Multidisciplinary approach to the management of children with female genital mutilation (FGM) or suspected FGM: service description and case series

ObjectiveTo describe the presentation and management of children referred with suspected female genital mutilation (FGM) to a UK safeguarding clinic.Design and settingCase series of all children under 18 years of age referred with suspected FGM between June 2006 and May 2014.Main outcome measuresThese include indication for referral, demographic data, circumstances of FGM, medical symptoms, type of FGM, investigations and short-term outcome.ResultsOf the 47 girls referred, 27 (57%) had confirmed FGM. According to the WHO classification of genital findings, FGM type 1 was found in 2 girls, type 2 in 8 girls and type 4 in 11 girls. No type 3 FGM was seen. The circumstances of FGM were known in 17 cases, of which 12 (71%) were performed by a health professional or in a medical setting (medicalisation). Ten cases were potentially illegal, yet despite police involvement there have been no prosecutions.ConclusionsThis study is an important snapshot of FGM within the UK paediatric population. The most frequent genital finding was type 4 FGM with no tissue damage or minimal scarring. FGM was performed at a young age, with 15% reported under the age of 1 year. The study also demonstrated significant medicalisation of FGM, which matches recent trends in international data. Type 4 FGM performed in infancy is easily missed on examination and so vigilance in assessing children with suspected FGM is essential.

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59: A case series of surgical reconstruction in patients with female genital mutilation/cutting utilizing 3D ultrasound

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.12.208 ◽

2020 ◽

Vol 222 (3) ◽

pp. S853-S854

Author(s):

E. Welch ◽

J. Alshiek ◽

A.S. Shobeiri

Keyword(s):

Female Genital Mutilation ◽

Case Series ◽

3D Ultrasound ◽

Surgical Reconstruction ◽

Genital Mutilation ◽

Female Genital

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The Acton Model: support for women with female genital mutilation

British Journal of Midwifery ◽

10.12968/bjom.2020.28.10.697 ◽

2020 ◽

Vol 28 (10) ◽

pp. 697-708

Author(s):

Juliet Albert ◽

Mary Wells

Keyword(s):

Pregnant Women ◽

Female Genital Mutilation ◽

Psychological Symptom ◽

Case Series ◽

World Health ◽

Specialist Service ◽

Genital Mutilation ◽

Wide Range ◽

Type 3 ◽

Female Genital

Objectives To identify the presenting characteristics, needs and clinical management of non-pregnant women with female genital mutilation who attended the Sunflower clinic, a midwife-led specialist service. Methods This was a retrospective case series review examining referral patterns, clinical findings and subsequent management between 1 April 2018 and 31 March 2019.The review was conducted at a multi-disciplinary female genital mutilation clinic for non-pregnant women aged 18 years and over in West London. Results There were 182 attendances at the clinic (88 new patients; 94 follow-up appointments). Almost half (52%) had type 3 mutilation, 32% had type 2; 9% had a history of type 3; 5% had type 1; one had type 4 and one declined assessment. A total of 35 women (40%) disclosed at least one psychological symptom (such as depression, anxiety, flashbacks, nightmares) during initial consultation. Conclusions Non-pregnant women attending female genital mutilation services present with a wide range of psychological and physical problems. Holistic woman-centred models of care appear to facilitate access to deinfibulation and counselling, which in turn may reduce long-term costs to the NHS. Safeguarding is an intrinsic part of midwives' work and is sometimes complex. The authors recommend a revision of the World Health Organization classifications to specify partial or total removal of the clitoral glans (rather than the clitoris as a whole) as this is inaccurate and may have a negative psychological impact for women.

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