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改善经历过女性生殖器切割的孕妇结局的干预措施。

Interventions for improving outcomes for pregnant women who have experienced genital cutting.

作者信息

Balogun Olukunmi O, Hirayama Fumi, Wariki Windy M V, Koyanagi Ai, Mori Rintaro

机构信息

Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Cochrane Database Syst Rev. 2013 Feb 28;2013(2):CD009872. doi: 10.1002/14651858.CD009872.pub2.

Abstract

BACKGROUND

Female genital cutting (FGC) refers to all procedures that involve the partial or total removal of the external female genitalia, or other injury to the female genital organs for cultural or other non-therapeutic reasons. There are no known medical benefits to FGC, and it can be potentially dangerous for the health and psychological well-being of women and girls who are subjected to the practice resulting in short- and long-term complications. Health problems of significance associated with FGC faced by most women are maternal and neonatal mortality and morbidity, the need for assisted delivery and psychological distress. Under good clinical guidelines for caring for women who have undergone genital cutting, interventions could provide holistic care that is culturally sensitive and non-judgemental to improve outcomes and overall quality of life of women. This review focuses on key interventions carried out to improve outcome and overall quality of life in pregnant women who have undergone FGC.

OBJECTIVES

To evaluate the impact of interventions to improve all outcomes in pregnant women or women planning a pregnancy who have undergone genital cutting. The comparison group consisted of those who have undergone FGC but have not received any intervention.

SEARCH METHODS

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2012) and organisations engaged in projects regarding FGC.

SELECTION CRITERIA

Randomised controlled trials (RCTs), cluster-randomised trials or quasi-RCTs with reported data comparing intervention outcomes among pregnant women or women planning a pregnancy who have undergone genital cutting compared with those who did not receive any intervention.

DATA COLLECTION AND ANALYSIS

We did not identify any RCTs, cluster-randomised trials or quasi-RCTs.

MAIN RESULTS

There are no included studies.

AUTHORS' CONCLUSIONS: FGC research has focused mainly on observational studies to describe the social and cultural context of the practice, and we found no intervention trials conducted to improve outcomes for pregnant women presenting with complications of FGC. While RCTs will provide the most reliable evidence on the effectiveness of interventions, there remains the issue of what is considered ethically appropriate and the willingness of women to undergo randomisation on an issue that is enmeshed in cultural traditions and beliefs. Consequently, conducting such a study might be difficult.

摘要

背景

女性生殖器切割(FGC)是指出于文化或其他非治疗性原因,涉及部分或全部切除女性外生殖器,或对女性生殖器官造成其他伤害的所有手术。女性生殖器切割没有已知的医学益处,对于接受这种手术的妇女和女孩的健康及心理健康可能具有潜在危险,会导致短期和长期并发症。大多数接受女性生殖器切割的妇女面临的重大健康问题包括孕产妇和新生儿死亡率及发病率、辅助分娩需求和心理困扰。在照顾接受过生殖器切割的妇女的良好临床指南下,干预措施可以提供具有文化敏感性且不带有评判性的全面护理,以改善妇女的结局和整体生活质量。本综述重点关注为改善接受女性生殖器切割的孕妇的结局和整体生活质量而开展的关键干预措施。

目的

评估干预措施对改善接受过生殖器切割的孕妇或计划怀孕的妇女的所有结局的影响。对照组由接受过女性生殖器切割但未接受任何干预措施的妇女组成。

检索方法

我们检索了Cochrane妊娠与分娩组试验注册库(2012年12月31日)以及参与女性生殖器切割相关项目的组织。

选择标准

随机对照试验(RCT)、整群随机试验或半随机对照试验,且有报告数据比较接受过生殖器切割的孕妇或计划怀孕的妇女与未接受任何干预措施的妇女的干预结局。

数据收集与分析

我们未识别出任何随机对照试验、整群随机试验或半随机对照试验。

主要结果

没有纳入研究。

作者结论

女性生殖器切割研究主要集中在观察性研究上,以描述这种行为的社会和文化背景,我们未发现为改善出现女性生殖器切割并发症的孕妇结局而进行的干预试验。虽然随机对照试验将为干预措施的有效性提供最可靠的证据,但在一个与文化传统和信仰交织的问题上,仍存在什么被认为在伦理上是合适的以及妇女是否愿意接受随机分组的问题。因此,进行这样一项研究可能会很困难。

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