A retrospective analysis of 34 potentially missed cases of female genital mutilation in the emergency department

Richard John Fawcett, W George Kernohan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

ObjectivesTo discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law.DesignA retrospective analysis of patients’ notes who were assigned an FGM code during the period of May 2015 to August 2016.SettingSingle-centre, large UK major trauma centre offering a tertiary FGM clinic.ParticipantsAny woman coded during the study period as having undergone FGM.Primary outcomeNumber of FGM cases identified by the ED.Secondary outcomesMean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status.Results 34 patients were identified as having undergone FGM, 19 had previously attended EDand none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation.ConclusionThis study demonstrates that the identification of FGM victims by an ED is very poor, andmore work needs to be done to increase awareness of the subject by front-line staff.
LanguageEnglish
Pages1-3
JournalEMERGENCY MEDICINE JOURNAL
Volume0
Issue number0
Early online date12 Sep 2017
DOIs
Publication statusE-pub ahead of print - 12 Sep 2017

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Female Circumcision
Hospital Emergency Service
Trauma Centers
Delivery of Health Care

Keywords

  • Female Genital Mutilation

Cite this

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title = "A retrospective analysis of 34 potentially missed cases of female genital mutilation in the emergency department",
abstract = "ObjectivesTo discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law.DesignA retrospective analysis of patients’ notes who were assigned an FGM code during the period of May 2015 to August 2016.SettingSingle-centre, large UK major trauma centre offering a tertiary FGM clinic.ParticipantsAny woman coded during the study period as having undergone FGM.Primary outcomeNumber of FGM cases identified by the ED.Secondary outcomesMean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status.Results 34 patients were identified as having undergone FGM, 19 had previously attended EDand none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation.ConclusionThis study demonstrates that the identification of FGM victims by an ED is very poor, andmore work needs to be done to increase awareness of the subject by front-line staff.",
keywords = "Female Genital Mutilation",
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note = "Reference text: 1 Dorkenoo E. Combating female genital mutilation: an agenda for the next decade. World Health Stat Q 1996;49:142–7. 2 Lockhat H. Female genital mutilation: treating the tears. London: Middlesex University Press, 2004. 3 United Nations Children’s Fund. Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change. New York: UNICEF, 2013. 4 WHO. Eliminating female genital mutilation: an interagency statement UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCHR, UNHCR, UNICEF, UNIFEM, WHO, 2008. 5 Universal Declaration of Human Rights. General assembly resolution 217: UN Doc, 1948. A/810. 6 Committee on the Rights of the Child. Adolescent health and development in the context of the convention on the rights of the child: CRC/GC/, 2003. General Comment No. 4. 7 Committee on the Elimination of All Forms of Discrimination against Women. General recommendation No. 14, 1990, female circumcision; general recommendation No. 19, 1992, Violence against women; and general recommendation No. 24: Women and health., 1999. 8 United Nations Economic and Social Council (ECOSOC), Commission on the Status of Women. Resolution on the ending of female genital mutilation, 2007. E/ CN.6/2007/L.3/Rev.1. 9 United Nations General Assembly. Declaration on the Elimination of Violence against Women: UN Doc., 1993. A/RES/48/104. 10 Protocol to the African charter on human and peoples’ rights on the rights of women in Africa, adopted 11: Assembly of the African Union, 2003(accessed 25 Nov 2005). 11 Macfarlane A, Dorkenoo E. Prevalence of female genital mutilation in England and wales: national and local estimates. . London: City University London in association with Equality Now, 2015:2015. 3–5. 12 Serious crime act, 2015. Chapter 9, Section 74. http://www.legislation.gov.uk/ukpga/ 2015/9/pdfs/ukpga_20150009_en.pdf(accessed 26 Jan 2017). 13 Female genital mutilation act, 2003. Chapter 31.. http://www.legislation.gov.uk/ ukpga/2003/31/pdfs/ukpga_20030031_en.pdf(accessed 26 Jan 2017). 14 Information standards board published SCCI2026 female genital mutilation enhanced dataset information standard. http://www.hscic.gov.uk/isce/publication/ scci2026(accessed 26 Jan 2017). 15 Census United Kingdom. Stoke-on-trent census demographics United Kingdom, 2017. http://localstats.co.uk/census-demographics/england/west-midlands/stoke-on-trent. (accessed 26 Jan 2017). 16 Fawcett R. A universal FGM flowchart and reporting tool: The Royal College of Emergency Medicine, Best Practice Guideline, 2017. http://www.rcem.ac.uk/ docs/RCEM{\%}20Guidance/FGM{\%}20-{\%}20BP{\%}20Guide{\%}20-{\%}20Jul{\%}202017. pdf(accessed 24 Jan 2017)",
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A retrospective analysis of 34 potentially missed cases of female genital mutilation in the emergency department. / Fawcett, Richard John; Kernohan, W George.

