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REEDA Scale: Evaluation of Episiotomy Healing

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REEDA scale is a method or tool to evaluate healing complications associated with episiotomy or laceration (viginal tear) occurring during delivery. To understand exactly what the REEDA scale or the REEDA assessment is, it is important to first understand the terms associated with this tool: Episiotomy and Perineal Laceration. 

What is Episiotomy?

Episiotomy is a common surgical procedure done by obstetricians during childbirth to eliminate the delivery complications and prevent rupture of muscle tissues. In this procedure, an obstetrician makes an incision at the perineum (an area between the viginal wall and anus) to stretch the viginal opening to some extent so that the delivery can be done without any complications. The episiotomy procedure is only performed when the viginal opening seems a little smaller for the baby to come out. 

What are Perineal Lacerations or Viginal Tears?

Perineal lacerations occur naturally during childbirth when the baby's head is larger than average size or the viginal opening does not stretch enough. These kinds of perineal lacerations are very common, especially among women who experience viginal birth for the very first time. 

Now that you know about episiotomy and viginal tears, it would be easy for you to understand the REEDA scale. Let's move ahead to the next section of this post. 

What is the REEDA Scale?

The REEDA scale is a perineal healing assessment tool. It evaluates the severity of perineal trauma or healing complications associated with episiotomy or viginal tears analyzing the inflammatory signs, including Redness (hyperaemia), Edema (swelling caused by excess fluid in the tissues) Ecchymosis (discoloration of the skin), Discharge, and Approximation. It is generally used by physicians or experienced nurses in the postpartum period. 

In many studies and research, it has been found that REEDA is a reliable perineal healing assessment tool as it accurately grades the perineal trauma. 

What is the REEDA Score? 

The REEDA Score is a grade given to the patient based on their REEDA assessment. It can range anywhere from 0 to 15 with each assessment area ranging from 0 to 3. A higher REEDA score, generally ranging from 11 to 15, indicates a worsened perineal trauma condition. 

Categorization of Perineal Trauma

Perineal trauma, including Episiotomy and Viginal Tears, can be categorized into four parts, depending on their severity. 

First-Degree Perineal Trauma- Episiotomy and viginal tears that include only perineal skin come under first-degree tear or episiotomy. These kinds of tears and cuts are least severe and heal naturally within a couple of weeks. They do not require any kind of treatment. 

Second-Degree Perineal Trauma- Episiotomy and tears that are relatively larger than first-degree tears and cuts and involve perineal skin along with perineal muscle come under this category. These kinds of tears and cuts require stitches to get healed. 

Third-Degree Perineal Trauma- Episiotomy and lacerations that come under this category often involve skin and muscle that surround the anus. These kinds of cuts and tears can lead to some severe complications, such as stool leakage and difficulty during having intercourse. These cuts and tears generally require repair and anesthesia which is done in an operating room rather than a delivery room. Also, it takes relatively a longer time than a few weeks for healing.

Fourth-Degree Perineal Trauma- Episiotomy and tears that extend way long to the anal sphincter and the mucous membrane are fourth-degree tears and cuts. These often require specialized treatment that is done in an operating room by specialized physicians. Many complications are associated with this, such as fecal incontinence and painful intercourse. The healing process for these kinds of cuts and tears may extend to one to two months. 

In the end, we hope it has been an informative read for you. Visit the Medical Algorithm website for such more qualitative and informative blogs and articles. 

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