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Lubricant for Reducing Perineal Trauma: A Systematic Review and Meta-analysis of Randomized Controlled Trials
  • +11
  • Qiuyu Yang,
  • Xiao Cao,
  • Shasha Hu,
  • Mingyao Sun,
  • Honghao Lai,
  • Liangying Hou,
  • Qi Wang,
  • Cailiang Wu,
  • Yu Wu,
  • Lin Xiao,
  • Xiaofeng Luo,
  • Jinhui Tian,
  • Long Ge,
  • Lei Shi
Qiuyu Yang
Lanzhou University
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Xiao Cao
Lanzhou University
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Shasha Hu
Lanzhou University First Affiliated Hospital
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Mingyao Sun
Lanzhou University
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Honghao Lai
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Liangying Hou
Lanzhou University
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Qi Wang
Lanzhou University
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Cailiang Wu
Shanghai General Hospital
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Yu Wu
Lanzhou University First Affiliated Hospital
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Lin Xiao
Southern Medical University
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Xiaofeng Luo
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Jinhui Tian
Lanzhou University
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Long Ge
Lanzhou University
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Lei Shi
Southern Medical University
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Abstract

Background Different techniques have been reported to prevent perineal lacerations, but the effects of the use of lubricant have been unclear and is still subject of debate. Objective To assess the effect of lubricants on reducing perineal trauma during vaginal delivery. Search strategy PubMed, Embase, the Cochrane Library, CINAHL, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), WanFang databases, ClinicalTrials.gov in 25 June 2021. Selection criteria Randomized controlled trials published in English or Chinese that compared the vaginal application of lubricant with standard care in women with cephalic presentation at vaginal delivery were included . Data collection and analysis Two independent reviewers selected eligible trials and extracted data on perineal trauma, duration of the second-stage labor, postpartum hemorrhage and Apgar score for meta-analysis. Main results Nineteen trials enrolling 5445 pregnant women were included. Compared with standard care, women using lubricants had a lower incidence of perineal trauma (RR 0.84, 95%CI 0.76 to 0.93), second-degree perineal laceration (RR 0.72, 95%CI 0.64 to 0.82) and episiotomy (RR 0.77, 95%CI 0.62 to 0.96), had a shorter duration of the second-stage labor (MD -13.72 minutes, 95%CI -22.68 to -4.77). Subgroup analysis indicated that women with obstetric gel had a shorter duration of the second-stage (MD -16.9 minutes, 95%CI -27.03 to -6.78 vs MD -8.38 minutes, 95%CI -11.11 to -5.65; P interaction=0.02) when compared with liquid wax. Conclusions Compared with standard care, lubricants could reduce the incidence of perineal trauma, especially second-degree perineal laceration, and shorten the duration of the second-stage labor.

Peer review status:UNDER REVIEW

23 Dec 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
24 Dec 2021Assigned to Editor
24 Dec 2021Submission Checks Completed
14 Jan 2022Reviewer(s) Assigned