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Female genital mutilation: Obstetric outcomes in metropolitan Sydney
Author(s) -
Davis Georgina,
Jellins Jessica
Publication year - 2019
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12954
Subject(s) - medicine , caesarean section , episiotomy , obstetrics , obstetrics and gynaecology , female circumcision , retrospective cohort study , gynecology , pregnancy , surgery , genetics , biology
Background 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. Aims To assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes. Methods 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. Results 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. Conclusions FGM is increasingly common in Australia. This study adds to the Australian literature quantifying the effects on obstetric outcomes in these high‐risk women.