Effects of Photobiomodulation Therapy on Pain and Healing of Episiotomies and Grade 2 and 3 Perineal Lacerations After Vaginal Delivery: A Prospective Observational Cohort Study

TL;DR

This study shows that photobiomodulation therapy helps reduce pain and improve healing after childbirth-related perineal injuries.

Contribution

The study introduces photobiomodulation therapy as a novel adjuvant treatment for postpartum perineal healing and pain management.

Findings

PBM significantly reduced pain scores compared to non-PBM-treated patients.

Pain scores decreased significantly after each PBM session over three days.

Preliminary results suggest better healing outcomes in the PBM group based on REEDA scores.

Abstract

Tissue trauma related to operative vaginal delivery or the use of episiotomy has been associated with complications such as pain and infection, and successful management is a key factor in promoting a faster and better recovery after delivery. Strategies that promote analgesia and tissue regeneration are especially relevant in obstetric care. Background/Objectives: To evaluate the effects of photobiomodulation (PBM) on pain and perineal healing in women who underwent episiotomy or sustained second- and third-degree lacerations after vaginal delivery. Methods: Observational cohort study. PBM is routinely offered postpartum as an adjuvant to standard hospital treatment daily throughout hospitalization for postpartum women who underwent episiotomy or second- and third-degree lacerations after vaginal delivery, recruited over a prospective 6-month period. The treatment protocol used an 808 nm laser at 100 mW, applied to five perilesional points at 4 J/cm2 daily during hospitalization. Propensity score matching (PSM) analysis and two-way ANOVA were used to compare subgroups of patients who agreed to receive adjuvant PBM and those who did not, in addition to conventional treatment. Daily pain was assessed using the numerical pain scale (NPS) before and after PBM and conventional treatment, and healing was evaluated using the REEDA scale. Results: Data from 149 PBM-treated women and 34 non-PBM-treated women were analyzed. After PSM matching, a mean difference in NPS scores of 1.6761 (standard error = 0.4379) was observed between the group submitted to two laser sessions and the no-laser group, indicating a statistically significant difference (F = 14.65; Pr = 0.000191). A significant decrease in NPS scores was observed with ANOVA before and after each PBM application (p < 0.05), over the three days of follow-up. Regarding the REEDA scale, the preliminary results indicate a trend toward lower scores (better outcomes) in the laser group, an effect that larger studies could confirm. Conclusions: PBM was associated with improvements in pain reduction and tissue healing.

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