title: Prevention of preterm delivery by 17 alpha-hydroxyprogesterone caproate in asymptomatic twin pregnancies with a short cervix: a randomized controlled trial.
abstract: OBJECTIVE
  The objective of the study was to evaluate the use of 17 alpha-hydroxyprogesterone caproate (17P) to reduce preterm delivery in women with a twin pregnancy and short cervix.
  
  
  METHODS
  This open-label, multicenter, randomized controlled trial included women with a twin pregnancy between 24(+0) and 31(+6) weeks of gestation who were asymptomatic and had a cervical length of 25 mm or less measured by routine transvaginal ultrasound. Women were randomized to receive (or not) 500 mg of intramuscular 17P, repeated twice weekly until 36 weeks or preterm delivery. The primary outcome was time from randomization to delivery. Analysis was performed according to the intent-to-treat principle.
  
  
  RESULTS
  The 17P and control groups did not differ significantly for median [interquartile range] time to delivery: 45 (26-62) and 51 (36-66) days, respectively. However, treatment with 17P was associated with a significant increase in the rate of preterm delivery before 32 weeks.
  
  
  CONCLUSIONS
  Twice-weekly injections of 17P did not prolong pregnancy significantly in asymptomatic women with a twin pregnancy and short cervix.
authors: Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Paris, Hopital Bicêtre, Hopital Antoine Béclère, Université Paris Sud, Faculté de Medecine, Paris, France. marie-victoire.senat@bct.aphp.fr
authors: Marie-Victoire
authors: MV
authors: Senat
authors: Raphael
authors: R
authors: Porcher
authors: Norbert
authors: N
authors: Winer
authors: Christophe
authors: C
authors: Vayssière
authors: Philippe
authors: P
authors: Deruelle
authors: Marianne
authors: M
authors: Capelle
authors: Florence
authors: F
authors: Bretelle
authors: Frank
authors: F
authors: Perrotin
authors: Yves
authors: Y
authors: Laurent
authors: Laure
authors: L
authors: Connan
authors: Bruno
authors: B
authors: Langer
authors: Aymeric
authors: A
authors: Mantel
authors: Shohreh
authors: S
authors: Azimi
authors: Patrick
authors: P
authors: Rozenberg
mesh_terms: D000077713:17 alpha-Hydroxyprogesterone Caproate; D000328:Adult; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006908:Hydroxyprogesterones / Q000627:therapeutic use*; D011247:Pregnancy; D059285:Pregnancy, Twin; D047928:Premature Birth / Q000188:drug therapy / Q000517:prevention & control*; D011372:Progestins / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D006908:Hydroxyprogesterones; D011372:Progestins; D000077713:17 alpha-Hydroxyprogesterone Caproate