PREVENTION OF PRETERM BIRTH IN MULTIFETAL GESTATION

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。与单胎妊娠的妇女相比，多胎妊娠妇女面临的风险更大。到目前为止，早产是这些问题中最常见和最重要的，但没有任何干预或方法有助于降低这一风险。近年来，早产的发生率急剧上升，这在很大程度上是由于辅助生殖技术。因此，早产问题在导致围产期发病率和死亡率方面发挥了越来越大的作用。由NICHD赞助的MFMU网络最近完成的试验首次证明了一种治疗方法，可以大幅降低早产高危妇女的早产率，因为她们以前有过自然早产的经历。与接受安慰剂的妇女相比，接受黄体酮治疗的妇女早产减少了35%。考虑到这种显著的益处以及多胎妊娠妇女早产的极高风险，评估黄体酮对多胎妊娠妇女的益处的试验是适当和及时的。这项方案概述了一项随机双盲临床试验，比较双胞胎或三胞胎妊娠妇女每周注射17-羟孕酮己酸酯(17P)和安慰剂的疗效。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Women with multifetal gestation face numerous risks in excess of those faced by women with singleton gestation. Preterm birth is by far the most common and the most significant of these problems, yet no intervention or approach has served to reduce this risk. The prevalence of preterm birth has risen dramatically in recent years, in large part due to Assisted Reproductive Technologies. Consequently, the problem of preterm births has assumed an ever greater role in contributing to perinatal morbidity and mortality. The recently completed trial by the NICHD sponsored MFMU Network has, for the first time, demonstrated a treatment that substantially reduces the rate of preterm birth in women at high risk for preterm delivery because of a prior spontaneous preterm birth. Preterm birth was reduced by 35% among progesterone-treated women when compared with women receiving placebo. Given this dramatic benefit and the extremely high risk of preterm birth in women with multifetal gestation, a trial to evaluate the benefit of progesterone in women with multifetal pregnancy is appropriate and timely. This protocol outlines a randomized double masked clinical trial comparing weekly treatment by injection of 17 alpha-hydroxyprogesterone caproate (17P) with placebo in women with twin or triplet gestation.