{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T02:03:35Z","timestamp":1783735415958,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2017,2,6]],"date-time":"2017-02-06T00:00:00Z","timestamp":1486339200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There remains no consensus on the best timing of deinfibulation in women with type <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> female genital mutilation (<jats:styled-content style=\"fixed-case\">FGM<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To conduct a systematic review of the effects of antepartum or intrapartum deinfibulation on childbirth outcomes in women with type <jats:styled-content style=\"fixed-case\">III FGM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>The following major databases were searched: Cochrane Central Register for Controlled Trials (<jats:styled-content style=\"fixed-case\">CENTRAL<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>, Scopus, Web of Science, and ClinicalTrials.gov, from inception until August 2015 without any language restrictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Studies of pregnant women or girls with type <jats:styled-content style=\"fixed-case\">III FGM<\/jats:styled-content> who were deinfibulated antepartum or intrapartum were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Two team members independently screened and collected data. Quality of evidence was assessed using <jats:styled-content style=\"fixed-case\">GRADE<\/jats:styled-content>. Summary odds ratios and proportions were calculated when possible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There is no evidence of a significant difference between antepartum and intrapartum deinfibulation for obstetric outcomes such as duration of labor, perineal lacerations, episiotomies, postpartum hemorrhage, and cesarean deliveries. Outcomes in women living with type <jats:styled-content style=\"fixed-case\">III FGM<\/jats:styled-content> and those who have undergone deinfibulation were not statistically different; however, trends show a benefit for deinfibulation. All studies were underpowered to detect statistical differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Larger studies are required to have full confidence in these findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO registration<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CRD<\/jats:styled-content>42015024464.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12055","type":"journal-article","created":{"date-parts":[[2017,2,6]],"date-time":"2017-02-06T08:05:22Z","timestamp":1486368322000},"page":"21-29","source":"Crossref","is-referenced-by-count":28,"title":["Antepartum or intrapartum deinfibulation for childbirth in women with type <scp>III<\/scp> female genital mutilation: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"136","author":[{"given":"Ekpereonne","family":"Esu","sequence":"first","affiliation":[{"name":"Department of Public Health College of Medical Science University of Calabar  Calabar Nigeria"},{"name":"Calabar Institute of Tropical Diseases Research and Prevention University of Calabar Teaching Hospital  Calabar Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atim","family":"Udo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology College of Medical Science University of Calabar  Calabar Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babasola O.","family":"Okusanya","sequence":"additional","affiliation":[{"name":"Experimental and Maternal Medicine Unit Department of Obstetrics and Gynecology Faculty of Clinical Sciences College of Medicine University of Lagos  Idi\u2010Araba, Lagos Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Agamse","sequence":"additional","affiliation":[{"name":"Calabar Institute of Tropical Diseases Research and Prevention University of Calabar Teaching Hospital  Calabar Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M.","family":"Meremikwu","sequence":"additional","affiliation":[{"name":"Calabar Institute of Tropical Diseases Research and Prevention University of Calabar Teaching Hospital  Calabar Nigeria"},{"name":"Department of Pediatrics University of Calabar Teaching Hospital  Calabar Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,6]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Eliminating Female Genital Mutilation: An Interagency Statement","author":"World Health Organization","year":"2008"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006316"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000224613.72892.77"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2007.00616.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.09.064808"},{"key":"e_1_2_8_7_1","volume-title":"Cochrane Handbook For Systematic Reviews of Interventions","author":"Higgins JP"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"e_1_2_8_9_1","volume-title":"A Cochrane Risk of Bias Assessment Tool: For Non\u2010Randomized Studies of Interventions (ACROBAT\u2010NRSI)","author":"Sterne JA","year":"2014"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000069119"},{"key":"e_1_2_8_12_1","first-page":"743","article-title":"Obstetrical consequences of female circumcision. 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