outcomes of labour among women with and witout female genital mutilation in the mother and child hospital of N'djamena/Chad

Gédéon NDAKMISSOU (ndakmissou@yahoo.fr)
Gynaecology and obstetrics, University of Yaounde I
July, 2014
 

Abstract

Introduction
Female Genital Mutilation/Cutting, is a world-wide traditional practice. More than 140 million women and girls are concerned and most of them in Africa. It is associated to many complications among which, we have obstetrical complications. For the purpose of contributing to the fight against this practice, a study was carried out to determine obstetrical outcomes of pregnancies at term among women who have undergone or not undergone female genital mutilation in N’djamena/Chad.

Methods

A prospective cohort study was carried out from December 1th 2013 to March 1th 2014. Data were collected with questionnaire during labor, delivery and early post-pastum period after patient or family consent. Each circumcised woman who fulfills inclusion criteria and did not present exclusion criteria were followed during labour, delivery and early post-partum period. Each mutilated woman was paired to a non-mutilated of the same age, parity and who delivered the same day. When a mutilated woman had not been paired according to the up listed criteria, she was not included in the analyzed sample. Data has been entered into SPSS 14.0 software, and analysis performed with EPI-INFO 7.1.3.3. The student/Wilcoxon test was used to compare means and the Khi²/Fisher’s test to compare frequencies.

Results

62, 63% of women were housewives (N=243). Ages varies from 15 to 41 years old with a mean of 24,57 years. Among mutilated women, Arabics, Sara, andOuaddaï ethnics count respectively 38,62% (N=73), 30,46% (N=53) and 18,,2% (N=39). In th non-mutilated group Mayo-Kebbi’sNgambaye’s and Gorane’s count respectively 30,46%(N=53) 27,01% (N=47), and 22,41% (N=39)/
64,4% (N=123) of mutilations were Type II, 21,4% (N=41) Type I, and 14,14 (N=27) of Type III.
Maternal complications with significant difference were: Mechanic Dystocia RR=8,8 (P<0,05 N=41), Perineal tear RR =3,64 ( p<0,05 N=62); Cesarean section RR= 4,66 ( P<0,05 N=56) and prolonged Hospitalization RR=1,34 ( P<0,05 N=92). There were no significant difference concerning post- partum haemorrhage, uterine revision and prolonged labour and maternal mortality.
Concerning the foetus the following complications have been observed. Fetal distress RR=4,5 (P<0,05 N=45), bad Apgar score RR= 3,5 (P<0,05 N=28); Neonatal resuscitation RR=3,14 (P<0,05 N=44) and fresh stillbirth RR= 3,16 (P<0,05 N=19).

Conclusion

Female Genital Mutilation/Cutting is a risk factor for the occurrence of many obstetrical complications such us dystocia, perineal tear, cesarean section, prolonged hospitalization, fetal distress, bad Apgar score, neonatal resuscitation and fresh still birth.


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