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

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.