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一项关于女性割礼与索马里分娩结局关系的前瞻性队列研究。

A prospective cohort study of the relationship of female genital mutilation with birth outcomes in Somalia.

机构信息

Department of Obstetrics and Gynecology, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey.

Department of Obstetrics and Gynecology, Recep Tayyip Erdogan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.

出版信息

BMC Womens Health. 2022 May 31;22(1):202. doi: 10.1186/s12905-022-01790-2.

Abstract

BACKGROUND

Female genital mutilation (FGM) is defined as the partial or complete removal of the external female genitalia for non-medical reasons. There are some complications related to childbirth that concern both the mother and the baby. In this study, we aimed to evaluate the birth outcomes of FGM, which is widely applied in Somalia.

METHODS

The study included 268 women who gave birth at 37-42 weeks of gestation with a cephalic singleton, 134 with FGM and 134 without FGM. This study was designed a prospective cohort study and conducted between January 2019 and December 2020. Patients' ages, duration of delivery, FGM types, caesarean section requirements, before and after birth hemoglobin levels, birth weeks, baby birth weights and perineal tear data were recorded. In addition, we analyzed neonatal intensive care needs and APGAR scores for infants.

RESULTS

In patients with FGM, it was determined that the outlet obstruction increased 2.33 times, perineal tears increased 2.48 times, the need for caesarean section increased 2.11 times compared to the control group, and the APGAR score below 7 at the 5th minute in the children increased 2 times and the need for neonatal intensive care increased 1.87 times.

CONCLUSIONS

FGM causes increased risk of perineal tear, prolongation in the second stage of labour, increased need for emergency caesarean section, and increased need for NICU for infants. Prevention of FGM will help reduce both obstetric and neonatal complications.

摘要

背景

女性外阴残割是指出于非医学原因部分或全部切除女性外生殖器。这种做法会带来一些与分娩相关的并发症,既影响产妇,也影响婴儿。本研究旨在评估在索马里广泛施行的女性外阴残割术对分娩结局的影响。

方法

本研究纳入了 268 名孕 37-42 周、头位单胎的产妇,其中 134 名有女性外阴残割史,134 名无女性外阴残割史。本研究采用前瞻性队列研究设计,于 2019 年 1 月至 2020 年 12 月进行。记录产妇年龄、产程时间、女性外阴残割类型、剖宫产需求、分娩前后血红蛋白水平、分娩周数、新生儿出生体重和会阴撕裂数据。此外,我们还分析了新生儿重症监护需求和新生儿 Apgar 评分。

结果

与对照组相比,有女性外阴残割史的产妇中,出口梗阻增加 2.33 倍,会阴撕裂增加 2.48 倍,剖宫产需求增加 2.11 倍,新生儿第 5 分钟 Apgar 评分<7 分的比例增加 2 倍,需要新生儿重症监护的比例增加 1.87 倍。

结论

女性外阴残割增加了会阴撕裂、第二产程延长、紧急剖宫产和新生儿重症监护的需求。预防女性外阴残割将有助于减少产科和新生儿并发症。

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