Effectiveness of Vaginal Magnesium Sulfate on Pain and Labor Duration: A systematic review and meta-analysis.

Abstract

This systematic review and meta-analysis aimed to evaluate the effectiveness of vaginal magnesium sulfate (MgSO₄) administration during labour. A comprehensive search was conducted across six databases up to 30 July 2024, and updated on 13 January 2025, with no restrictions on time, language, or geographical region. The risk of bias was assessed using the RoB 2 tool, and the certainty of evidence was evaluated using GRADEpro. A total of seven randomised controlled trials were included. The meta-analysis demonstrated that topical magnesium sulfate significantly increased cervical dilatation by 2.27 cm (95% confidence interval [CI]: 1.98 to 2.56; P <0.00001) and cervical effacement by 15.3% (95% CI: 7.79 to 22.82; P <0.0001) two hours after administration, compared to control groups. Furthermore, it shortened the active phase of labour by 1.63 hours (95% CI: -2.15 to -1.11; P <0.00001) and reduced reported pain levels. These findings suggest that vaginal magnesium sulfate may be a promising and easily administered intervention, warranting further investigation in clinical practice.