Q: I'm 33 years old and just found out that I'm pregnant with my second child. I'm elated but also slightly concerned because I delivered my first child prematurely. Does my history put me at an increased risk of delivering a preemie? If so, are there any steps that I can take to know what my chances are?
A: Congratulations on your pregnancy. Believe it or not, you're already a step ahead of other women when it comes to knowing the risks of preterm birth. You are correct--the fact that you delivered a preemie in the past does put you at an increased risk to deliver prematurely during this pregnancy. In fact, the three biggest risk factors of preterm birth include women with a history of a previous preterm birth, multiple gestations, and women with certain cervical/uterine abnormalities.
Knowing that you're at an increased risk allows your physician to employ additional measures to encourage the best outcomes. Specifically, there is an FDA-approved, noninvasive test that detects the likelihood that you will deliver prematurely. FullTerm, The Fetal Fibronectin Test, detects the presence of fetal fibronectin (a glue-like substance) in the vaginal canal. This test is similar to a pap-test and is performed between weeks 22 and 35 of pregnancy. During this time this substance should be nearly undetectable in women whose pregnancy will continue for another two weeks or longer. Women like you who are at high-risk for delivering prematurely, as well as women who present with symptoms of preterm labor, are potential candidates for this test.
A negative test result provides 99 percent reassurance that delivery will not occur within the next 14 days. This helps to prevent over-treatment with drugs and various other medical interventions such as bed rest or hospital admission. Women can feel reassured and comfortable in continuing their normal routines, such as working, traveling, caring for other children, and socializing with friends and family.
A positive result is a strong independent predictor of preterm birth at less than 32 weeks. This information can help physicians delay or possibly prevent a preterm birth through the use of medications, bed rest, and other medical interventions. Women for whom preterm birth is inevitable benefit from the early warning, which allows them to travel closer to a hospital with specialized services for premature babies.
To learn more about FullTerm, The Fetal Fibronectin Test please visit Fullterm.net.
Dr. Andrei Rebarber is a board-certified Maternal Fetal Medicine Specialist and serves as the President, Maternal Fetal Medicine Associates President, Carnegie Hill Imaging, Director of Maternal Fetal Medicine at Valley Hospital in Ridgewood, NJ, and an Associate Professor of Maternal Fetal Medicine at Mount Sinai School of Medicine in New York, N.Y.
