Paediatric gynaecology & FGM Flashcards
What is FGM?
The partial or total removal of female external genitalia
For non-medical reasons
What are the 4 types of FGM?
- Remove clitoris
- Remove clitoris and labia minora +/- labio majora
- Narrowing of vaginal orifice
- Anything else
Why is FGM done?
Status and respect for family
Preserves chastity, virginity, purifies
Rite of passage
Sense of belonging in community
Social acceptance
What are some of the long-term problems associated with FGM?
Dyspareunia Anorgasmia Chronic pain Keloid scar Dysmenorrhoea Urinary outflow obstruction PTSD Difficulty conceiving
What problems do women who’ve had FGM face at childbirth?
Increased risk of needing:
- C section
- episiotomy
- long hospital stay
When FGM is likely to impact on the woman’s ability to give birth, what can be done? When should it be done?
Reversal of infundibulation (surgery)
Ideally before conception, but can be done ante-natally
Intra-partum: anterior episiotomy
When should menarche happen?
Does ovulation occur in the first few cycles?
Usually 11-14
No.
What’s the difference between primary and secondary amenorrhoea?
Primary: no menses have occurred by age 16, or absence of secondary sexual characteristics
Secondary: cessation after onset of menses
What are some causes of primary and secondary amenorrhoea?
Primary: Turner’s, hypothalamic-pituitary problem, anatomical
Secondary: weight loss, excessive exercise
What is precocious puberty?
Onset of puberty before age 8 in girls and 9 in boys
What are the causes of precocious puberty?
Central (gonadotropin dependent, early maturation of HPG axis)
- CNS trauma, tumour, hydrocephalus
Pseudopuberty (gonadotropin independent)
- CAH
- adrenal or ovarian tumours
What is:
- HPG
- CAH?
HPG = hypothalamic, pituitary, gonadotropin
CAH = congenital adrenal hyperplasia
