Vaginal Progesterone and Premature Birth Prevention

Unfortunately, even today Premature Birth is a major cause of perinatal morbidity and mortality. In recent years,

cervicometry

Uterine cervix ultrasound (cervicometry) has made a great contribution in the prevention and treatment of premature labor.

Scientific research has repeatedly proposed therapeutic solutions but Preterm Birth remains a particularly serious threat to babies.

Much effort has been focused on prevention, but certainly the multifactorial nature of this disease has not made it easy: we know that predisposing factors may be different and sometimes concurrent; among these are congenital (malformation) or acquired uterus abnormalities (such as fibroids).

Infections or changes in the amniotic fluid, metabolic and pregnancy hypertensive disorders, multiple pregnancy undoubtedly play an important role.

Sometimes it is impossible to detect a cause and a dramatic cervix expansion (opening) could happen, bringing to a labor at early gestational ages. Of course, we need to know much more about the causes and, in addition, pregnancy endocrine-immunology and mother-fetus relationship must not be neglected.

Certainly, there has been an increase in preterm births and this may be explained by the increasing use of Medically Assisted Reproduction techniques and a higher age of pregnant women.

cervix ultrasound

Cervix ultrasound with a cervicometry less than 2,5 cm can predict a premature birth.

The Cervix Ultrasound morphological study (cervicometry) and in particular of its length, proved to be an excellent tool in prevention and treatment of premature labor. In particular, a shortening of less than or equal to 2.5 cm is highly predictive of a premature labor. In addition, an objective parameter of reference has allowed a better monitoring of the treatment effects.

Talking about therapy, there are more and more convincing results on Progesterone effectiveness linked to minimal side effects, particularly when used vaginally usually at a dose between 200 and 400 mg per day.

Using Progesterone, during pregnancy, is not a new solution. In fact, different formulations were used, for example in threatened abortion, but now using it for premature labor threat is giving more and more effectiveness confirmations.

It is known from physiology and pathophysiology studies how progesterone play an important role in pregnancy and in childbirth determinism. Administration of vaginal Progesterone now seems particularly effective in situations of risk.

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Filiberto Di Prospero
Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism. Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy). Private clinics in Civitanova Marche, Rome and Milan.

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