Vaginal versus Intramuscular Progesterone for Prevention of Preterm Labour in Women with a Twin Pregnancy: a Randomized Controlled Trial

Abstract

Abstract Background Twins constitute 2-4% of all births, and the rate of twining has increased by 76% between 1980 and 2009.Twin pregnancies, compared with singletons, are at increased risk for fetal anomalies, preterm births, aberrant fetal growth, cerebral palsy, and perinatal and infant mortality. Maternal complications associated with twin pregnancies include hypertensive disorders, gestational diabetes, cesarean delivery, postpartum hemorrhage, and maternal mortality. Aim of the Work This study aims to assess the efficacy of vaginal progesterone compared to intramuscular therapy in decreasing the rate of preterm birth in women with twin pregnancy. Patients and Methods Randomized Controlled Trial, women presented to Ain Shams University Maternity Hospital. The study was presented for approval from the ethical committee of the department of Obstetrics and Gynecology, faculty of medicine, Ain Shams University. Informed consent after explaining the study purpose and methods to the subjects. Data presentation will not be by the patient name but by diagnosis. Results There is no statistically significance between the two groups regarding number of neonatal RDS, NICU admission and neonatal death but lower percentage among vaginal progesterone group. Birth weight was significantly higher among vaginal group. NICU stay was significantly higher among intramuscular group. Conclusion Compared with intramuscular 17-OHPC, vaginal progesterone in women with twin pregnancy is associated with lower percentage of preterm labour, less recurrent SPTB, less adverse maternal side effects, fewer NICU admissions, better compliance.