Saleh Wael F, Torky Haitham A, Youssef Mohamed A, Ragab Wael S, Ahmed Mohamed A Sayed, Eldaly Ashraf
Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
As-Salam International Hospital, Cairo, Egypt.
J Perinat Med. 2018 May 24;46(4):419-424. doi: 10.1515/jpm-2016-0429.
To examine the effect of the degree of female genital cutting (FGC) performed by health-care professionals on perineal scarring; delivery mode; duration of second stage of labor; incidence of perineal tears and episiotomy in a cohort of uncircumcised versus circumcised (types I and II) women.
A prospective cohort study included 450 primigravida women in active labor attending the Faculty of Medicine Cairo University Hospital between January 2013 and August 2014. Women were divided into three groups based on medical examination upon admission. Group I (Control) included 150 uncut women, Group II included 150 women with type I FGC and Group III included 150 women with type II FGC. A structured questionnaire elicited the information on women's socio-demographic characteristics including age, residence, occupation, educational level, age of marriage and FGC circumstances. Association between FGC and labor complications was examined.
risk of perineal scarring; delivery mode; duration of second stage of labor; incidence of perineal tears and episiotomy.
Family history of genitally cut mother/sister was the most significant socio-demographic factor associated with FGC. FGC especially type II was associated with significantly higher incidence of vulvar scar (P<0.0002), perineal tears (P<0.0001) and increased likelihood of additional vaginal and perineal trauma [odds ratio (OR): 1.85, 95% CI: 0.60-5.65. P≤0.001]. There was insignificant difference in risks of cesarean section (CS), instrumental delivery, episiotomy and short-term neonatal outcomes.
The study strengthens the evidence that FGC increases the risk of tears in spite of medicalization of the practice.
研究医疗保健专业人员实施的女性生殖器切割（FGC）程度对会阴瘢痕形成、分娩方式、第二产程时长、会阴撕裂发生率以及会阴切开术发生率的影响，对比未行切割与行切割（I型和II型）的女性队列。
一项前瞻性队列研究纳入了2013年1月至2014年8月在开罗大学医学院医院待产的450名初产妇。根据入院时的医学检查将女性分为三组。第一组（对照组）包括150名未切割女性，第二组包括150名I型FGC女性，第三组包括150名II型FGC女性。通过一份结构化问卷收集有关女性社会人口学特征的信息，包括年龄、居住地、职业、教育水平、结婚年龄和FGC情况。研究FGC与分娩并发症之间的关联。
会阴瘢痕形成风险、分娩方式、第二产程时长、会阴撕裂发生率和会阴切开术发生率。
母亲/姐妹有生殖器切割史是与FGC相关的最显著社会人口学因素。FGC尤其是II型与外阴瘢痕（P<0.0002）、会阴撕裂（P<0.0001）的发生率显著升高以及额外阴道和会阴创伤的可能性增加相关[比值比（OR）：1.85，95%置信区间：0.60 - 5.65，P≤0.001]。剖宫产（CS）、器械助产、会阴切开术风险和短期新生儿结局方面无显著差异。
该研究强化了以下证据，即尽管FGC已医学化，但仍会增加撕裂风险。
