Antenatal Azithromycin to Prevent Preterm Birth in Pregnant women with Vaginal Cerclage. A Randomized Controlled Trial

Abstract

reterm birth is the main cause of perinatal morbidity and mortality around the world. Risk factors for preterm labour include premature rupture of membranes, short cervix, infection, previous preterm labour, multiple pregnancy, maternal age > 35 years, African American descent, and smoking. There is enough evidence to support the pathophysiological mechanism that microorganisms from the lower genital tract could cross the cervical canal and reach the decidua, especially when the cervix is shortened. It was observed that patients with preterm birth before 34 weeks have higher concentrations of interleukin 6 and white blood cells amniotic fluid, supporting the role of inflammation in the genesis of preterm labor and preterm birth. The clinical expression of amniotic inflammation is more common than proven by biochemical methods in patients with preterm labor and intact membranes; and one possibility is that these patients suffer some degree of amniotic inflammation and even infection that cannot be proven by current methods.