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Twin pregnancies are associated with substantially higher neonatal morbidity and mortality than are singleton pregnancies, largely because of preterm labor. In a government-funded double-blind trial conducted at U.K. centers specializing in care of women with multiple pregnancies, investigators randomized women with uncomplicated twin pregnancies to daily progesterone gel (90 mg) or placebo gel self-administered vaginally beginning at 24 weeks’ gestation. The primary outcome was delivery or intrauterine death before 34 weeks’ gestation. Each treatment arm had 247 evaluable participants. The authors also performed a meta-analysis of previous trials of progesterone for this indication.
The combined rates of delivery or intrauterine death befor…