Pregnant women with twins and who have a short cervix as well as their babies benefit from a treatment with vaginal progesterone. Vaginal received progesterone reduces the risk of preterm birth and associated neonatal complications and death in pregnant women. Romero et al. came to this conclusion after conducting a meta-analysis of individual patient data.
In the later stage of pregnancy, the cervix thins and shortens in preparation for birth. In some women, the cervix shortens already in the second trimester of pregnancy. The meta-analysis included the results of six studies, encompassing 303 women pregnant with twins, all of whom had a cervical length of 25 mm or less in the mid-trimester. Of these, 159 women received vaginal progesterone and 144 received a placebo or no treatment. Women who received vaginal progesterone were 31 percent less likely to deliver before 33 weeks of pregnancy. Vaginal progesterone also reduced the rate of preterm delivery before 32 weeks and 34 weeks. All results were statistically significant.
Beyond this, infants born to patients who received vaginal progesterone had a 30 percent reduction in the rate of respiratory distress syndrome, the most common complication of prematurity, a 46 percent reduction in the rate of mechanical ventilation, and a 47 percent reduction in the risk of dying in the neonatal period. These results were all statistically significant, as well.
This study was published in Ultrasound in Obstetrics and Gynaecology.
Previous studies have already shown that the natural hormone progesterone inserted in the vagina either as a gel or tablet has decreased the risk for preterm birth associated with a short cervix in women also pregnant with a single foetus.
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