New tool that measures and assesses first and second-degree perineal tears

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A researcher from the University of Birmingham has co-developed a device to significantly improve the maternity aftercare of many new mothers - and the invention could also help lead the way in forensic investigations.

Alison Metcalfe, of the University's School of Health Sciences, and five midwives from Birmingham have developed the Peri-Rule, a tool which measures and assesses first and second-degree perineal tears. During childbirth 25-35 per cent of women get spontaneously occurring tears to their perineum, which can often cause long-term problems for women, including incontinence and general discomfort.

The Peri-Rule enables midwives to make a more detailed and objective assessment of the severity of damage so they can make informed decisions for further treatment that may be required, which should lead to a reduction in the number of women that have severe damage missed. Because the Peri-Rule can be sterilised it can be used to measure and assess many other types of wound and tissue damage, including those seen in forensic science to reduce the risk of contamination of important evidence.

The device will be launched at The Conference on Issues in Perineal Trauma and Launch of the Peri-Rule which takes place on 14 July between 10am and 4pm at the Botanical Gardens, Birmingham.

The conference will cover all aspects of the research, including the results of the trials, midwives' experiences and the wider implications of perineal trauma for women's health. Speakers will include representatives from the areas of midwifery and women's heath, including Gillian Fletcher, President of the National Childbirth Trust.

Alison Metcalfe said: "The Peri-Rule was developed as a result of a research project carried out into the effectiveness of suturing (stitching) of perineal tears. Midwives have no indicator of the actual size of the tear and there is growing debate in midwifery practice as to whether to leave the tear unstitched. However, some women can experience discomfort and complications and may have ongoing problems, so it is important to establish the best practice based on the size of the tear.

"This device will enable midwives to make informed decisions about the treatment of patients, so this will significantly improve the clinical care of women after childbirth. It also provides an opportunity to carry out further research in this area of maternity care, which has often been overlooked in terms of funding and support for education and training of midwives in this aspect of care."

The Peri-Rule consists of a practical measuring device and an assessment pro forma. It was developed by the Birmingham Perineal Research Evaluation Group (BPREG) and initially funded by Birmingham Heartlands & Solihull NHS Trust and Mercia Spinner, while regional development agency, Advantage West Midlands, has helped design the tool.

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