Defibulation during vaginal delivery for women with type III female genital mutilation.
OBJECTIVE
To assess the routine practice of defibulation during vaginal delivery for women who have undergone female genital mutilation or cutting.


METHODS
A case-control study was conducted on women from Sudan, Somalia, Ethiopia, Egypt, and Yemen who delivered at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from January 1, 2000, to November 30, 2011. Women who had defibulation were identified, and their records were examined. For each woman who had defibulation, a woman from the same nationality who delivered without defibulation on the same day or the next days was chosen as a control. Data collected included demographics, mode of delivery, blood loss, intraoperative and postoperative complications, and labor outcome.


RESULTS
During the study period, 388 women underwent defibulation during vaginal delivery. Women who did not have defibulation were chosen as a control group (n=388). In the defibulation group, 300 (77.3%) women were registered during pregnancy; 88 (22.7%) women were unregistered. Defibulation during vaginal delivery was successfully performed by residents and senior residents under the care of the attending on call. No cesarean delivery was performed because of female genital mutilation or cutting, and no spontaneous rupture of the scar occurred. There were no statistically significant differences between women who had defibulation with those who did not or between infibulated registered and unregistered women in the duration of labor, episiotomy rates, blood loss, Apgar score, or fetal birth weight.


CONCLUSIONS
Defibulation during vaginal delivery is a valid management option. Labor attendants should be trained to perform it.
Department of Obstetrics and Gynecology, King Abdulaziz University, Jeddah, Saudi Arabia. aarouzi@gmail.com
Abdulrahim A
AA
Rouzi
Sharifa A
SA
Al-Sibiani
Nisma M
NM
Al-Mansouri
Nawal S
NS
Al-Sinani
Eetedal A
EA
Al-Jahdali
Khalid
K
Darhouse
D000328:Adult; D016022:Case-Control Studies; D019093:Circumcision, Female / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004534:Egypt; D005002:Ethiopia; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D012529:Saudi Arabia; D012998:Somalia; D013397:Sudan; D015006:Yemen