A randomized controlled trial of two-doses of vaginal progesterone 400 vs. 200mg for prevention of preterm labor in twin gestations.

Abstract

To compare between the effectiveness and safety of two different daily doses of vaginal progesterone (400 vs. 200mg) in the prevention of preterm labor in twin pregnancy. This is a prospective single-blinded randomized controlled trial conducted on 100 primi-gravida who had twin pregnancy and attended the antenatal clinic of a University hospital. They were equally and randomly allocated into two arms each containing 50 patients. Arm 1 received 400mg and arm 2 received 200mg vaginal progesterone daily at bed time starting from 14weeks of pregnancy to 36weeks. Transvaginal ultrasound was performed for assessment of the length of cervix at 14 and 22weeks. Both arms of the current study were comparable regarding the cervical length at 14 and 22weeks, mean gestational age at delivery, incidence of pre-term delivery, birth weight of the first twin. Second twin in addition to the average weight of both twins. No statistical significance differences between two arms regarding incidence of early neonatal death. NICU, mechanical ventilation, length of admission in NICU for the first twin. Second twin as well as both twins. Vaginal progesterone treatment with different doses was tolerable, but wasn't effective in the prevention of preterm labor in twin pregnancy.