"Is it necessary to use a speculum for the fetal fibronectin test or can you use a 'blind sweep'?"

The manufacturer of the fFn test recommends that during a speculum examination  the sterile polyester tipped swab provided with the kit should be lightly rotate across the posterior fornix of the vagina for approximately 10 seconds  to absorb cervicovaginal secretions [1]. However, Stafford and coworkers found excellent agreement between fetal fibronectin results obtained by speculum and two nonspeculum collection methods [2].

The first method involved "placing the index finger through the vaginal opening and depressing the posterior vaginal wall and sliding the polyester swab along the fingers until resistance was met and the posterior fornix was reached. The swab was left in place for 10 seconds, removed, and placed in the holding medium."

The second nonspeculum method involved "blind swabbing" accomplished by first separating the labia, then inserting the polyester swab toward the posterior fornix for 30 seconds without guidance along an intravaginal finger as with the first method above.