Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women’s individual requirements, to strengthen obstetricians’ knowledge in guiding decision-making for women in childbirth.

Background: Cesarean section (CS) frequently results in abdominal scarring, affecting recovery, aesthetics, and quality of life. Platelet-rich plasma (PRP), an autologous concentrate rich in growth factors, may enhance wound healing. This pilot trial assessed the effect of intraoperative PRP on CS scar outcomes. Methods: In this single-center, single-blind randomized controlled trial (February 2023–December 2024), 100 women undergoing elective CS were randomized to PRP treatment (n = 50) or standard care (n = 50). PRP, prepared from 20 mL autologous blood, was infiltrated into uterine incision margins and subcutaneously before skin closure. Scar healing was evaluated at day 7 and day 40 postpartum using the Patient and Observer Scar Assessment Scale (POSAS; physician and patient), Vancouver Scar Scale, Manchester Scar Scale, REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) Scale, Visual Analog Scale (VAS), and Numeric Rating Scale (NRS). Mann–Whitney U tests and Cohen’s d effect sizes were calculated. Results: Follow-up was complete for all participants. On day 7, PRP-treated patients had lower mean scores across most scales (e.g., Vancouver: 1.74 ± 1.58 vs. 2.54 ± 2.30; p = 0.063). At day 40, improvements persisted, with POSAS Patient scores significantly lower in the PRP group (7.24 ± 1.81 vs. 8.00 ± 2.06; p = 0.029). Effect sizes were small-to-moderate (<0.5), suggesting underpowering. No adverse events occurred. Conclusions: PRP administration during CS showed favorable trends toward improved scar quality and reduced patient-reported discomfort, with statistical significance for POSAS Patient scores at 40 days. Larger, multicenter trials with extended follow-up are needed to confirm these findings.

Background: Episiotomy-related morbidity remains a substantial challenge in postpartum recovery, often affecting maternal quality of life. Given the crucial role of local microbiota and wound environment in perineal healing, intravaginal lactic acid gel emerges as a promising adjunctive therapy. Objective: To evaluate the effectiveness and safety of intravaginal lactic acid gel (Canesbalance^®, Bayer) in enhancing scar healing and reducing pain following mediolateral episiotomy. Methods: In this single-center randomized controlled trial, 100 postpartum women with mediolateral episiotomy were allocated to either a treatment group receiving intravaginal lactic acid gel (Canesbalance^®, Bayer) or a standard care group. Scar healing was assessed at 7 and 40 days postpartum using POSAS, VAS, and NRS scores; hematological parameters were also monitored. Results: The lactic acid gel group demonstrated significantly greater reductions in scar severity and pain scores over time (p < 0.05), with no adverse hematological effects. Effect sizes (Cohen’s d) were moderate to high for scar healing (d = 0.76) and pain reduction (VAS: d = 0.83; NRS: d = 0.79), indicating clinical relevance beyond statistical significance. Conclusions: Intravaginal application of lactic acid gel may offer a safe and effective strategy to enhance perineal wound healing and pain relief after episiotomy. Further large-scale studies are warranted to validate these promising findings and explore underlying mechanisms.

Episiotomy is a common obstetric intervention aimed at facilitating childbirth and reducing severe perineal trauma. Lactic acid, a naturally occurring alpha-hydroxy acid (AHA), has emerged as a promising alternative to conventional wound-care methods due to its antimicrobial, anti-inflammatory, and regenerative properties. Objective: This systematic review evaluates the effectiveness of lactic acid in episiotomy wound healing compared to conventional wound-care methods, focusing on healing time, infection rates, and patient-reported outcomes. Methods: A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, and Scopus using the keywords “lactic acid”, “episiotomy wound healing”, “perineal wound care”, and “infection prevention”. Inclusion criteria covered randomized controlled trials (RCTs), observational studies, and systematic reviews. The Cochrane Risk of Bias 2 (RoB 2) tool and the Newcastle–Ottawa Scale were used for quality assessment. Results: Eight studies met the inclusion criteria. Lactic acid-treated wounds demonstrated 30% faster healing rates, 50% lower infection rates, and reduced pain scores compared with standard wound-care methods (e.g., povidone-iodine or saline). A meta-analysis of five RCTs found a significant reduction in post-episiotomy infections (RR = 0.68, 95% CI: 0.52–0.85). Conclusions: Lactic acid shows promise in episiotomy wound care by improving healing outcomes and reducing infection and discomfort. However, further large-scale RCTs are needed to confirm its safety and long-term efficacy.

