Fetal fibronectin (fFN) is a protein produced during pregnancy and functions as a biological glue, attaching the fetal sac to the uterine lining. During the first trimester and for about half of the second trimester (up to 22 weeks of gestation), fFN is normally present in the cervico-vaginal secretions of pregnant women. In most pregnancies, after 22 weeks, this protein is no longer detected until the end of the last trimester (one to three weeks before labor).

The presence of fFN during weeks 24-34 of a high-risk pregnancy, along with symptoms of labor, suggests that the "glue" may be disintegrating ahead of schedule and alerts doctors to a possibility of preterm delivery.

Fetal Fibronectin (fFN): A Test for Preterm Delivery available at: http://www.marchofdimes.com/professionals/14332_1149.asp

i got my answer from this site: http://www.marchofdimes.com/prematurity/21239_5809.asp

Fetal fibronectin is a protein that acts as a "glue" during pregnancy, attaching the amniotic sac — the fluid-filled membrane that cushions your baby in the uterus — to the lining of the uterus.

Fetal fibronectin is often present in cervical secretions during early pregnancy. Fetal fibronectin also shows up again later in pregnancy, about one to three weeks before labor begins. If the client is being tested for possible preterm labor, the health care provider may test a swab from the woman's cervical canal for the presence of fetal fibronectin. A positive fetal fibronectin test is a clue that the "glue" has been disturbed and the woman is at increased risk of preterm labor.

http://www.ohiohealth.com/bodymayo.cfm?xyzpdqabc=0&id=6&action=detail&ref=4478&hr=Healthy%20Living&topic=Life%20Stages&subtopic=Adult

Fetal Fibronectin (fFN): A Test for Preterm Delivery
The American College of Obstetrics and Gynecology recommends that screening for the presence of fetal fibronectin (fFN) may be useful for some pregnant women with symptoms of preterm labor (1). The presence of fFN in the cervico-vaginal secretions of symptomatic women during weeks 24 through 34 of gestation (5 1/2 to 8 1/2 months) indicates an increased risk of preterm delivery. However, the absence of fFN is a much more reliable predictor, indicating that the pregnancy is likely to continue for at least another two weeks.

The Role of Fetal Fibronectin
Fetal fibronectin (fFN) is a protein produced during pregnancy and functions as a biological glue, attaching the fetal sac to the uterine lining. During the first trimester and for about half of the second trimester (up to 22 weeks of gestation), fFN is normally present in the cervico-vaginal secretions of pregnant women. In most pregnancies, after 22 weeks, this protein is no longer detected until the end of the last trimester (one to three weeks before labor).

The presence of fFN during weeks 24-34 of a high-risk pregnancy, along with symptoms of labor, suggests that the "glue" may be disintegrating ahead of schedule and alerts doctors to a possibility of preterm delivery.

A number of factors are associated with a high risk of preterm delivery. Leading risk factors include a previous preterm birth, multiple pregnancy, an incompetent cervix (a cervix that dilates too early in the pregnancy), uterine abnormalities and amniotic fluid infection. Additional risk factors include vaginal infections and sexually transmitted diseases, maternal smoking and drug abuse, poor nutrition, extremes of maternal weight, and lack of prenatal care. Stress, genetic predisposition and environmental toxins may also contribute to preterm delivery.

The fFN Test
A cotton swab is used to collect samples of cervico-vaginal secretions during a speculum examination (similar to a Pap smear). The analysis of the collected sample usually takes less than 24 hours to complete. The result is either positive (fFN is present) or negative (fFN is not present). The results are valid for up to two weeks from the date of the test.

Recommendations
The greatest value of the fFN test is the high level of reliability of a negative test result. According to ACOG, “Fetal fibronectin testing may be useful in women with symptoms of preterm labor to identify those with negative values and a reduced risk of preterm birth, thereby avoiding unnecessary intervention” (1)

In women with symptoms of preterm labor, a positive fFN result, while less reliable, allows doctors and patients to take preventive measures to delay labor for as long as possible and to consider labor-suppressing (tocolytic) medications.

