Obstetric gel shortens second stage of labor and prevents perineal trauma in nulliparous women: a randomized controlled trial on labor facilitation

Abstract

Objective: To determine whether the obstetric gel shortens the second stage of labor and exerts a protective effect on the perineum. Method: A total of 251 nulliparous women with singleton low-risk pregnancies in vertex position at term were recruited. A total of 228 eligible women were randomly assigned to Group A, without obstetric gel use, or to Group B, obstetric gel use, i.e., intermittent application into the birth canal during vaginal examinations, starting at the early first stage of labor (prior to 4 cm dilation) and ending with delivery. Results: A total of 183 cases were analyzed. For vaginal deliveries without interventions, such as C-section, vaginal operative procedure or Kristeller maneuver, obstetric gel use significantly shortened the second stage of labor by 26 min (30%) (Ps0.026), and significantly reduced perineal tears (Ps0.024). First stage of labor and total labor duration were also shortened, but not significantly. Results did not show a significant change in secondary outcome parameters, such as intervention rates or maternal and newborn outcomes. No side effects were observed with obstetric gel use. Conclusion: Systematic vaginal application of obstetric gel showed a significant reduction in the second stage of labor and a significant increase in perineal integrity. Future studies should further investigate the effect on

Quantification of friction force reduction induced by obstetric gels

“…Nevertheless, the applied obstetric gels generally reduced the friction force in comparison to distilled water as a reference. The presented procedure thus confirmed the benefit of obstetric gels with respect to childbirth facilitation, which has already been observed in first clinical trials [12].…”

“…Just recently, obstetric gels for labor facilitation in humans have been developed and brought onto the market. In a first randomized controlled study, these obstetric gels significantly shortened the duration of the second stage of labor and significantly reduced the risk for perineal tears in nulliparous women [12].…”

Safety aspects and side-effects of ExEm-gel and foam for uterine cavity distension and tubal patency testing

“…The HEC gel was used as an intra-vaginal contrast agent for sonographic examination of the cervix during pregnancy (O'Brien et al, 2003). Intermittent application of obstetric gel containing HEC and GLY into the birth canal in a randomised-controlled trial showed a significant reduction in the second stage of labour and a significant increase in perineal integrity (Schaub et al, 2008). No side-effects were observed in this study.…”

Searching for Medical Substances Safe for Mother and Child, Facilitating the Delivery of Pain Management and Decreasing Exhaustion—Evaluation of Obstetric Gel by Pregnant Women

“…From a point of view of kinetics, friction forces between the child and the vaginal part of the birth canal are opposing the force of myospasms of the womb and can hinder delivery. Inside the birth canal, obstetric gel is a means of reducing friction (Riener et al, 2009;Schaub et al, 2008;Zhuk & Pekhnyo, 2009). It is worthwhile emphasizing that many pharmacologic means of reducing delivery pains and facilitating the course of delivery exist whose application was abandoned in gynecology and obstetrics as a result of complications they can cause, whereas obstetric gel does not contain active pharmaceutical substances.…”

“…In the present study, the authors examine an obstetric gel containing polyacrylic acid as a bioadhesive agent. A study conducted on use of the gel in Switzerland in 2005 and 2006 on a group of 183 pregnant women reported that its use was closely connected with shortening the second stage of labor and reducing perineal tears (Schaub et al, 2008). Moreover, in the 1950s in Germany and Italy a similar study was performed with the use of a similar substance, hyaluronic acid, in the perineal area in order to reduce abrasions during labor.…”