Female Genital Mutilation - World Health Organization

– If injury is very extensive refer client for surgical
intervention.
Shock
Shock can occur as a result of severe bleeding
and/or pain. The management of shock associated with
FGM is the same as the management of shock under
any other circumstances. The procedure is as follows:
● Assess the severity of shock by checking vital signs.
● Treat for shock by raising the client’s extremities
above the level of her head to allow blood to drain
to the vital centres in the brain.
● Cover the client to keep her warm.
● If she is having difficulty breathing, administer
oxygen.
● Have a resuscitation tray near by.
● Give I.V. fluids to replace lost fluid.
● Check vital signs and record every quarter of an
hour (15 minutes).
● If client’s condition does not improve, refer her for
medical attention.
Infection and septicaemia
Infection may occur as a result of unhygienic
surroundings and dirty instruments used to carry out
FGM. The management of this condition is as follows:
● Inspect the vulva carefully for signs of an infected
wound, and to check for anything that might be
contributing to the infection, such as obstruction
of urine.
● Take a vaginal swab and a urine sample to test for
the presence of infection and to identify the
organisms involved. Any obstruction found should
to be removed
● If the wound is infected, it should be cleaned and
left dry. The Client should be treated with
antibiotic and analgesic
● Follow up client after 7 days to assess the progress.
● If infection persists refer the client for medical
attention.
Urine retention
Urine retention may be the result of injury, pains and
fear of passing urine, or occlusion of the urethra during
infibulation. Management of this condition is as follows:
● Carry out an assessment to determine cause.
● Use appropriate nursing skills and techniques to
encourage the client to pass urine, such as turning
on a water tap.
● If she is unable to pass urine because of pain and
fear, give her strong analgesics.
● Give the client personal encouragement and support.
● If inability to pass urine is due to infibulation,
open up the infibulation (see procedure for
opening up type III FGM) after counselling the
client, or her attendant if the client is a child.
● If retention is due to injury of the urethra, refer for
surgical intervention under anaesthetic.
Anaemia
Anaemia can be due to bleeding or infection or it
can be due to malaria, especially in children.
Management of this condition is as follows:
● Assess the severity of anaemia and send blood for
Hb and grouping.
● If anaemia is mild, give folic acid and iron tablets
and advise on nutritious diet.
FEMALE GENITAL MUTILATION
STUDENT MANUAL
● In cases of malaria treat appropriately.
● If anaemia is severe, refer for medical attention.
Managing long-term physical
complications
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Keloid formation
A keloid may form in the scar tissue and may cause
obstruction to the introitus. Management of this
condition is as follows:
● Inspect client’s genitalia to assess size of keloid.
● If the keloid is small, advise the woman to leave it
undisturbed, and reassure her that it will not cause
harm.