Evaluation of the ease of use and acceptability of an innovative device – the ‘Episiometer’, in ensuring an accurate mediolateral episiotomy: a pilot study

Abstract

The present study was undertaken at the Port Moresby General Hospital, Papua New Guinea, to evaluate the ease of use and acceptability of a perineal measuring device (Episiometer) for giving a correct length and angle of a mediolateral episiotomy. An Episiometer was placed on the perineum to guide the angle and length immediately before giving an episiotomy. A feedback survey was collected and the angle and length of the episiotomy were measured at the time of delivery and at 6 weeks postpartum. The length and angle of episiotomy were found to be accurate in 86% of the cases. Forty-two of the fifty (86%) clinicians felt that the Episiometer was easy or very easy to use. They also found this device to be beneficial (92%). The Episiometer seems to be an easy-to-use and feasible device that is well accepted by clinicians and patients and may aid in standardising the length and angle of an episiotomy.

Impact statement

• What is already known on this subject? Episiotomy is the commonest obstetric procedure performed worldwide. However, the angle and length of an episiotomy vary greatly amongst operators. It is also recognised that birth trauma and an inaccurate episiotomy result in debilitating anal sphincter injury. Therefore, a pilot study was conducted to evaluate the ease of use and acceptability of a new, inexpensive, low- tech device “Episiometer” to guide clinicians and midwives to perform an appropriate episiotomy.

• What do the results of this study add? This pilot study to evaluate the usability of the new innovation amongst clinician and patients revealed high acceptance of the device amongst clinicians and positive attitude of the patients towards the device. The clinicians also felt the device to be an effective teaching tool. Usage if the device results in a more accurate length and angle of an episiotomy.

• What are the implications of these findings for clinical practice and/or further research? Further research and multicentre randomised control trials are needed to establish the effectiveness of the device in reducing the complications of episiotomy and risk of OASIS. The present study has shown the Episiometer as an acceptable and easy to use device amongst clinicians and can benefit the young clinicians as a teaching tool in directing a correct angle and length of episiotomy.

Keywords:

• Episiotomy
• Episiometer
• perineal trauma
• OASIS

Ethical approval

Townsville HHS Human Research Ethics Committee, Approved on 12/06/2017; Approval Number: HREC/17/QTHS/37; Port Moresby General Hospital Ethics Committee, Approved on 18/06/2017; Approval No. IRB/21/2017.

Acknowledgements

Wiley Editing Services. No external funding was sought or obtained for this study.

Disclosure statement

The authors have no conflicts of interest.