Premature hope
December 15, 2011
PERFORMING a cervical
ultrasound in all pregnant women
and treating those with a short
cervix with vaginal progesterone
reduces the rate of preterm birth
and neonatal complications,
according to a new study
published in the American Journal
of Obstetrics & Gynecology.
Based on the analysis of all
randomised clinical trials of vaginal
progesterone conducted
worldwide, the study concluded
that the vaginal application of
progesterone reduces the rate of
preterm birth in women at less
than 33 weeks of gestation, but
also is effective at less than 28, 32
and 35 weeks meaning that the
application reduces both “early”
and “late” preterm births.
The study also found that vaginal
progesterone administration to
women with a short cervix reduced
the rate of: admission to the
newborn intensive care unit;
respiratory distress syndrome; the
need for mechanical ventilation;
and a composite score of
complications that included
intracranial hemorrhage, bowel
problems, respiratory difficulties,
infection and death.
In addition the study showed that
vaginal progesterone is effective in
reducing the rate of neonatal
complications in twin gestations.
“Despite decades of clinical and
basic research, there has not been
much progress in the prevention of
premature birth,” said a statement
from the researchers.
“The most significant advance to
prevent preterm birth consists of a
two-pronged strategy in which all
pregnant women undergo a
measurement of the cervical
length, and those with a short cervix
(at risk for preterm birth) would be
treated with vaginal progesterone,”
the researchers added.
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