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Weekly treatment with 17 alpha-hydroxyprogesterone caproate (17P) recently was shown to reduce the rate of recurrent preterm birth in singleton gestations. Now, investigators have evaluated the effect of 17P on preterm birth in women with twin gestations. Women carrying twins were randomly assigned to receive weekly intramuscular injections of 17P (250 mg) or placebo beginning at 16 to 20 weeks’ gestation and continuing through week 34 or until delivery, whichever came first. The women received usual care and were evaluated at each weekly visit for side effects; the primary outcome was delivery or fetal death before 35 completed weeks’ gestation.
Delivery or fetal death before 35 weeks occurred in 41.5% of 325 women treated with 17P and in 3…