is (essentially) preparing for labour. So it is an indicator of premature labour not a cause IYSWIM. The contractions were a cause. The meds you had treated the cause (contractions) because the indicator (fibronectin; and contractions in your case) were present. It is not necesary to treat the indicator. An analogy is with a car. If you wanted to stop a car turning a corner you have to turn the wheels. Turning the indicator off will do nothing, and won't change the direction of travel of a car.

I think that what you can say is that your body was planning to boot baby out within 3wks. The meds stopped that...how long for is anyones guess.....

[TinkerBellesMum]

Thanks, that's helpful.

Do you know how related the breaking down of the Fibronectin and contractions are? From what I read it starts to break down and leaks to the other side, which is where they pick it up. Would contractions cause it or do the two happen as the body is getting ready for impending labour?

I think even if I can get past the next week - 10 days I have probably 5 weeks left before my body gets to what it thinks is term, I think this has just confirmed that it doesn't believe in 40 weeks and the 8lb babies I'm predicted to have!

[DraculaNeedsArteries]

Hi TBM,

I have done a bit of research on your behalf and I have to say that I made a small error in my original post.

There is a very very good correlation between a -ve fFN test and no labour. The correlation between +ve fFN test and labour is not as strong.

Looking at Wikipedia (and although I couldn't find hte %'s the raw scientific data supports wiki).

If you have a -ve fFN you have 95% chance of staying pg for at least 2 weeks.
If you have a +ve fFN you have a 60% chance of delivering in the next 2 weeks. Which means that you have a 40% chance of keeping bubs inside for the next 2 weeks.

This makes sense. Because if there is no fFN then your uterus isn't ready to go into labour. The presence of fFN seems to be caused by mechanical damage to the membrane/uterus junction. That may be because of a bump. It may be because contractions have sheared the surfaces and caused them to seperate (I suspect this is the case for you). This in itself isn't a problem, and the body can repair itself pretty well, or cope without (and obviously does in at least 40% of cases).

The papers seem to say that the results are only valid for 2 weeks....so with a +ve test you could have baby tomorrow or you could be sitting waiting for an induction at 42wks (which I appreciate is highly unlikely with your history).

I think that the key message is that if your fFN was -ve you coudl almost gurantee that you were safe for another 2 weeks. With a positive result that is reduced to about 40%.

40% is still significantly better than 100%. I think you just have to sit tight and keep your legs crossed .

That is probably just a rehash of all the googling you have done....but hopefully I have put some perspective on it for you. If I can be of any more help (I have access to some research not available on the web) just shout

[TinkerBellesMum]

Thanks, that is helpful. I'm sure though if I get through another week with not much more happening that I'll only have a month left anyway. I had been hopeful all through that it would be longer than Tink, but knew it wouldn't be much longer, but now I think getting to 31 weeks is going to be an achievement.

[DraculaNeedsArteries]

I think with your history every day should be seen as an acheivment.

I can't imagine how you are feeling...I know how I felt with my second pg - and I knew that my preterm labour was almost certainly due to the fact it was twins, and that there was a very good chance I would go to term with a singleton.

My target was 26+6 (when I delivered). I know how nervous I was getting to this stage.

My next target was 32wks as I knew the respiratory system would be solid

My next target was 33 wks (cos my twin bump was equivalent of a 33wker bumpwhen I delivered; So was this as big as my bump could get before it burst? IYSWIM)

My final target was 37wks..cos then I wouldn't be prem.

37+1 was overdue as far as I was concerned...and 39+5 when I finally delivered was thoroughly overdue. God knows what I woudl have done if I had gone to 42wks....

Remember, with your history, every day is a milestone....every day improves his/her wellbeing no end....

Good Luck...

[TinkerBellesMum]

I've rather disconnected myself from this pregnancy, I've still not convinced myself I am pregnant! So I'm not too worried, I think there's a little part of me that is probably a bit too relaxed about prematurity because it's what I'm used to "ah, she'll be OK, Tink was". My milestones were (before this latest episode):

24 weeks - viable
27 weeks - I seem to remember being told that's one and it's stuck
31 weeks - to match Tink

Then I'd just be grateful for each day inside.

Since all this I've added in every Sunday (start of a new week) and if I get to 31 weeks I will be really happy and call myself term.

I've avoided buying preterm clothes because whilst I know it's going to happen I didn't want to be seen as being negative - plus preterm has different sizes and you don't know what you're going to get or what size they will be when they can wear proper clothes. But last week I bought a lovely little outfit from Tesco in "Early Baby" size because it's up to 7lb and I see that now as thinking positive.

[SnoopDog]

tink,

tis jules here,

i seen your post last week and i offered to help with anything you needed at LWH,

i am so glad you and baby tink are doing ok,

i am sitting with fingers crossed x

[TinkerBellesMum]

Thanks Jules I didn't see the thread until I got home, but it was lovely to read all the messages there. I find it amazing that so many people who I've never even met cared so much.

[DraculaNeedsArteries]

TBH - I hope you don't mind me asking...but just looking at your profile I see that your DDs b=name isn't Tinkerbelle....I'm confused...

[TinkerBellesMum]

When we were thinking about names we had a shortlist and my OH told his mother and grandmother (against my wishes) who (of course, the reason I didn't want them to know) told him all the bad things about the names and what she would be called at school with each name. So I said "OK, if we're worrying about what she'll be called at school we'll ask the kids" so he asked his sons and I asked my brothers kids. All five chose the same name (my choice), my niece though who is deaf and thick as the proverbial (not being mean, she really is) said "I like Tinker Belle the best" "Tinker Belle? Do you mean Isobel? Can you say Isobel" "Yes, Isobel, but I like Tinker Belle the best" so Tinker Belle stuck. She's known by everyone as Tinker Belle, I call her Tink Tink and she refers to herself as "Tint Tint".

[DraculaNeedsArteries]

Thanks for that.

I had always assumed her name was Tinkerbelle - obviously your MN name implies that - and I know you refer to her as Tink on the board.

I was just surprised when I saw your profile.

DD3 is called Bobbie and Bob frequently. That is nothing like her name.

Mad how we choose one name for them and end up calling them another isn't it!

[TinkerBellesMum]

I just felt it was more appropriate to use her nick name on a forum and it's what we know her as anyway.