Published in:
01-01-2016 | Maternal-Fetal Medicine
RETRACTED ARTICLE: Vaginal progesterone for prevention of
preterm labor in asymptomatic twin pregnancies with sonographic short cervix: a
randomized clinical trial of efficacy and safety
Authors:
Waleed El-refaie, Mohamed S. Abdelhafez, Ahmed Badawy
Published in:
Archives of Gynecology and Obstetrics
|
Issue 1/2016
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Abstract
Purpose
To evaluate the value of vaginal progesterone therapy for reduction
of preterm labor in asymptomatic women with twin pregnancies and sonographic short
cervix.
Methods
This randomized controlled study was conducted in Mansoura
University Hospital and private practice settings in Mansoura, Egypt. Of 322 women
with dichorionic twin pregnancy, 250 asymptomatic women with cervical length of
20–25 mm at 20–24 weeks of gestation were included in the study. All women were
randomly divided into two groups; the study group (n = 125) received vaginal progesterone suppositories in a dose of
400 mg daily starting at 20–24 weeks of gestation while the control group
(n = 125) received no treatment. The primary
outcome measure was preterm labor before 34 weeks of gestation and the secondary
outcome measures were neonatal respiratory distress syndrome (RDS) and early
neonatal death (END).
Results
224 women (116 in the study group and 108 in the control group) were
subjected to final analysis. The duration of pregnancy was significantly longer in
the study group and the incidence of preterm labor before 34 and 32 weeks of
gestation was significantly lower in the study group. The neonatal morbidities and
mortality were significantly lower in the study group as shown by lower incidence
of very low (<1500 gm) birth weight, neonatal RDS, the need for mechanical
ventilation and END.
Conclusions
Vaginal progesterone administration in asymptomatic twin pregnancies
with sonographic short cervix (20–25 mm) at 20–24 weeks of gestation is effective
and safe treatment for reducing the incidence of preterm labor with subsequent
reduction in the neonatal morbidities and mortality associated with preterm
birth.