# Targeting Uterine Quiescence: A Multitarget Strategy with Vitamin D, High Molecular Weight Hyaluronic Acid, Magnesium, and Palmitoylethanolamide to Prevent Preterm Birth

## TL;DR

This paper explores using a combination of natural molecules to maintain uterine quiescence and prevent preterm birth.

## Contribution

The novelty lies in proposing a multitarget strategy using vitamin D, hyaluronic acid, magnesium, and palmitoylethanolamide.

## Key findings

- Uterine quiescence is a complex mechanism not fully understood.
- Natural molecules may offer an innovative approach to maintaining uterine quiescence.
- Current tocolytic agents and progesterone have controversial efficacy.

## Abstract

Maintaining a quiescent uterus until labor is of utmost importance for a successful pregnancy and still represents the most challenging issue in clinical practice. Despite the existence of standard approaches (short-term use of tocolytic agents or preventive use of vaginal progesterone), whose efficacy is still controversial, several natural molecules have garnered attention in recent years as an effective therapeutic approach in high-risk pregnancies and beyond. Despite inflammatory activation, premature contractility depends on several factors, since myometrial quiescence is a complex mechanism not fully understood. Therefore, the synergistic activity of different natural molecules could be an innovative approach for acting simultaneously and maintaining uterine quiescence.