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Deinfibulation for preventing or treating complications in women living with type III female genital mutilation: A systematic review and meta‐analysis
Background Deinfibulation is a surgical procedure carried out to re‐open the vaginal introitus of women living with type III female genital mutilation (FGM). Objectives To assess the impact of deinfibulation on gynecologic or obstetric outcomes by comparing women who were deinfibulated with women wi...
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Published in: | International journal of gynecology and obstetrics 2017-02, Vol.136 (S1), p.13-20 |
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Main Authors: | , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Background
Deinfibulation is a surgical procedure carried out to re‐open the vaginal introitus of women living with type III female genital mutilation (FGM).
Objectives
To assess the impact of deinfibulation on gynecologic or obstetric outcomes by comparing women who were deinfibulated with women with type III FGM or women without FGM.
Search strategy
Major databases including CENTRAL, MEDLINE, and Scopus were searched until August 2015.
Selection criteria
We included nonrandomized studies that compared obstetric outcomes of women with deinfibulation, type III FGM (not deinfibulated during labor), and no FGM.
Data collection and analysis
Quality of evidence was determined following the GRADE methodology. Summary measures were calculated using odds ratios at 95% confidence intervals.
Results
We found no randomized controlled trials. We included four case–control studies. The quality of evidence was very low. Compared with women with type III FGM at delivery, deinfibulated women had a significant reduction in the risk of having a cesarean delivery or postpartum hemorrhage. Compared with women without FGM, deinfibulated women had a similar risk of episiotomy, cesarean delivery, vaginal lacerations, postpartum hemorrhage, and blood loss at vaginal delivery. The length of second stage of labor, mean maternal hospital stay, and Apgar scores less than 7 were also comparable.
Conclusions
Low‐quality evidence suggests deinfibulation improves birth outcomes for women with type III FGM.
PROSPERO registration
CRD42015024466.
Low‐quality evidence suggests deinfibulation reduces the risk of cesarean delivery and postpartum hemorrhage in women living with type III female genital mutilation. |
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ISSN: | 0020-7292 1879-3479 |
DOI: | 10.1002/ijgo.12056 |