Background and Objectives: Adolescent pregnancy remains a major global public-health concern, particularly in low- and middle-income countries. Romania consistently reports the highest teenage birth rate in the European Union, with pronounced regional disparities. This study aimed to assess the incidence, sociodemographic predictors, and obstetric outcomes of adolescent pregnancies over a ten-year period in southeastern Romania. Materials and Methods: A retrospective, population-based study was conducted at the Clinical County Hospital “Saint Andrew the Apostle”, Constanța, from 1 January 2014 to 31 December 2023. All deliveries involving mothers aged ≤19 years were identified from institutional databases. Demographic variables (age, residence, education) and obstetric outcomes (mode of delivery, gestational age, neonatal parameters) were analyzed. Statistical tests included Pearson’s χ², t-tests or Mann–Whitney U tests, and multivariate logistic regression to identify independent predictors of cesarean delivery and preterm birth. Results: Among 13,416 hospital deliveries, 1640 (12.2%) involved adolescent mothers (mean age 16.3 ± 1.4 years). Most originated from rural areas (64.6%) and had only primary education (42.8%). Cesarean section was performed in 58.3% of cases—significantly higher among rural (61.2%) and low-education (62.4%) groups (p < 0.05). The leading indications were cervical dystocia (19.2%) and cephalopelvic disproportion (16.9%). Preterm birth occurred in 30.5% and low birth weight in 27.1% of neonates. Multivariate analysis identified primiparity (OR 2.10; 95% CI 1.45–3.05; p < 0.001) and low education (OR 1.56; 95% CI 1.09–2.21; p = 0.015) as independent predictors of cesarean delivery, while rural residence and low education predicted prematurity (OR 1.84; 95% CI 1.12–3.02; p = 0.016). Conclusions: Adolescent pregnancy in southeastern Romania remains a persistent public-health challenge concentrated among rural and low-education populations. These patterns are consistent with previously described vulnerabilities in adolescent populations, including developmental and healthcare-access challenges, although such factors were not directly measured in this study. Community-based prevention, comprehensive sexual education, and adolescent-friendly obstetric pathways are urgently needed to reduce the burden of teenage pregnancy in Eastern Europe. These associations should be interpreted with caution, as the retrospective design precludes causal inference.

Background: Cesarean delivery is a frequent surgical procedure associated with postoperative scarring, which may impact both the aesthetic and functional recovery of patients. Platelet-rich plasma (PRP), a concentration of autologous platelets containing bioactive growth factors, has shown promising effects in promoting wound healing and tissue regeneration. However, its efficacy in enhancing cesarean wound healing remains underexplored. Methods: This single-arm prospective observational study included 50 patients undergoing cesarean section who received intraoperative PRP in two stages: 5 mL applied before hysterorrhaphy and 5 mL injected subcutaneously before skin closure. Scars were assessed at 7 and 40 days using six validated scales (Manchester, Patient and Observer Scar Assessment Scale (POSAS), Vancouver, Visual Analog Scale (VAS), Numeric Rating Scale (NRS), and REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation). Hematological parameters (hemoglobin, hematocrit, leukocyte count, and platelet count) were monitored to correlate systemic inflammatory response and healing progression. Statistical analysis included the Wilcoxon signed-rank test and Pearson correlation. Results: Mean scar scores improved significantly from 8.88 ± 2.13 at day 7 to 6.46 ± 1.23 at day 40 (p < 0.001). Hematological parameters improved between day 7 and day 40, reflecting the expected course of postoperative recovery; these were considered secondary outcomes. Exploratory analyses revealed correlations between hemoglobin and POSAS (r = 0.42, p < 0.05), leukocyte count and REEDA (r = 0.68, p < 0.01), and platelet count and POSAS (r = −0.48, p < 0.05). Conclusions: Intraoperative PRP administration significantly enhanced postoperative scar healing after cesarean delivery and was associated with reduced inflammation and improved hematological recovery. These findings support the use of PRP as an adjunctive regenerative therapy in obstetric surgery. Randomized controlled trials are warranted to validate efficacy of the intervention, and moreover long-term outcomes.