Female genital mutilation as a risk factor of obstetric urethral and paraurethral injuries among primiparous women during vaginal delivery

Background: Female genital mutilation (FGM) is defined by the World Health Organization as “all procedures involving partial or total removal of the female genitalia, or other injuries to the female genital organs for non-medical reasons”. Aim of the study: to investigate the impact of FGM on urethral and paraurethral injuries among primiparous women. Patients and Methods: this case control study was done on 168 primiparous women and categorized into two groups :Group (A): Primiparous women who were not circumcised. Group (B): Primiparous women who are circumcised. Patients who fit the inclusion criteria were recruited from obstetrics and gynecology maternity unit in El-Demerdash and AFCMH. Results: Both groups (FGM and non-FGM) had similar age and BMI, but women with FGM had significantly lower education levels. Women with FGM experienced a significantly prolonged second stage of labor, which was especially evident in those with more severe forms of FGM. Urethral and paraurethral injuries, as well as vaginal lacerations and tears, were significantly more common in women with FGM, particularly in those with Type 3 FGM. The severity of FGM directly correlated with the risk of injuries, with Type 3 FGM showing the highest rates of urethral, paraurethral, and vaginal trauma. Conclusion: FGM, especially its severe forms, significantly increases the risk of maternal injuries and labor complications. Neonatal outcomes were unaffected, but the findings emphasize the adverse effects of FGM on maternal health during childbirth