Two cycles of Atosiban in preventing preterm birth in twin pregnancies

Twin gestation contributes significantly to perinatal morbidity and mortality related to high occurrence of preterm birth. We evaluated 202 women consecutively selected with twin pregnancies and threatened preterm labor. 98 women were threatened with a single cycle of Atosiban; 34% of them delivered before 34 weeks. The study group consisted of 104 patients submitted to a second cycle of Atosiban because of regular uterine contractions and or cervical length modifications occurred from 48 hours to 7 days and gestational age was prior to 32 week of gestation (group A). After the second cycle of Atosiban, 49 out of 104 patients received a treatment with a vaginal tablet of lactoferrin (group B). After the second cycle of Atosiban, 84% of patients of group A and 90% of patients of group B delivered after 34 weeks. The overall rate of delivery before 34 weeks in the studies groups was of 16%. In our experience, repeated cycles of Atosiban have shown effectiveness in delaying delivery in twin pregnancies. It seems logical to use an oxytocin receptor antagonist as first line drugs in twin pregnancies because of the increased risk of pulmonary edema.