Georgina Davis1,2, Jessica Jellins3,4,5. 1. Department of Obstetrics and Gynaecology, The Canterbury Hospital, Sydney, Australia. 2. Department of Obstetrics and Gynaecology, Northern Beaches Health Service, Sydney, Australia. 3. Department of Obstetrics and Gynaecology, Royal Prince Alfred Hospital and The Canterbury Hospital, Sydney, Australia. 4. Discipline of Obstetrics, Gynaecology & Neonatology, Central Clinical School, The University Of Sydney, Sydney, Australia. 5. School of Medicine, The University of Notre Dame, Sydney, Australia.
Abstract
BACKGROUND: Female genital mutilation (FGM) and its impact on women's health are becoming relevant in Australia due to increases in numbers of refugees and migrants from affected countries. Notwithstanding the psychological trauma from FGM, there is a broad range of sequelae relevant to obstetrics and gynaecology, particularly related to maternal morbidity from labour and delivery. AIMS: To assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes. METHODS: Retrospective cohort study of women affected by FGM who delivered at a metropolitan hospital in Sydney over a five-year period. The primary outcome was mode of delivery and secondary outcomes addressed maternal morbidity and neonatal nursery admission compared with women unaffected by FGM. RESULTS: A full data set was available for 141/142 women affected by FGM. The overall prevalence of FGM was 1.64%. The majority of women affected by FGM were documented to have FGM 3 (41.1%). There was no difference in caesarean section rate. Women with FGM were less likely to be delivered by vacuum or forceps (11.1% vs 2.8%; P = 0.0009). There was no difference in perineal trauma, postpartum haemorrhage and neonatal nursery admission. Women with FGM 3 were more likely to have an episiotomy (4.8% vs 25.9%; P = 0.0007) without an increase in anal sphincter injury (P = 0.7). Documentation complying with local policy and guidelines was poor. CONCLUSIONS: FGM is increasingly common in Australia. This study adds to the Australian literature quantifying the effects on obstetric outcomes in these high-risk women.
BACKGROUND: Female genital mutilation (FGM) and its impact on women's health are becoming relevant in Australia due to increases in numbers of refugees and migrants from affected countries. Notwithstanding the psychological trauma from FGM, there is a broad range of sequelae relevant to obstetrics and gynaecology, particularly related to maternal morbidity from labour and delivery. AIMS: To assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes. METHODS: Retrospective cohort study of women affected by FGM who delivered at a metropolitan hospital in Sydney over a five-year period. The primary outcome was mode of delivery and secondary outcomes addressed maternal morbidity and neonatal nursery admission compared with women unaffected by FGM. RESULTS: A full data set was available for 141/142 women affected by FGM. The overall prevalence of FGM was 1.64%. The majority of women affected by FGM were documented to have FGM 3 (41.1%). There was no difference in caesarean section rate. Women with FGM were less likely to be delivered by vacuum or forceps (11.1% vs 2.8%; P = 0.0009). There was no difference in perineal trauma, postpartum haemorrhage and neonatal nursery admission. Women with FGM 3 were more likely to have an episiotomy (4.8% vs 25.9%; P = 0.0007) without an increase in anal sphincter injury (P = 0.7). Documentation complying with local policy and guidelines was poor. CONCLUSIONS: FGM is increasingly common in Australia. This study adds to the Australian literature quantifying the effects on obstetric outcomes in these high-risk women.
Authors: Laura Gombau-Giménez; Pilar Almansa-Martínez; María Suarez-Cortés; Alonso Molina-Rodríguez; César Leal-Costa; Ismael Jiménez-Ruiz Journal: Int J Environ Res Public Health Date: 2022-08-16 Impact factor: 4.614
Authors: David Tordrup; Chrissy Bishop; Nathan Green; Max Petzold; Fernando Ruiz Vallejo; Joshua P Vogel; Christina Pallitto Journal: BMJ Glob Health Date: 2022-02