ASAPP Pilot Trial: Efficacy of Azithromycin for Short cervix and Amniotic fluid sludge for the Prevention of Preterm birth

Preterm birth — being born too early — is a leading cause of newborn illness and death. One warning sign is a short cervix (the entrance to the uterus) combined with a finding called 'amniotic fluid sludge,' which is a cloud-like substance seen in the amniotic fluid on ultrasound that appears to be associated with infection and early labour. This pilot trial is testing whether an antibiotic called azithromycin can eliminate the sludge and potentially reduce the risk of preterm birth. The study is designed to establish whether a larger, more definitive trial is feasible and to check whether azithromycin removes amniotic fluid sludge as a measurable early outcome. If successful, this research could lead to a treatment that prevents dangerous early deliveries for women with this specific combination of risk factors. You may be eligible if you are pregnant between 13 and 24 weeks of pregnancy with a cervix length of 25 mm or less and amniotic fluid sludge seen on ultrasound, and are not having signs of labour. Women with multiple pregnancies (twins, triplets), major foetal abnormalities, a prior rupture of membranes, suspected infection of the uterus, a known allergy to azithromycin, heart conditions, or significant liver disease are not eligible. The study is run by the University of Melbourne.