Davis Georgina, Jellins Jessica
Department of Obstetrics and Gynaecology, The Canterbury Hospital, Sydney, Australia.
Department of Obstetrics and Gynaecology, Northern Beaches Health Service, Sydney, Australia.
Aust N Z J Obstet Gynaecol. 2019 Apr;59(2):312-316. doi: 10.1111/ajo.12954. Epub 2019 Feb 7.
Female genital mutilation (FGM) and its impact on women's health are becoming relevant in Australia due to increases in numbers of refugees and migrants from affected countries. Notwithstanding the psychological trauma from FGM, there is a broad range of sequelae relevant to obstetrics and gynaecology, particularly related to maternal morbidity from labour and delivery.
To assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes.
Retrospective cohort study of women affected by FGM who delivered at a metropolitan hospital in Sydney over a five-year period. The primary outcome was mode of delivery and secondary outcomes addressed maternal morbidity and neonatal nursery admission compared with women unaffected by FGM.
A full data set was available for 141/142 women affected by FGM. The overall prevalence of FGM was 1.64%. The majority of women affected by FGM were documented to have FGM 3 (41.1%). There was no difference in caesarean section rate. Women with FGM were less likely to be delivered by vacuum or forceps (11.1% vs 2.8%; P = 0.0009). There was no difference in perineal trauma, postpartum haemorrhage and neonatal nursery admission. Women with FGM 3 were more likely to have an episiotomy (4.8% vs 25.9%; P = 0.0007) without an increase in anal sphincter injury (P = 0.7). Documentation complying with local policy and guidelines was poor.
FGM is increasingly common in Australia. This study adds to the Australian literature quantifying the effects on obstetric outcomes in these high-risk women.
由于来自受影响国家的难民和移民数量增加，女性生殖器切割（FGM）及其对女性健康的影响在澳大利亚正变得日益重要。尽管女性生殖器切割会造成心理创伤，但仍存在一系列与妇产科相关的后遗症，尤其是与分娩时的孕产妇发病率有关。
评估我们科室女性生殖器切割的患病率，并记录其对孕产妇和新生儿结局的影响。
对在悉尼一家大都市医院分娩的受女性生殖器切割影响的女性进行回顾性队列研究。主要结局是分娩方式，次要结局是与未受女性生殖器切割影响的女性相比的孕产妇发病率和新生儿入住新生儿重症监护室情况。
142名受女性生殖器切割影响的女性中有141名有完整数据集。女性生殖器切割的总体患病率为1.64%。记录显示，受女性生殖器切割影响的大多数女性为3型切割（41.1%）。剖宫产率没有差异。接受女性生殖器切割的女性通过真空吸引或产钳助产的可能性较小（11.1%对2.8%；P = 0.0009）。会阴创伤、产后出血和新生儿入住新生儿重症监护室情况没有差异。3型切割的女性更有可能接受会阴切开术（4.8%对25.9%；P = 0.0007），但肛门括约肌损伤没有增加（P = 0.7）。符合当地政策和指南的记录情况较差。
女性生殖器切割在澳大利亚越来越普遍。这项研究为澳大利亚文献增添了内容，量化了这些高危女性对产科结局的影响。
