{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T08:37:45Z","timestamp":1783067865878,"version":"3.54.6"},"reference-count":19,"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 & Obste"],"published-print":{"date-parts":[[2017,2]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Deinfibulation is a surgical procedure carried out to re\u2010open the vaginal introitus of women living with type III<\/jats:styled-content> female genital mutilation (FGM<\/jats:styled-content>).<\/jats:p><\/jats:sec>Objectives<\/jats:title>To assess the impact of deinfibulation on gynecologic or obstetric outcomes by comparing women who were deinfibulated with women with type III FGM<\/jats:styled-content> or women without FGM<\/jats:styled-content>.<\/jats:p><\/jats:sec>Search strategy<\/jats:title>Major databases including CENTRAL<\/jats:styled-content>, MEDLINE<\/jats:styled-content>, and Scopus were searched until August 2015.<\/jats:p><\/jats:sec>Selection criteria<\/jats:title>We included nonrandomized studies that compared obstetric outcomes of women with deinfibulation, type III FGM<\/jats:styled-content> (not deinfibulated during labor), and no FGM<\/jats:styled-content>.<\/jats:p><\/jats:sec>Data collection and analysis<\/jats:title>Quality of evidence was determined following the GRADE<\/jats:styled-content> methodology. Summary measures were calculated using odds ratios at 95% confidence intervals.<\/jats:p><\/jats:sec>Results<\/jats:title>We found no randomized controlled trials. We included four case\u2013control studies. The quality of evidence was very low. Compared with women with type III FGM<\/jats:styled-content> at delivery, deinfibulated women had a significant reduction in the risk of having a cesarean delivery or postpartum hemorrhage. Compared with women without FGM<\/jats:styled-content>, deinfibulated women had a similar risk of episiotomy, cesarean delivery, vaginal lacerations, postpartum hemorrhage, and blood loss at vaginal delivery. The length of second stage of labor, mean maternal hospital stay, and Apgar scores less than 7 were also comparable.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Low\u2010quality evidence suggests deinfibulation improves birth outcomes for women with type III FGM<\/jats:styled-content>.<\/jats:p><\/jats:sec>PROSPERO registration<\/jats:title>CRD<\/jats:styled-content>42015024466.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12056","type":"journal-article","created":{"date-parts":[[2017,2,6]],"date-time":"2017-02-06T08:05:22Z","timestamp":1486368322000},"page":"13-20","source":"Crossref","is-referenced-by-count":33,"title":["Deinfibulation for preventing or treating complications in women living with type III<\/scp> female genital mutilation: A\u00a0systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"136","author":[{"given":"Babasola O.","family":"Okusanya","sequence":"first","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":"Olabisi","family":"Oduwole","sequence":"additional","affiliation":[{"name":"Institute of Tropical Diseases Research and Prevention University of Calabar Teaching Hospital Calabar Nigeria"},{"name":"Cochrane Nigeria Institute of Tropical Diseases Research and Prevention University of Calabar Teaching Hospital Calabar Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Nwachuku","sequence":"additional","affiliation":[{"name":"Institute of Tropical Diseases Research and Prevention University of Calabar Teaching Hospital Calabar Nigeria"},{"name":"College of Medical Sciences University of Calabar Calabar Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M.","family":"Meremikwu","sequence":"additional","affiliation":[{"name":"Institute of Tropical Diseases Research and Prevention University of Calabar Teaching Hospital Calabar Nigeria"},{"name":"Cochrane Nigeria Institute of Tropical Diseases Research and Prevention University of Calabar Teaching Hospital Calabar Nigeria"},{"name":"College of Medical Sciences University of Calabar Calabar Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.04.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.09.64808"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006316"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68805-3"},{"key":"e_1_2_8_6_1","volume-title":"WHO Guidelines on the Management of Health Complications From Female Genital Mutilation","author":"World Health Organization","year":"2016"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2012-008155"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2004.01.024"},{"key":"e_1_2_8_9_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JPT","year":"2011"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12050"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182590343"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00227.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2013.04.008"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.10.028"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1297-9589(01)00128-X"},{"key":"e_1_2_8_19_1","unstructured":"Royal College of Obstetricians and Gynaecologists.Female Genital Mutilation and its Management. Green-top Guideline No. 53. July2015.https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/gtg53\/. 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