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Missed opportunities for diagnosis of female genital mutilation.

Int J Gynaecol Obstet. 2014 Mar 5. pii: S0020-7292(14)00114-3. doi: 10.1016/j.ijgo.2013.11.016. [Epub ahead of print]

Missed opportunities for diagnosis of female genital mutilation.

Abdulcadir J, Dugerdil A, Boulvain M, Yaron M, Margairaz C, Irion O, Petignat P.

ABSTRACT

OBJECTIVE: To investigate missed opportunities for diagnosing female genital mutilation (FGM) at an obstetrics and gynecology (OB/GYN) department in Switzerland.

METHODS: In a retrospective study, we included 129 consecutive women with FGM who attended the FGM outpatient clinic at the Department of Gynecology and Obstetrics at the University Hospitals of Geneva between 2010 and 2012. The medical files of all women who had undergone at least 1 previous gynecologic exam performed by an OB/GYN doctor or a midwife at the study institution were reviewed. The type of FGM reported in the files was considered correct if it corresponded to that reported by the specialized gynecologist at the FGM clinic, according to WHO classification.

RESULTS: In 48 (37.2%) cases, FGM was not mentioned in the medical file. In 34 (26.4%) women, the diagnosis was correct. FGM was identified but erroneously classified in 28 (21.7%) cases. There were no factors (women’s characteristics or FGM type) associated with missed diagnosis.

CONCLUSION: Opportunities to identify FGM are frequently missed. Measures should be taken to improve FGM diagnosis and care.

This article can be accessed in this LINK.

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Archives Blog Original research

[“I will not circumcise my daughter”]

Krankenpfl Soins Infirm. 2012;105(12):55.

[“I will not circumcise my daughter”]. [Article in French]

Taillens F.

There is no ABSTRACT available for this article.

There is no LINK to view this article online.

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[Female genital mutilation–need for answers at the age of adolescence]

Rev Med Suisse. 2008 Jun 11;4(161):1445-6,1448-50.

[Female genital mutilation–need for answers at the age of adolescence]. [Article in French]

Renteria SC.

Département de gynécologie-obstétrique, c/o UMSA, CHUV, Lausanne. Saira-Christine.Renteria@chuv.ch

ABSTRACT

In Switzerland, the estimated number of survivors after traditional female genital mutilation in the country of origin or girls and adult women at risk is 6-7000. Health professionals must be able to respond adequately to their questions not only during adolescence but through out the different periods of life. The lack of information or transmission by the seniors as well before the excision as at the time of sexual maturity contributes in a large measure to the frequent biographic trauma. It can be very difficult for the girls to deal with the gap between socio cultural and family expectations and their individual life experience in Switzerland.

There is no link to view this article online.

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Archives Blog Original research

Effects of female genital mutilation on birth outcomes in Switzerland.

BJOG. 2009 Aug;116(9):1204-9. Epub 2009 May 14.

Effects of female genital mutilation on birth outcomes in Switzerland.

Wuest S, Raio L, Wyssmueller D, Mueller MD, Stadlmayr W, Surbek DV, Kuhn A.

Department of Obstetrics and Gynaecology, University of Berne and Inselspital Berne, Berne, Switzerland.

OBJECTIVE: The primary aim of this study was to determine the desires and wishes of pregnant patients vis-à-vis their external genital anatomy after female genital mutilation (FGM) in the context of antenatal care and delivery in a teaching hospital setting in Switzerland. Our secondary aim was to determine whether women with FGM and non-mutilated women have different fetal and maternal outcomes.

DESIGN: A retrospective case-control study.

SETTING: A teaching hospital.

POPULATION: One hundred and twenty-two patients after FGM who gave consent to participate in this study and who delivered in the Department of Obstetrics and Gynaecology in the University Hospital of Berne and 110 controls.

METHODS: Data for patients’ wishes concerning their FGM management, their satisfaction with the postpartum outcome and intrapartum and postpartum maternal and fetal data. As a control group, we used a group of pregnant women without FGM who delivered at the same time and who were matched for maternal age.

MAIN OUTCOME MEASURES: Patients’ satisfaction after delivery and defibulation after FGM, maternal and fetal delivery data and postpartum outcome measures.

RESULTS: Six percent of patients wished to have their FGM defibulated antenatally, 43% requested a defibulation during labour, 34% desired a defibulation during labour only if considered necessary by the medical staff and 17% were unable to express their expectations. There were no differences for FGM patients and controls regarding fetal outcome, maternal blood loss or duration of delivery. FGM patients had significantly more often an emergency Caesarean section and third-degree vaginal tears, and significantly less first-degree and second-degree tears.

CONCLUSION: An interdisciplinary approach may support optimal antenatal and intrapartum management and also the prevention of FGM in newborn daughters.

This article can be accessed in this LINK.