Positive actim partus 27+3

[numberonepartyanthem]

Hi looking for other people’s experiences with this please.
Went into triage at 27+3 pregnant with watery discharge in a high volume - was worried I was leaking amniotic fluid.
They swabbed my cevix and confirmed no amniotic fluid was leaking however my cervix while closed looked ‘fragile’ and so they did an Actim Partus swab, which came back a faint positive, so I got admitted.
I had anecdotal reassurance from some midwives on the ward that it can be a false positive caused by thrush, but they wanted to give me 2 steroid jabs 12 hours apart to protect babies lungs if they did make a quick appearance. They also monitored for contractions which was I am not having.

I then got left for hours tbh and no clear plan was given, I decided I wanted to go home, as my gut was telling me labour isn’t near no pain or contractions and declined the steroids for babies lungs (increased risk of autism and adhd, just felt it wasn’t necessary please don’t berate me for this my personal choice for my child, I have all jabs and it’s the first time in my life I’ve declined an intervention based on my own thorough research).

any previous experiences with testing positive for actim partus and what went on to happen?

thank you

Honestly that all sounds a bit unusual - actim partus when you haven’t got any signs of labour (ie contractions), “fragile” cervix also a weird way to describe - did they think it was shortening? Did they do a cervix length scan? And did they say you have thrush to cause that swab result?

faint positive AP with no symptoms of labour, no risk factors, and without a short cervix is probably nearly meaningless… even in women with symptoms suggestive of labour it isn’t a good predictor, only around 20% with positive test will actually deliver <34 weeks.

From your description it sounds like declining the steroids is really reasonable, would just also have a really low threshold to go in for another check if you still feel like you’re leaking fluid, or if you feel like contractions are starting.

I do want to address though, steroids causing ADHD/autism is not based on any conclusive evidence so would just caution anyone reading as I don’t want people to be scared off steroids when they’re really justified. Like any treatment they can have their benefits and risks. There’s some evidence to say that if you have steroids preterm and then actually deliver at full term there might be slight differences in neurodevelopment in some kids, and studies are trying to clarify this, as well as assess really carefully for any other risks. On the flip side if you have steroids preterm and you then deliver preterm, esp extremely preterm, they are literally lifesaving - essentially half the risk of death and severe complications vs no steroids. So they’re really valuable when needed - it’s just that your doctors should be thinking carefully who to give them to and should be able to clearly explain to you why they think steroids are needed.

Thank you for coming back to me. I have asked for my hospital notes from my community midwife so I can see what the term ‘fragile’ means in real terms. As ‘fragile’ is not a helpful way to describe it at all. They didn’t do a cervix length scan. They said the thrush ‘may’ have caused the result but no way to know for sure which wasn’t helpful at all. It all felt very anecdotal and nothing concrete and as a result hasn’t put my mind at ease at all and any minor twinge is making me panic.

Either way it was a really scary day.

I agree with all your comments about steroids and did my thorough research before making the decision.

especially agreeing in some cases the steroids are life saving for preterm babies. Thank you for being so clear and keeping the facts here

Midwife has come back to say my cervix is closed with little ectropian

Now 28+1 baby still cooking

Currently 31 weeks and 5 days and still pregnant no signs he will come any time soon