2015 53 FGM Flashcards
** What are the 4 aspects of the FGM act 2003 in England? **
- Illegal unless essential surgical operation
- Illegal to assist overseas transport for the purpose of FGM
- Parents must protect their children
- Mandatory police reporting of child <18 within 1 month
** Under what circumstances is female genital cosmetic surgery allowed? **
Necessary for physical or mental health
** Under what circumstances is re-infibulation allowed? **
None, it’s illegal
** What are the potential signs & symptoms of recent FGM? **
- Pain
- Bleeding
- Infection
- Urinary retention
** What investigations should be offered in FGM? **
- HIV
- Hepatitis B & C
- Sexual health screen
** What procedures may require de-infibulation? **
- Cervical smears
- Genital infection screens
- SMOM
- STOP
- Birth!
** When can de-infibulation be performed? **
- As gynae outpatient
- Antenatally, usually mid-2nd trimester
- 1st stage of labour
- At delivery
- Peri-CS
What are the FGM classifications?
Type 1: Partial or total clitoridectomy
Type 2: Clitoris & labia minora +/- majora
Type 3: Appositioning labia minora &/or majora
Type 4: All other
What is the global epidemiology of FGM?
125 million
What is the UK epidemiology of FGM?
137,000 including 10,000 girls <15
Which countries have >90% rate of FGM?
Somalia
Guinea
Djibouti
Egypt
What are the long-term consequences of FGM?
- Genital scarring
- Urinary tract complications
- Dyspareunia, apareunia & impaired sexual function
- Psychological
- Menstrual difficulties
- Genital infection & PID
- Infertility
- HIV & hepatitis
- Obstetric complications
What are the obstetric complications of FGM?
- Prolonged labour
- PPH
- Perineal trauma
- Increased CS rate
- Need for neonatal resuscitation
- Increased stillbirth & NND