If the results of fFN negative screening would affect treatment, testing may also be appropriate for women who are asymptomatic, but at high risk of preterm birth. Screening for these women may be done at 24-34 weeks gestation to assist in clinical management (2). In these cases, a negative test result would help prevent unnecessary medical interventions, such as bedrest, prenatal corticosteroids, cervical cerclage, hospitalization and tocolytics.

ACOG currently does not recommend routine fFN screening of pregnant women, as its use has not been shown to be clinically effective in predicting preterm labor in low-risk, asymptomatic pregnancies.

Signs and symptoms of impending preterm labor that the mother should know.:

persistent, dull, low backache
intestinal crampingPersistent uterine contractions for every 20 minutes
Rupture of membranes
vaginal spotting
feeling of pelvic pressure or abdominal tightening
menstrual like cramping (like menstrual period)
increase vaginal discharge
Abdominal cramps with or without diarrhea

Angel mentioned about the danger signs that need immediate medical advice:

• Fever, chills, dizziness, vomiting or a bad headache
• Blurry vision or spots before eyes
• A significant change in baby’s movement

with regards to her smoking.. i (think) she has been doing it not as an outlet for stress but out of HABIT...

yes, perhaps the boyfriend maybe reminding her to stop but views the situation as "picking fight." the scenario may be biased on her POV

I found research regarding intimate partner violence. It was stated there that women with no formal education were more likely to have experienced IPV than women with some education and above. Furthermore, previous history of sexual abuse, alcohol use by male partner and having a partner with other sexual partners were all independently associated with being a target of IPV. In a study by Paterson et al [29] in New Zealand, education was protective against IPV. Lack of education may result in lack of job opportunity or other income earning potential. In a study by Wilson et al [30] in North Carolina in the United States, despite the small sample size, all 25 women seeking care for IPV studied were unemployed.

BMC Womens Health. 2008; 8: 17.
Published online 2008 October 10. doi: 10.1186/1472-6874-8-17. PMCID: PMC2570659

Joseph Ntaganira: jntaganira@yahoo.com; Adamson S Muula: muula@email.unc.edu; Florence Masaisa: kabasius@yahoo.fr; Fidens Dusabeyezu: dfidens@yahoo.fr; Seter Siziya: ssiziya@yahoo.com; Emmanuel Rudatsikira: erudatsikira@llu.edu
Received January 13, 2008; Accepted October 10, 2008.

Women experience contractions throughout pregnancy, and the frequency of contractions increases as the pregnancy progresses. This can make preterm labor particularly difficult to assess.

In fact, 13% of women with preterm labor have minimal symptoms and 10% of women with normal pregnancies have painful contractions. Further, women may misinterpret the signs of pelvic pressure or abdominal cramps as gas pains, intestinal cramps, or constipation.

Signs and symptoms of preterm labour:
• Bad cramps or stomach pains that don’t go away
• Bleeding, trickle or gush of fluid from vagina
• Lower back pain/pressure, or a change in lower backache
• A feeling that the baby is pushing down
• Contractions or change in the number of them
• An increase in the amount of vaginal discharge
• Contractions may feel more regular, do not go away if you move or lie down
Some women may just feel that “something is not right”
They should also need medical advice if they have:
• Fever, chills, dizziness, vomiting or a bad headache
• Blurry vision or spots before eyes
• A significant chane in baby’s movement

Preterm Labour: Signs and symptoms. Available at: http://www.beststart.org/resources/rep_health/pdf/preterm_broch_eng_04.pdf

this are the warning signs we can give her so as she can detect if she's having premature labor

-if she experiences contractions (the feeling of the abdomen tightening like a fist) every 10 minutes or more often.
- if she observes that there are changes in vaginal discharge (leaking fluid or bleeding from her vagina)
- presence of pelvic pressure—the feeling that her baby is pushing down
- she experiences low, dull backache
- she's having cramps that feels like she's having her menstrual period
- she also experiences bdominal cramps with or without diarrhea.

