Role Of Vaginal Progesterone In Reducing Preterm Labour In Women With Short Cervix Identified In Mid Trimester Scan - Singleton Vs Twin Gestation: A Prospective Observational Comparative Study

Background Preterm labor, especially in cases of short cervical length, is a major cause of neonatal morbidity and mortality. Vaginal progesterone has been recognized as an effective treatment to reduce preterm labor risk. However, its role in twin gestations needs further exploration. Methods This prospective observational comparative study was conducted at Fernandez Hospital, Hyderabad, from August 2020 to August 2021. Women with singleton and twin pregnancies diagnosed with a short cervix (cervical length <25mm) in the mid-trimester scan were administered vaginal progesterone (200 mg) daily, and their cervical lengths were monitored weekly. Primary outcomes included preterm labor incidence and neonatal outcomes. Results A total of 219 women were enrolled, with 146 in the singleton group and 73 in the twin group. The use of vaginal progesterone significantly reduced preterm births before 34 weeks in the singleton group compared to the twin group. NICU admissions and adverse neonatal outcomes were higher in the twin gestation group. Conclusion Vaginal progesterone is effective in lowering preterm labor risks in women with a short cervix, with better outcomes observed in singleton pregnancies compared to twin gestations.