TITLE:
Obstetric Complications Due to Female Genital Mutilation (FGM) at N’Djamena Mother and Child Hospital (Chad)
AUTHORS:
Lhagadang Foumsou, Richard Norbert Nglalé, Jeanne Fouedjio, Gédéon Ndakmissou, Bray Madoué Gabkika, Sadjoli Damthéou, Philip Njotang Nana, Abdoulaye Sépou
KEYWORDS:
Female Genital Mutilation, Childbirth, Maternal-Fetal Complication, N’Djamena (Chad)
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.14,
November
30,
2015
ABSTRACT: Background: Female genital mutilation (FGM) or female circumcision is all
procedures involving partial or total removal of the external female genital
organ or other injuries to the female genital organ whether for cultural or any
other non-therapeutic reasons. Female genital mutilation causes numerous
complications. Four in such cases multiplies obstetric complications. The aim
of this study was to identify obstetric complications due to FGM. Patients and Material:
We conducted a comparative prospective case-control study for three months,
from January 1st to March 31st, 2014 in the maternity of N’Djamena
Mother and Child. It focused on identifying neonatal and/or maternal
complications during childbirth due to FGM. The study population consisted of
pregnant women at term admitted for delivery labor. All parturients had to present
the same sociodemographic and clinical profiles. A history of FGM was the main
distinguishing criterion. Results: During the study period, we recorded 312
births to women with genital mutilation, among 1905 deliveries, representing a
prevalence of 16.4%. One hundred ninety-one cases
of circumcised women responding to the inclusion criteria were selected. Most
of these women were between the ages of 20 and 29. The extreme age group was 15
and 39 (with a mean of 24.5 years). FGM was significant in age group over 20
years (Khi2 = 10.8; OR = 2.6 [1.4 - 4.9]; P = 0.001). The type II of
FGM which removed a part of the clitoris and the adjacent labia minora
represented 64.40% patients in the group of women with FGM. Perinea laceration
was the frequent maternal complication among parturient with FGM (Khi2 = 9.8; OR = 2.2 [1.4 to 3.6]; P = 0.0007). FGM type III was associated with a
high proportion of maternal complication (Khi2 = 11.2; OR = 7.3 [1.97
- 31.6]; P = 0.0001). Still births were significantly higher in the group of
parturient with FGM (11.5%, P = 0.015). Conclusion: Female genital mutilation
is a common cultural practice in our country; it contributes to worsening
maternal and fetal complications.