In: EMERGENCY MEDICINE JOURNAL, Vol. 0, No. 0, 12.09.2017, p. 1-3.

Research output: Contribution to journalArticle

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N1 - Reference text: 1 Dorkenoo E. Combating female genital mutilation: an agenda for the next decade. World Health Stat Q 1996;49:142–7. 2 Lockhat H. Female genital mutilation: treating the tears. London: Middlesex University Press, 2004. 3 United Nations Children’s Fund. Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change. New York: UNICEF, 2013. 4 WHO. Eliminating female genital mutilation: an interagency statement UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCHR, UNHCR, UNICEF, UNIFEM, WHO, 2008. 5 Universal Declaration of Human Rights. General assembly resolution 217: UN Doc, 1948. A/810. 6 Committee on the Rights of the Child. Adolescent health and development in the context of the convention on the rights of the child: CRC/GC/, 2003. General Comment No. 4. 7 Committee on the Elimination of All Forms of Discrimination against Women. General recommendation No. 14, 1990, female circumcision; general recommendation No. 19, 1992, Violence against women; and general recommendation No. 24: Women and health., 1999. 8 United Nations Economic and Social Council (ECOSOC), Commission on the Status of Women. Resolution on the ending of female genital mutilation, 2007. E/ CN.6/2007/L.3/Rev.1. 9 United Nations General Assembly. Declaration on the Elimination of Violence against Women: UN Doc., 1993. A/RES/48/104. 10 Protocol to the African charter on human and peoples’ rights on the rights of women in Africa, adopted 11: Assembly of the African Union, 2003(accessed 25 Nov 2005). 11 Macfarlane A, Dorkenoo E. Prevalence of female genital mutilation in England and wales: national and local estimates. . London: City University London in association with Equality Now, 2015:2015. 3–5. 12 Serious crime act, 2015. Chapter 9, Section 74. http://www.legislation.gov.uk/ukpga/ 2015/9/pdfs/ukpga_20150009_en.pdf(accessed 26 Jan 2017). 13 Female genital mutilation act, 2003. Chapter 31.. http://www.legislation.gov.uk/ ukpga/2003/31/pdfs/ukpga_20030031_en.pdf(accessed 26 Jan 2017). 14 Information standards board published SCCI2026 female genital mutilation enhanced dataset information standard. http://www.hscic.gov.uk/isce/publication/ scci2026(accessed 26 Jan 2017). 15 Census United Kingdom. Stoke-on-trent census demographics United Kingdom, 2017. http://localstats.co.uk/census-demographics/england/west-midlands/stoke-on-trent. (accessed 26 Jan 2017). 16 Fawcett R. A universal FGM flowchart and reporting tool: The Royal College of Emergency Medicine, Best Practice Guideline, 2017. http://www.rcem.ac.uk/ docs/RCEM%20Guidance/FGM%20-%20BP%20Guide%20-%20Jul%202017. pdf(accessed 24 Jan 2017)

PY - 2017/9/12

Y1 - 2017/9/12

N2 - ObjectivesTo discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law.DesignA retrospective analysis of patients’ notes who were assigned an FGM code during the period of May 2015 to August 2016.SettingSingle-centre, large UK major trauma centre offering a tertiary FGM clinic.ParticipantsAny woman coded during the study period as having undergone FGM.Primary outcomeNumber of FGM cases identified by the ED.Secondary outcomesMean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status.Results 34 patients were identified as having undergone FGM, 19 had previously attended EDand none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation.ConclusionThis study demonstrates that the identification of FGM victims by an ED is very poor, andmore work needs to be done to increase awareness of the subject by front-line staff.

AB - ObjectivesTo discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law.DesignA retrospective analysis of patients’ notes who were assigned an FGM code during the period of May 2015 to August 2016.SettingSingle-centre, large UK major trauma centre offering a tertiary FGM clinic.ParticipantsAny woman coded during the study period as having undergone FGM.Primary outcomeNumber of FGM cases identified by the ED.Secondary outcomesMean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status.Results 34 patients were identified as having undergone FGM, 19 had previously attended EDand none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation.ConclusionThis study demonstrates that the identification of FGM victims by an ED is very poor, andmore work needs to be done to increase awareness of the subject by front-line staff.

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