Obstetric Perineal Lacerations in Women With Female Genital Mutilation (FGM) [11G

Abstract

INTRODUCTION: To evaluate whether or not women, who have undergone FGM III, have an increased rate of second degree and higher obstetric perineal lacerations than a control group of similar patients. METHODS: For this retrospective chart review, we searched the electronic medical record (EMR) for patients speaking Somali, Arabic, Kurdish, Swahili, and French, who delivered at the University of Louisville Hospital from April 10, 2016 through August 10, 2017. We then entered baseline characteristics and delivery details into a secure database. A total of 110 patients were included. We looked at type of FGM, mode of delivery, rates of assisted delivery and primary cesarean section, types of perineal lacerations, and whether or not defibulation was performed. RESULTS: The baseline characteristics had several significant differences between the controls (n=84), FGM II (n=11), and FMG III (n=15) patients. Most strikingly, the FGM III population was 93% nulliparous. We controlled for this in our analysis with logistic regression models. The odds ratios (OR) of a second degree or higher perineal laceration comparing FGM III to controls (OR 5.06, 0.87-53.84) was not significant (p=0.0687). After logistic regression was applied controlling for body mass index, nulliparity, and assisted delivery, there was no increased risk of laceration in women with FGM III (AOR 1.06, CI 0.11-10.35, p=0.9571). We found that we correctly followed the standard of care and defibulated 89% (8/9) of women with FGM III that underwent vaginal delivery. CONCLUSION: Women with FGM III did not appear to have an increased risk of second degree and higher perineal lacerations.