ABSTRACT
OBJECTIVE: To investigate missed opportunities for diagnosing female genital mutilation (FGM) at an obstetrics and gynecology (OB/GYN) department in Switzerland. METHODS: In a retrospective study, we included 129 consecutive women with FGM who attended the FGM outpatient clinic at the Department of Gynecology and Obstetrics at the University Hospitals of Geneva between 2010 and 2012. The medical files of all women who had undergone at least 1 previous gynecologic exam performed by an OB/GYN doctor or a midwife at the study institution were reviewed. The type of FGM reported in the files was considered correct if it corresponded to that reported by the specialized gynecologist at the FGM clinic, according to WHO classification. RESULTS: In 48 (37.2%) cases, FGM was not mentioned in the medical file. In 34 (26.4%) women, the diagnosis was correct. FGM was identified but erroneously classified in 28 (21.7%) cases. There were no factors (women's characteristics or FGM type) associated with missed diagnosis. CONCLUSION: Opportunities to identify FGM are frequently missed. Measures should be taken to improve FGM diagnosis and care.
Subject(s)
Circumcision, Female/statistics & numerical data , Diagnostic Errors/statistics & numerical data , Gynecology/standards , Obstetrics/standards , Adolescent , Adult , Child , Child, Preschool , Circumcision, Female/classification , Female , Humans , Infant , Outpatient Clinics, Hospital , Retrospective Studies , Switzerland , Young AdultABSTRACT
Elder abuse and in particular material and financial exploitation involving the misappropriation of the older person's money or property is common but rarely identified or managed in clinical practice. It has a direct impact on quality of life, health and social status. Our aim is to assist clinicians by summarizing this frequently unrecognized problem. We discuss risk factors, alerting signs, clinical manifestations, and specific questions that can be used for screening purposes as well as intervention strategies preferably in the context of a multidisciplinary team.
Subject(s)
Elder Abuse/statistics & numerical data , Patient Care Team/organization & administration , Quality of Life , Aged , Aged, 80 and over , Elder Abuse/diagnosis , Elder Abuse/economics , Female , Humans , Mass Screening/methods , Risk FactorsABSTRACT
In multi-ethnic European society medical professionals are faced with an increasing number of women originating from countries where female genital mutilations/cuttings (FGM/C) are practised. Recent studies, however, emphasise the lack of knowledge on this subject. This review article aims to present FGM/C as a complex socio-healthcare and multidisciplinary issue, outlining the definition, classification, epidemiology and anthropologico-legal aspects of FGM/C. It explains the approach to be adopted to FGM/C women, focusing on defibulation, clitoral restoration/repair and re-infibulation. Finally, it reports on the discussions surrounding pricking/nicking and the proposals for alternative rituals in recent years.
