title: Female circumcision: a risk factor in postpartum haemorrhage.
abstract: A major postpartum haemorrhage occurred in a patient with a previous history of female circumcision. Following assisted vaginal delivery 6 litre blood loss occurred as a result of tears to the vagina and perineum. The tears were sutured, followed by insertion of vaginal packs. Replacement fluid therapy was given. To reduce the incidence of tears and accompanying haemorrhage, it is advisable to perform two episiotomies viz. anterior and midline posterior or mediolateral.
authors.affiliation: Sir Humpry Davy Dept of Anaesthesia, Bristol Royal Infirmary.
authors.forename: M M
authors.initials: MM
authors.lastname: McSwiney
authors.forename: P R
authors.initials: PR
authors.lastname: Saunders
mesh_terms: D000328:Adult; D002944:Circumcision, Male; D003469:Culture; D004841:Episiotomy; D005260:Female; D006801:Humans; D008297:Male; D010502:Perineum / Q000293:injuries; D006473:Postpartum Hemorrhage / Q000209:etiology* / Q000628:therapy; D011247:Pregnancy; D012307:Risk Factors; D014621:Vagina / Q000293:injuries