If she experiences any of these then she must;

-Call her health care provider (nurse, doctor or midwife) or go to the hospital right away. (even if she have only one sign.)

- Stop what she was doing. Rest on her left side for one hour.

- Drink 2-3 glasses of water or juice (not coffee or soda).

- remind her that if the symptoms get worse or do not go away after one hour, she has to call her provider again or go to the hospital. If the symptoms get better, relax for the rest of the day.

possible health teachings to the woman is she is experiencing the signs and symptoms:

>The woman should be on bedrest with bathroom priveleges to relieve the pressure of the fetus to the baby.
>Monitor the fetal heart rate and uterine contractions daily.
>TAke the prescribed tocolytic medication on time to maintain constant blood level.
>Avoid activities that could stimulate labor (nipple stimulation).
>Consult primary health care provider on concerns about sexual relations.
>Immediately report/consult to the doctor if there are: ruptured membranes, vaginal bleeding, UTI, pulmunary congestion due to tocolytic drugs use.
>Keep self well hydrated.
>If uterine contractions occur: Telephone health care provider to report incident and ask further care measures.

yes meg.

Signs and Symptoms of Preterm Labor:
• Contractions (your abdomen tightens like a fist) every 10 minutes or more often
• Change in vaginal discharge (leaking fluid or bleeding from your vagina)
• Pelvic pressure—the feeling that your baby is pushing down
• Low, dull backache
• Cramps that feel like your period
• Abdominal cramps with or without diarrhea

What to do?

Call your health care provider (nurse, doctor or midwife) or go to the hospital right away if you think you're having preterm labor, or if you have any of the warning signs. Call even if you have only one sign.
Your health care provider may tell you to:
• Come into the office or go to the hospital for a checkup.
• Stop what you're doing. Rest on your left side for one hour.
• Drink 2-3 glasses of water or juice (not coffee or soda).
If the symptoms get worse or do not go away after one hour, call your provider again or go to the hospital. If the symptoms get better, relax for the rest of the day.


Fetal Fibronectin (fFN): A Test for Preterm Delivery

Fetal fibronectin (fFN) is a protein produced during pregnancy and functions as a biological glue, attaching the fetal sac to the uterine lining. During the first trimester and for about half of the second trimester (up to 22 weeks of gestation), fFN is normally present in the cervico-vaginal secretions of pregnant women. In most pregnancies, after 22 weeks, this protein is no longer detected until the end of the last trimester (one to three weeks before labor). The greatest value of the fFN test is the high level of reliability of a negative test result.

According to American College of Obstetrics and Gynecology, “Fetal fibronectin testing may be useful in women with symptoms of preterm labor to identify those with negative values and a reduced risk of preterm birth, thereby avoiding unnecessary intervention”

In women with symptoms of preterm labor, a positive fFN result, while less reliable, allows doctors and patients to take preventive measures to delay labor for as long as possible and to consider labor-suppressing (tocolytic) medications.

Text References
(1) American College of Obstetricians and Gynecologists. Assessment of Risk Factors for Preterm Birth. ACOG Practice Bulletin, number 31, October 2001.

(2) Iams, J.D. Prediction and Early Detection of Preterm Labor. Obstetrics and Gynecology, volume101, number 2, pages 402-412, February 2003.

for the cause of the fights, everyone has almost the same answer and that is because of the way Martha acts during the course of pregnancy/manage her pregnancy (smoking..)

i agree with jenny and ara's preterm s/sx...

considering that the scenario is tainted with signs of domestic violence, further assessment of the situation would be necessary.

while saying that violence may be the outlet of the boyfriend in releasing his stress, it is still downright WRONG. his partner is preganant for crying out loud did he not think of that?