FGM Flashcards
What is FGM?
Female genital mutilation (FGM) refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons.
Describe the WHO classification of FGM?
Type 1 Partial or total removal of the clitoris and/or the prepuce (clitoridectomy).
Type 2 Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).
Type 3 Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).
Type 4 All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization.
What term is sometimes preferred by women who have undergone FGM?
Affected women prefer the term genital cutting over FGM.
What are the short term complications of FGM?
Death, blood loss, sepsis, pain, urinary retention, tetanus, hepatitis and HIV.
What are the long term complications of FGM?
Apareunia, superficial dyspareunia, anorgasmia, sexual dysfunction, chronic pain, keloid scar, slow urination, recurrent UTIs, subfertility and issues with childbirth such as CS, PPH, episiotomy and fistula.
What management can be offered to women with FGM?
Defibulation – may performed before marriage, at 20 weeks gestation or in the 1st stage of Labour. If not corrected antenatally then delivery must occur in a unit with emergency obstetric care.
If vaginal examination poorly tolerated or anterior episiotomy anticipated, then an epidural is offered.
Repair after delivery can control bleeding but re-infibulation is illegal
What are the duties of a doctor in regards to FGM?
Duty as a Doctor – report all cases of FGM in girls under the age of 18 to the police.
In women over the age of 18, enquire about it and if they are willing ask them to divulge where it was done and who did it then report this to the police.
