Interpretation
The finding of our meta-analysis seems to contradict the previous meta-analysis,12 which was performed to deny the impact of lubricant gel on the duration of second-stage labor. The previous meta-analysis included three RCTs with 512 women for analysis, which also included in our study, and revealed that vaginal application of lubricant gel during labor did not significantly reduce the duration of the second-stage of labor in pregnant women (MD -7.11 minutes, 95% CI -15.60 to 1.38). Our analysis included seven RCTs with 1332 women for analysis, and suggested that pregnant women in obstetric gel group had a shorter duration of the second-stage labor (MD -16.9 minutes, 95%CI -27.03 to -6.78). Compared with previous meta-analysis, we included other four recent RCTs, with the added statistical power of having 892 women, the present meta-analysis suggested that obstetric gel shortened the duration of the second-stage labor. The previous meta-analysis focused only on the effect of gel on the duration of the second-stage labor. Besides this outcome, our meta-analysis also focused on other important outcomes such as perineal trauma, postpartum hemorrhage and Apgar score. Our analysis suggested that use of obstetric gel during vaginal delivery did not increase the risk of postpartum hemorrhage and neonatal asphyxia. In addition, finding from our meta-analysis showed that liquid wax had a positive effect on reducing perineal trauma, which was simple and practical and had no adverse to the women and their newborn.26, 29