Department of Obstetrics and Gynecology, King Abdulaziz University, Jeddah, Saudi Arabia.
Obstet Gynecol. 2012 Jul;120(1):98-103. doi: 10.1097/AOG.0b013e3182590343.
To assess the routine practice of defibulation during vaginal delivery for women who have undergone female genital mutilation or cutting.
A case-control study was conducted on women from Sudan, Somalia, Ethiopia, Egypt, and Yemen who delivered at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from January 1, 2000, to November 30, 2011. Women who had defibulation were identified, and their records were examined. For each woman who had defibulation, a woman from the same nationality who delivered without defibulation on the same day or the next days was chosen as a control. Data collected included demographics, mode of delivery, blood loss, intraoperative and postoperative complications, and labor outcome.
During the study period, 388 women underwent defibulation during vaginal delivery. Women who did not have defibulation were chosen as a control group (n=388). In the defibulation group, 300 (77.3%) women were registered during pregnancy; 88 (22.7%) women were unregistered. Defibulation during vaginal delivery was successfully performed by residents and senior residents under the care of the attending on call. No cesarean delivery was performed because of female genital mutilation or cutting, and no spontaneous rupture of the scar occurred. There were no statistically significant differences between women who had defibulation with those who did not or between infibulated registered and unregistered women in the duration of labor, episiotomy rates, blood loss, Apgar score, or fetal birth weight.
Defibulation during vaginal delivery is a valid management option. Labor attendants should be trained to perform it.
评估对接受女性外阴残割/切割的女性在阴道分娩时行切开术的常规做法。
这是一项病例对照研究，纳入了 2000 年 1 月 1 日至 2011 年 11 月 30 日期间在沙特阿拉伯吉达的阿卜杜勒-阿齐兹国王大学医院分娩的来自苏丹、索马里、埃塞俄比亚、埃及和也门的女性。确定行切开术的女性，并对其记录进行检查。对于每一位行切开术的女性，选择同日或次日分娩且未行切开术的来自同一国籍的女性作为对照。收集的数据包括人口统计学资料、分娩方式、出血量、术中及术后并发症和分娩结局。
研究期间，388 例女性在阴道分娩时行切开术。未行切开术的女性被选为对照组（n=388）。在切开术组中，300 例（77.3%）女性在妊娠期间登记；88 例（22.7%）女性未登记。切开术由住院医师和高年住院医师在主治医生的指导下成功施行。没有因为女性外阴残割/切割而施行剖宫产，也没有发生切口瘢痕自发性破裂。行切开术的女性与未行切开术的女性、有登记的切开术与未登记的切开术女性之间的分娩时间、会阴切开率、出血量、阿普加评分或胎儿出生体重均无统计学差异。
阴道分娩时行切开术是一种有效的处理方法。应培训分娩医护人员施行该操作。
