University College Hospital, London, UK.
Department of Paediatrics, The Whittington Hospital, London, UK.
Arch Dis Child. 2016 Mar;101(3):212-6. doi: 10.1136/archdischild-2015-308243. Epub 2015 Jul 27.
To describe the presentation and management of children referred with suspected female genital mutilation (FGM) to a UK safeguarding clinic.
Case series of all children under 18 years of age referred with suspected FGM between June 2006 and May 2014.
These include indication for referral, demographic data, circumstances of FGM, medical symptoms, type of FGM, investigations and short-term outcome.
Of the 47 girls referred, 27 (57%) had confirmed FGM. According to the WHO classification of genital findings, FGM type 1 was found in 2 girls, type 2 in 8 girls and type 4 in 11 girls. No type 3 FGM was seen. The circumstances of FGM were known in 17 cases, of which 12 (71%) were performed by a health professional or in a medical setting (medicalisation). Ten cases were potentially illegal, yet despite police involvement there have been no prosecutions.
This study is an important snapshot of FGM within the UK paediatric population. The most frequent genital finding was type 4 FGM with no tissue damage or minimal scarring. FGM was performed at a young age, with 15% reported under the age of 1 year. The study also demonstrated significant medicalisation of FGM, which matches recent trends in international data. Type 4 FGM performed in infancy is easily missed on examination and so vigilance in assessing children with suspected FGM is essential.
描述因疑似女性外阴残割（FGM）而被转介到英国保护诊所的儿童的临床表现和处理方法。
2006 年 6 月至 2014 年 5 月期间，对所有 18 岁以下疑似 FGM 的儿童进行的病例系列研究。
包括转诊原因、人口统计学数据、FGM 情况、医疗症状、FGM 类型、检查和短期结果。
47 名被转介的女孩中，有 27 名（57%）被确诊为 FGM。根据世界卫生组织对生殖器发现的分类，2 名女孩为 FGM 1 型，8 名女孩为 FGM 2 型，11 名女孩为 FGM 4 型。未见 FGM 3 型。17 例 FGM 情况已知，其中 12 例（71%）由卫生专业人员或医疗环境进行（医学化）。10 例可能是非法的，但尽管警方介入，仍未进行起诉。
本研究是英国儿科人群中 FGM 的重要写照。最常见的生殖器发现是 4 型 FGM，无组织损伤或最小疤痕。FGM 在很小的时候就进行了，有 15%的报告发生在 1 岁以下。该研究还表明 FGM 存在显著的医学化趋势，这与国际数据的最新趋势相符。在婴儿期进行的 4 型 FGM 很容易在检查中被忽视，因此，对疑似 FGM 的儿童进行评估时必须保持警惕。
