Balachandran Aswini A, Duvalla Swapna, Sultan Abdul H, Thakar Ranee
Department of Obstetrics and Gynaecology, Croydon University Hospital, 530 London Road, London, CR7 7YE, UK.
Int Urogynecol J. 2018 Mar;29(3):339-344. doi: 10.1007/s00192-017-3466-5. Epub 2017 Sep 9.
Female genital mutilation (FGM) has been associated with adverse obstetric and neonatal outcomes, such as postpartum haemorrhage (PPH), perineal trauma, genital fistulae, obstructed labour and stillbirth. The prevalence of FGM has increased in the UK over the last decade. There are currently no studies available that have explored the obstetric impact of FGM in the UK. The aim of our study was to investigate the obstetric and neonatal outcomes of women with FGM when compared with the general population.
We conducted a retrospective case-control study of consecutive pregnant women with FGM over a 5-year period between 1 January 2009 and 31 December 2013. Each woman with FGM was matched for age, ethnicity, parity and gestation with subsequent patients without FGM (control cohort) over the same 5-year period. Outcomes assessed were mode of delivery, duration of labour, estimated blood loss, analgaesia, perineal trauma and foetal outcomes.
A total of 242 eligible women (121 FGM, 121 control) were identified for the study. There was a significant increase in the use of episiotomy in the FGM group (p = 0.009) and a significant increase in minor PPH in the control group during caesarean sections (p = 0.0001). There were no differences in all other obstetric and neonatal parameters.
In our unit, FGM was not associated with an increased incidence of adverse obstetric and foetal morbidity or mortality.
女性生殖器切割（FGM）与不良产科及新生儿结局相关，如产后出血（PPH）、会阴创伤、生殖道瘘、产程梗阻和死产。在过去十年中，英国女性生殖器切割的患病率有所上升。目前尚无研究探讨其在英国对产科的影响。我们研究的目的是调查与普通人群相比，接受女性生殖器切割的女性的产科及新生儿结局。
我们对2009年1月1日至2013年12月31日这5年间连续的接受女性生殖器切割的孕妇进行了一项回顾性病例对照研究。在同一5年期间，将每名接受女性生殖器切割的女性与随后未接受女性生殖器切割的患者（对照组）按年龄、种族、胎次和孕周进行匹配。评估的结局包括分娩方式、产程时长、估计失血量、镇痛情况、会阴创伤和胎儿结局。
共确定242名符合条件的女性（121名接受女性生殖器切割者，121名对照者）参与研究。接受女性生殖器切割组的会阴切开术使用率显著增加（p = 0.009），对照组剖宫产期间轻微产后出血显著增加（p = 0.0001）。所有其他产科和新生儿参数均无差异。
在我们的单位，女性生殖器切割与不良产科及胎儿发病率或死亡率的增加无关。
