Effect of lubricant gel on the length of the first stage of labor and perineal trauma in primiparous women: A Randomized Controlled Trial

Introduction:Perineal injuries are caused following natural vaginal delivery. These injuries have short and long term complications. Episiotomy in the short term causes the complications. Researchers are looking for strategies to reduce the use of episiotomy. According to new investigations, the usefulness of episiotomy has been obscured.Aim: To evaluate the effect of using of lubricant gel on the length of the first stage of labor and perineal trauma in primiparous women.Materials and Methods:This study was a randomized controlled trial that includes all primiparous women who were referred to Iranshahr Iran hospital for normal delivery from March 2016 to February 2017. A total of 110 primiparous women were randomly assigned to the two groups of using lubricant gel and control group. In the intervention group, during cervical dilatation of 4 cm until complete cervical dilatation, 5 ml of water-soluble lubricant gel was used at each vaginal examination. In the control group, routine care was performed. Results: The mean length of the first (P=0.012(and second) P=0.022(stage of labor were significantly different between intervention and control groups. In the present study, the total length of delivery stages was significantly different in the lubricant gel and control groups (P=0.025(. In the intervention group, the frequency of healthy perineum was 61.8 %( n=34) and perineal trauma was 38.2%(n=21) and in the control group, these values were 14.5%(n=8) and 85.5%(n=47), respectively. Two patients in the intervention group and 3in the control group had grade II perineal tears. In the control group, only 5 cases of grade III perineal tears were reported, but no cases of grade 4 perineal tear were reported in both the groups. Conclusion: It seems that using lubricant gel during the first phase of the active phase of labor is a suitable strategy to reduce the length of the first stage of labor, the number of episiotomy and perineal trauma.

Keywords:

Lubricant gel , Delivery length , Perineal trauma , Primiparous