Carcopino X, Shojai R, Boubli L
Service de Gynécologie-Obstétrique, Hôpital Nord, chemin des Bourrely, 13015 Marseille.
J Gynecol Obstet Biol Reprod (Paris). 2004 Sep;33(5):378-83. doi: 10.1016/s0368-2315(04)96544-1.
Evaluation of female genital mutilation complications and their clinical management.
Review of the literature.
Female genital mutilation is still performed in some regions of Africa. Although female genital mutilation are often considered as a religious act, tradition and social habits seems to be the best explanation. Infibulation is the most severe form, in which the clitoris, the labia minora and part of labia majora are removed. Stitching of the raw surfaces created covers the urethra and the vaginal entrance. There only remains a small opening at the base of the vulva. Health consequences directly depend on the severity of the initial mutilation. They are more severe in infibulated women. Pregnancy, childbirth and the obstetrical period are particuliary dangerous for the mother and the child. Female genital mutilation contributes to childhood and maternal mortality and morbidity. Decreasing the impact depends on the obstetrical team's competence. Defibulation is absolutely necessary for the delivery of infibulated women. This simple surgical act can be performed under local anesthesia.
With increasing immigration, obstetrical teams in developed countries can be confronted with such situations. They should be aware of proper clinical management practices for these women.
评估女性生殖器切割并发症及其临床处理。
文献回顾。
非洲某些地区仍存在女性生殖器切割现象。尽管女性生殖器切割常被视为一种宗教行为，但传统和社会习俗似乎是最佳解释。阴部扣锁法是最严重的形式，即切除阴蒂、小阴唇及部分大阴唇。对所形成的创面进行缝合，覆盖尿道和阴道口。仅在外阴底部留下一个小开口。健康后果直接取决于初始切割的严重程度。在接受阴部扣锁法的女性中后果更为严重。妊娠、分娩及产褥期对母亲和孩子尤其危险。女性生殖器切割导致儿童期及孕产妇死亡率和发病率上升。减轻影响取决于产科团队的能力。对于接受阴部扣锁法的女性进行阴部松解术绝对必要。这一简单的外科手术可在局部麻醉下进行。
随着移民增加，发达国家的产科团队可能会面临此类情况。他们应了解针对这些女性的恰当临床处理方法。
