The effectiveness of surgical interventions for women with FGM/C: a systematic review

Autor: Sølvi Taraldsen, Maryan Said, Rigmor C. Berg, Ingvil Krarup Sørbye, Siri Vangen
Rok vydání: 2017
Předmět:
Adult
medicine.medical_specialty
Reconstructive surgery
medicine.medical_treatment
Psychological intervention
Clitoris
Lower risk
03 medical and health sciences
0302 clinical medicine
systematic review
Pregnancy
VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gynecology and obstetrics: 756
medicine
obstetric
Humans
Sex organ
Caesarean section
030212 general & internal medicine
Defibulation
Gynecology
030219 obstetrics & reproductive medicine
business.industry
Obstetrics
Cesarean Section
excision of cyst
Pregnancy Outcome
Obstetrics and Gynecology
Professional-Patient Relations
Plastic Surgery Procedures
Delivery
Obstetric
Confidence interval
reconstructive surgery
Female Urogenital Diseases
Obstetric Labor Complications
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Gynekologi og obstetrikk: 756
medicine.anatomical_structure
female genital mutilation/cutting
Relative risk
Circumcision
Female
Vagina
Female
business
Zdroj: BJOG: an International Journal of Obstetrics and Gynaecology
ISSN: 1471-0528
Popis: This is the peer reviewed version of the following article: Berg, R., Taraldsen, S., Said, M., Sørbye, I. & Vangen, S. (2017). The effectiveness of surgical interventions for women with FGM/C: a systematic review. BJOG: an International Journal of Obstetrics and Gynaecology, 125(3), 278-287. https://doi.org/10.1111/1471-0528.14839, which has been published in final form at https://doi.org/10.1111/1471-0528.14839. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Background Female genital mutilation/cutting (FGM/C) changes normal genital functionality and can cause complications. There is an increasing demand for treatment of FGM/C‐related complications. Objectives We conducted a systematic review of empirical quantitative research on the outcomes of interventions for women with FGM/C‐related complications. Search strategy A search specialist searched 16 electronic databases. Selection criteria Selection was performed independently by two researchers. We accepted quantitative studies that examined the outcome of an intervention for an FGM/C‐related concern. Data collection and analysis We extracted data into a pre‐designed form, calculated effect estimates, and performed meta‐analyses. Main results We included 62 studies (5829 women), which investigated the effect of defibulation, excision of cysts, and clitoral reconstruction. Meta‐analyses of defibulation versus no defibulation showed a significantly lower risk of caesarean section (relative risk, RR: 0.33; 95% confidence interval, 95% CI: 0.25–0.45) and perineal tears with defibulation: second‐degree tear (RR: 0.44, 95% CI: 0.24–0.79), third‐degree tear (RR: 0.21, 95% CI: 0.05–0.94), fourth‐degree tear (RR: 0.06, 95% CI: 0.01–0.41). The meta‐analyses detected no significant differences in obstetric outcomes of antenatal versus intrapartum defibulation. Except for one study, none of the studies on the excision of cysts indicated any complications, and the results were deemed favourable. Reconstructive surgery resulted in a visible clitoris in about 77% of women. Most women self‐reported improvements in their sexual life, but up to 22% experienced a worsening in sexuality‐related outcomes after reconstruction. Conclusions Women with FGM/C who seek therapeutic surgery should be informed about the scarcity of evidence for benefits and the potential harms of the available procedures.
Databáze: OpenAIRE
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