Preterm labour in multiple pregnancy, as with polyhy-dramnios, is attributed to uterine over-distension. Accordingly, there are no specific preventative measures aside from fetal reduction in high-order multiples, as discussed pp. 173-174.
Although hospitalization for bed rest has been practised in the past, there is little evidence to support its use. Indeed, meta-analysis of six randomized controlled trials suggests that bed rest in twins increases the chance of preterm delivery . With the exception of progesterone, prophylactic tocolytics are of no benefit in singletons, and thus it is not surprising that randomized trials similarly report no clear benefit in twins . There was no reduction in preterm birth or related outcomes in the only trial of 17-hydroxyprogesterone caproate in twins .
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.