PREVENTION OF PRETERM BIRTH IN MULTIFETAL GESTATION

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。多胎妊娠妇女面临的风险超过单胎妊娠妇女面临的风险。早产是迄今为止最常见和最重要的这些问题，但没有干预或方法来减少这种风险。近年来，早产的流行率急剧上升，这在很大程度上是由于辅助生殖技术。因此，早产问题在造成围产期发病率和死亡率方面发挥了越来越大的作用。最近由NICHD赞助的MFMU网络完成的试验首次证明了一种治疗方法，该治疗方法可大幅降低因先前自发性早产而具有早产高风险的妇女的早产率。与接受安慰剂的妇女相比，接受炔雌醇治疗的妇女早产率降低了35%。考虑到这种巨大的益处和多胎妊娠妇女早产的极高风险，评估孕酮在多胎妊娠妇女中的益处的试验是适当和及时的。该方案概述了一项随机双盲临床试验，比较了双胎或三胎妊娠妇女每周注射17 α-羟孕酮己酸酯（17 P）与安慰剂的治疗。

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.