Ask any obstetrician in this country: What is the most challenging clinical problem we face in pregnancy? The answer would most likely be premature birth.
The exact mechanism as to why preterm labor occurs has not yet been fully understood. Yes, there are risk factors such as infection, uterine anomalies, cervical lesions and multifetal gestation. But in many cases, these risk factors are not present.
Premature birth is the leading cause of death and illness among newborns. Nearly 13 million babies are born premature worldwide, with 500,000 in the United States alone.
A new study indicates that a daily dose of a hormone gel could reduce premature births by half among women with high-risk pregnancies.
The treatment, a progesterone gel that is inserted vaginally every day during the second half of pregnancy, is designed for women with short cervices, which can soften too early and lead to preterm delivery.
Dr. Roberto Romero, chief of the perinatology research branch at the National Institutes of Health, estimates that as many as 2 percent of the nation's annual preterm births - approximately 10,000 a year - could be prevented if all pregnant women are screened for short cervices. This measure would save the U.S. about $12 million a year in health care costs.
I think this particular study is of great value because it focuses on utilizing early ultrasound screening to identify women where the cervix is getting shorter. This is an important step in identifying high-risk pregnancies. It also uses progesterone, which is a very inexpensive and non-harmful substance to prevent women from developing premature contractions.
The study continues to corroborate existing evidence that antenatal surveillance, along with the utilization of progesterone, is an effective way to decrease the incidence of premature deliveries.