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Effects of clitoral reconstruction for female genital mutilation on perinatal outcomes: a retrospective case-control study
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  • Sebastien Madzou,
  • Chloe Reau-Guisti,
  • Soazig Herve,
  • Katherine ZhuOrcid,
  • Charlemagne Ouédrago,
  • Caroline Verhaeghe,
  • Philippe Gillard,
  • Laurent Catala,
  • Vanessa Combaud,
  • Philippe Descamps,
  • Guillaume Legendre,
  • Romain Corroenne
Sebastien Madzou
CHU Angers
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Chloe Reau-Guisti
CHU Angers
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Soazig Herve
CHU Angers
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Katherine Zhu
Orcid
Baylor College of Medicine
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Charlemagne Ouédrago
Bogodo OUagadougou University Hospital
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Caroline Verhaeghe
CHU Angers
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Philippe Gillard
CHU Angers
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Laurent Catala
CHU Angers
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Vanessa Combaud
CHU Angers
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Philippe Descamps
CHU
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Guillaume Legendre
CHU Angers
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Romain Corroenne
CHU Angers
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Peer review status:UNDER REVIEW

20 May 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
21 May 2020Assigned to Editor
21 May 2020Submission Checks Completed
21 May 2020Reviewer(s) Assigned
30 Jun 2020Review(s) Completed, Editorial Evaluation Pending

Abstract

Objectives: To investigate the perinatal outcomes of women with a history of female genital mutilation (FGM) who underwent clitoral reconstruction (CR) compared with women with FGM who did not undergo CR. Design: Retrospective case-control study Setting: Angers University Hospital, between 2005 and 2017 Methods: Inclusion criteria: pregnant women >18 years who underwent CR after FGM. Only the first subsequent delivery after CR was included. Each woman with CR was matched for age, ethnicity, FGM type, parity, and gestational age at the time of delivery with two women with FGM who did not undergo CR during the same period of time. Main outcome measures: at birth: need for episiotomy and intact perineum Results: 84 women were included (28 in the CR group; 56 in the control group). In the CR group, patients required significantly fewer episiotomies (5/17[29.4%]) compared to the control group (28/44[63.6%], p=0.02), even after excluding operative vaginal deliveries (2/13[15.4%] vs 21/36[58.3], p<0.01). CR reduces the risk of episiotomy (aOR=0.15, 95%CI [0.04-0.56]; p<0.01) after adjusting on the infant weight and the need for instrumental delivery. In the CR group, 47% of the patients had an intact perineum after delivery, compared to 20.4% in the control group (p=0.04). CR increases the odds of having an intact perineum at birth by 3.46 times (CI95%[1.04-11.49]; p=0.04). Conclusion: CR after FGM increases the chances of having an intact perineum after delivery by 3.46 times and reduces the risk of episiotomy by 0.15 times compared to women with FGM who did not underwent CR.