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.
Regarding Delayed versus immediate pushing in the second stage of labor in women with neuraxial analgesia: a systematic review and meta-analysis of randomized controlled trials.
