Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Urogynecology Journal
Published in: International Urogynecology Journal 3/2018

01-03-2018 | Original Article

Are obstetric outcomes affected by female genital mutilation?

Authors: Aswini A Balachandran, Swapna Duvalla, Abdul H Sultan, Ranee Thakar

Published in: International Urogynecology Journal | Issue 3/2018

Login to get access

Abstract

Introduction and hypothesis

Female genital mutilation (FGM) has been associated with adverse obstetric and neonatal outcomes, such as postpartum haemorrhage (PPH), perineal trauma, genital fistulae, obstructed labour and stillbirth. The prevalence of FGM has increased in the UK over the last decade. There are currently no studies available that have explored the obstetric impact of FGM in the UK. The aim of our study was to investigate the obstetric and neonatal outcomes of women with FGM when compared with the general population.

Methods

We conducted a retrospective case–control study of consecutive pregnant women with FGM over a 5-year period between 1 January 2009 and 31 December 2013. Each woman with FGM was matched for age, ethnicity, parity and gestation with subsequent patients without FGM (control cohort) over the same 5-year period. Outcomes assessed were mode of delivery, duration of labour, estimated blood loss, analgaesia, perineal trauma and foetal outcomes.

Results

A total of 242 eligible women (121 FGM, 121 control) were identified for the study. There was a significant increase in the use of episiotomy in the FGM group (p = 0.009) and a significant increase in minor PPH in the control group during caesarean sections (p = 0.0001). There were no differences in all other obstetric and neonatal parameters.

Conclusions

In our unit, FGM was not associated with an increased incidence of adverse obstetric and foetal morbidity or mortality.
Literature
1.
WHO. Female genital mutilation: an overview. Geneva: World Health Organisation; 1998.
2.
3.
Macfarlane A, Dorkenoo E. Female genital mutilation in England & Wales. Updated statistical estimates of the numbers of affected women in living in England and Wales and girls at risk. London: Equality Now and City University London; 2014.
4.
5.
Mathers N, Rymer J. Mandatory reporting of female genital mutilation by healthcare professionals. Br J Gen Pract Jun. 2015;65(635):282–3.CrossRef
6.
Dorkenoo E, Morison L, Macfarlane A. A statistical study to estimate the prevalence of female gential mutilation in England and Wales. Summary report. UK: Foundation for Women’s Health, Research and Development (FORWARD); 2007.
7.
Adelufosi A, Edet B, Arikpo D, Aquaisua E, Meremikwu MM. Cognitive behavioral therapy for post-traumatic stress disorder, depression or anxiety disorders in women and girls living with female geneital mutilation: a systematic review. Int J Gynaecol Obstet. 2017;136(Suppl 1):56–9.CrossRefPubMed
8.
Moxey J, Jones L. A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. BMJ Open. 2016;6:e009846.CrossRefPubMedPubMedCentral
9.
Rushwan H. Female genital mutilation (FGM) management during pregnancy, childbirth and the postpartum period. Int J Gynaecol Obstet. 2000;70:99–104.CrossRefPubMed
10.
Banks E, Meirik O, Faley T, et al. Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries. Lancet. 2006;367:1835–41.CrossRefPubMed
11.
WHO. A systematic review of the health complications of female genital mutilation including sequelae in childbirth. Geneva, Switzerland: World Health Organization; 2000.
12.
NICE Intrapartum care for healthy women and babies CG 190 December 2014.
13.
Royal College of Obstetricians and Gynaecologists. Female Genital Mutilation and its Management. 2015. Green-top Guideline No 53.
14.
15.
Wuest S, Raio L, Wyssmueller D, Mueller MD, Stadlmayr W, Surbek DV, et al. Effects of female gential mutilation on birth outcomes in Switzerland. BJOG. 2009;116(9):1204–9.CrossRefPubMed
16.
17.
Sheldon WR, Blum J, Vogel JP, Souza JP, Gülmezgolu AM, WHO Multicountry Survey on Maternal and Newborn Health Research Network. Postpartum haemorrhage management, risks and maternal outcomes: findings from the World Health Organization multicountry survey on maternal and newborn health. BJOG. 2014;121(Suppl 1):5–13.CrossRefPubMed
18.
Gilber L, Porter W, Brown VA. Postpartum haemorrhage – continuing problem. BJOG. 1987;94:67–71.CrossRef
19.
Ndlaye P, Diongue M, Gaye A, Ouedraogo D, Dia AT. Female genital mutilation and complications in childbirth in the province of Gourma (Burkina Faso). Sante Publique. 2010;22(5):563–700.CrossRef
20.
Elnashar A, Abdelhady R. The impact of female genital cutting on health of newly married women. Int J Gynecol Obstet. 2007;97(3):238–44.CrossRef
21.
Prual A, Bouvier-Colle MH, de Bernis L, Bréart G. Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates. Bull World Health Organ. 2000;78(5):593–602.PubMedPubMedCentral
22.
Jager F, Schulze S, Hohlfeld P. Female genital mutilation in Switzerland: a survey among gynaecologists. Swiss Med Wkly. 2002;132(19–20):259–64.PubMed
23.
Leye E, Ysebaert I, Deblonde J, Claeys P, Vermeulen G, Jacquemyn Y, et al. Female genital mutilation: knowledge, attitudes and practices of Flemish gynaecologist. Eur J Contracept Reprod Health Care. 2008;13(2):1820190.CrossRef
24.
Tamaddon L, Johnsdotter S, Liljestrand J, Essen B. Swedish health care providers’ experience and knowledge of female genital cutting. Health Care Women Int. 2006;27(8):709–22.CrossRefPubMed
25.
Purchase TC, Lamoudi M, Colman S, Allen S, Latthe P, Jolly K. A survey on knowledge of female genital mutilation guidelines. Acta Obstet Gynaecol Scand. 2013;92(7):858–61.CrossRef
26.
Zaidi N, Khalil A, Roberts C, Browne M. Knowledge of female genital mutilation among healthcare professionals. J Obstet Gynaecol. 2008;27:161–4.CrossRef
Metadata
Title
Are obstetric outcomes affected by female genital mutilation?
Authors
Aswini A Balachandran
Swapna Duvalla
Abdul H Sultan
Ranee Thakar
Publication date
01-03-2018
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 3/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3466-5

Other articles of this Issue 3/2018

International Urogynecology Journal 3/2018 Go to the issue

Original Article

Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, type, and risk factors

Original Article

Obstetric fistula in Niger: 6-month postoperative follow-up of 384 patients from the Danja Fistula Center

Commentary

Commentary on: The Manchester-Fothergill procedure versus vaginal hysterectomy with uterosacral ligament suspension: a matched historical cohort study

Original Article

Anal sphincter injury in vaginal deliveries complicated by shoulder dystocia

Original Article

No episiotomy versus selective lateral/mediolateral episiotomy (EPITRIAL): an interim analysis

Original Article

The effectiveness of mediolateral episiotomy in preventing obstetric anal sphincter injuries during operative vaginal delivery: a ten-year analysis of a national registry