Ekpereonne Esu1,2, Atim Udo3, Babasola O Okusanya4, David Agamse2, Martin M Meremikwu2,5. 1. Department of Public Health, College of Medical Science, University of Calabar, Calabar, Nigeria. 2. Calabar Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria. 3. Department of Obstetrics and Gynecology, College of Medical Science, University of Calabar, Calabar, Nigeria. 4. Experimental and Maternal Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria. 5. Department of Pediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria.
Abstract
BACKGROUND: There remains no consensus on the best timing of deinfibulation in women with type III female genital mutilation (FGM). OBJECTIVES: To conduct a systematic review of the effects of antepartum or intrapartum deinfibulation on childbirth outcomes in women with type III FGM. SEARCH STRATEGY: The following major databases were searched: Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov, from inception until August 2015 without any language restrictions. SELECTION CRITERIA: Studies of pregnant women or girls with type III FGM who were deinfibulated antepartum or intrapartum were included. DATA COLLECTION AND ANALYSIS: Two team members independently screened and collected data. Quality of evidence was assessed using GRADE. Summary odds ratios and proportions were calculated when possible. RESULTS: There is no evidence of a significant difference between antepartum and intrapartum deinfibulation for obstetric outcomes such as duration of labor, perineal lacerations, episiotomies, postpartum hemorrhage, and cesarean deliveries. Outcomes in women living with type III FGM and those who have undergone deinfibulation were not statistically different; however, trends show a benefit for deinfibulation. All studies were underpowered to detect statistical differences. CONCLUSION: Larger studies are required to have full confidence in these findings. PROSPERO REGISTRATION: CRD42015024464.
BACKGROUND: There remains no consensus on the best timing of deinfibulation in women with type III female genital mutilation (FGM). OBJECTIVES: To conduct a systematic review of the effects of antepartum or intrapartum deinfibulation on childbirth outcomes in women with type III FGM. SEARCH STRATEGY: The following major databases were searched: Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov, from inception until August 2015 without any language restrictions. SELECTION CRITERIA: Studies of pregnant women or girls with type III FGM who were deinfibulated antepartum or intrapartum were included. DATA COLLECTION AND ANALYSIS: Two team members independently screened and collected data. Quality of evidence was assessed using GRADE. Summary odds ratios and proportions were calculated when possible. RESULTS: There is no evidence of a significant difference between antepartum and intrapartum deinfibulation for obstetric outcomes such as duration of labor, perineal lacerations, episiotomies, postpartum hemorrhage, and cesarean deliveries. Outcomes in women living with type III FGM and those who have undergone deinfibulation were not statistically different; however, trends show a benefit for deinfibulation. All studies were underpowered to detect statistical differences. CONCLUSION: Larger studies are required to have full confidence in these findings. PROSPERO REGISTRATION: CRD42015024464.
Authors: Laura Jones; Emma Danks; Joanne Clarke; Lailah Alidu; Benjamin Costello; Kate Jolly; Alison Byrne; Meg Fassam-Wright; Pallavi Latthe; Julie Taylor Journal: BMJ Open Date: 2019-10-17 Impact factor: 2.692