The utility of fetal fibronectin in the prediction and prevention of spontaneous preterm birth.

Spontaneous preterm birth remains a significant problem in the United States despite intense research to decrease its prevalence. Strategies have been limited by inability to identify patients at risk for preterm birth, as the majority of patients do not have historical risk factors. The development of an assay to detect vaginal fetal fibronectin, along with the use of transvaginal ultrasonography to determine cervical length, has greatly increased our ability to identify those patients at highest risk. This article reviews the most significant studies on this topic, providing a context for suggested management algorithms for both symptomatic and asymptomatic patients at risk for spontaneous preterm birth.