The use of intrapartum defibulation in women with female genital mutilation

Abdulrahim A. Rouzi , Etedal A. Aljhadali , Zouhair O. Amarin , Hassan S. Abduljabbar
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Abstract

Objective To assess the use of intrapartum defibulation for women who have had female genital mutilation.

Design A retrospective case analysis.

Setting King Abdulaziz University Hospital, a teaching hospital in Jeddah, Saudi Arabia.

Sample Two hundred and thirty-three Sudanese and 92 Somali women who were delivered at the hospital between January 1996 and December 1999.

Methods The outcome of labour of women with female genital mutilation who needed intrapartum defibulation were compared with the outcome of labour of women without female genital mutilation who did not need intrapartum defibulation.

Results One hundred and fifty-eight (48.6%) women had infibulation and needed intrapartum defibulation to deliver vaginally, 116 women (35.7%) did not have infibulation and gave birth vaginally without defibulation, and 51 (15.7%) women were delivered by caesarean section. There were no statistically significant differences, between women who underwent intrapartum defibulation and those who did not, in the duration of labour, rates of episiotomy and vaginal laceration, APGAR scores, blood loss and maternal stay in hospital. The surgical technique of intrapartum defibulation was easy and no intraoperative complications occurred.

Conclusions Intrapartum defibulation is simple and safe, but sensitivity to the cultural issues involved is essential. In the longer term, continuing efforts should be directed towards abandoning female genital mutilation altogether.

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切割女性生殖器官的妇女在分娩时使用节育术
目的探讨女性外阴残割术后产妇产时节育的应用情况。设计回顾性案例分析。背景:阿卜杜勒阿齐兹国王大学医院,位于沙特阿拉伯吉达的一家教学医院。抽样1996年1月至1999年12月期间在该医院分娩的233名苏丹妇女和92名索马里妇女。方法对女性外阴残割术后需行宫内除管术的分娩结局与未行宫内除管术的分娩结局进行比较。结果有宫内节育术且需宫内节育术顺产的产妇158例(48.6%),未行节育术且未节育术顺产的产妇116例(35.7%),剖宫产51例(15.7%)。在分娩持续时间、会阴切开术和阴道撕裂率、APGAR评分、出血量和产妇住院时间等方面,接受分娩时止血术的妇女与未接受分娩时止血术的妇女之间没有统计学上的显著差异。产时除颤术操作简单,无术中并发症发生。结论:产时去管术是一种简单、安全的方法,但对相关文化问题的敏感性是至关重要的。从较长期来看,应继续努力完全放弃切割女性生殖器官的做法。
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