Genital Trauma and FGM Awareness

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Questions and Answers

What is the age-standardised abortion rate in the UK for 2021?

15.3 per 1,000 women

20.1 per 1,000 women

12.5 per 1,000 women

18.6 per 1,000 women (correct)

Under what conditions can a termination of pregnancy be legally performed after 24 weeks?

If there is a diagnosis of fetal abnormality (correct)

If the woman is over 35 years old

If the pregnancy poses social hardship

If the baby's gender is not preferred

What are the two medications typically used in the Medical Termination of Pregnancy (MTOP) process?

Mifepristone and Misoprostol (correct)

Levonorgestrel and Clomiphene

Progesterone and Estrogen

Oxytocin and Methotrexate

What is a consideration when providing MTOP medication through the Pills by Post scheme?

Women can access it even if they are over 10 weeks’ gestation Signup and view all the answers

What tool should be used to aid decision-making regarding resuscitation in cases of formed/viable babies?

Newborn Assessment Card Signup and view all the answers

What procedure is performed to terminate a pregnancy through surgical or medical means?

Dilation and curettage Signup and view all the answers

Which condition is characterized by abnormally heavy or prolonged menstrual bleeding?

Menorrhagia Signup and view all the answers

Which type of trauma encompasses any damage to external or internal female genital areas?

Genital trauma Signup and view all the answers

What must be done if signs of female genital mutilation (FGM) are observed in children?

Report to a safeguarding official Signup and view all the answers

What is NOT a potential cause of vaginal bleeding?

Ovarian cyst rupture Signup and view all the answers

Which type of FGM involves the partial or total removal of external genitalia?

Type 2 Signup and view all the answers

What complication can Type 3 or Type 4 FGM cause during childbirth?

Obstructed childbirth Signup and view all the answers

What is a common psychological response to genital trauma or bleeding?

Heightened anxiety Signup and view all the answers

What is the recommended action if excessive bleeding occurs post-termination of pregnancy?

Call 999 Signup and view all the answers

Which of the following is typically NOT a symptom of a prolapsed uterus?

Severe abdominal pain that radiates to the shoulders Signup and view all the answers

What approach is suggested for managing gynaecological conditions?

ABCDE approach Signup and view all the answers

Which of the following statements about surgical termination of pregnancy is false?

It is performed under general anaesthetic only. Signup and view all the answers

In the case of a prolapsed uterus, which symptom indicates an immediate need for concern?

Vaso-vagal symptoms or signs of shock Signup and view all the answers

What should be done if the patient exhibits time-critical features regarding gynaecological conditions?

Pre-alert the nearest obstetric unit Signup and view all the answers

What is NOT a typical anaesthesia method for surgical termination of pregnancy?

Epidural anaesthesia Signup and view all the answers

Which of the following correctly defines the term 'prolapsed uterus'?

A condition where the uterus drops down into the vagina Signup and view all the answers

Study Notes

Genital Trauma

Refers to injury to external or internal female genitalia.
Includes trauma to the labia majora, labia minora, vaginal opening, perineum, clitoris.
Also includes injury to the hymen, vagina, cervix, anus, and rectum.
Penetrating trauma, sexual abuse and assault are classified as genital trauma.

Female Genital Mutilation (FGM)

Involves partial or total removal of external female genitalia or other injuries to the genital organs.
Procedures may include piercing, stretching, or staining.
Most commonly performed on young girls between infancy and the age of 15 before puberty.
Classified as illegal in the UK and a form of child abuse.

Suspected FGM

Safeguarding referral is necessary via EBS.
Report any physical signs or disclosure of FGM in children under 18 to the police under the Serious Crime Act 2015
Type 3 or Type 4 FGM, involving closure of the vaginal opening, requires a lower threshold for conveyance to the nearest obstetric unit in laboring women as it can cause complications for the mother and baby.

Termination of Pregnancy

Also known as abortion.
Age-standardized abortion rate in the UK was 18.6 per 1,000 women in 2021.
Can be done for social or medical reasons including fetal abnormality or risk to the woman's health.
Legal for social reasons up to 24 weeks.
Can be done after 24 weeks in limited circumstances, such as when the mother's life is at risk or the baby has a severe or life-limiting disability.

Medical Termination of Pregnancy (MTOP)

Often referred to as "Pills by Post", MTOP involves taking two medications, Mifepristone and Misoprostol, 24-48 hours apart.
Mifepristone softens the cervix, while Misoprostol encourages the uterus to contract, ending the pregnancy.
Ultrasound scans are usually performed to confirm gestational age, but telemedicine is increasingly being used to access MTOP in early pregnancy.

Surgical Termination of Pregnancy

A procedure to remove the pregnancy done under local anesthetic, sedation, or general anesthetic depending on the gestation.
Often carried out as outpatient surgery, with women returning home the same day.

Post-Termination

Some bleeding and discomfort are normal for up to two weeks.
Call 999 if you notice excessive bleeding (incontinence pad saturated with 500 ml).
Excessive bleeding post-termination is considered a postpartum hemorrhage and requires a pre-alert to the nearest obstetric unit.

Prolapsed Uterus

Defined as the uterus dropping down into the vagina, caused by weakened pelvic floor muscles.
Not usually life-threatening, but can cause shock or vasovagal symptoms.

Prolapsed Uterus Symptoms

Feeling of heaviness around the lower abdomen or genitals.
Discomfort during sexual intercourse.
Seeing or feeling a bulge or lump in or coming out of the vagina.
Problems urinating.

Management of Gynaecological Conditions

(C)A, B ,C, D, E approach:
- Assess for any time-critical features or red flags (If yes, pre-alert).
- Consider paramedic assistance.
- Administer oxygen if the patient is shocked, hypoxic, or hypovolemic according to JRCALC guidelines.
- Conduct a secondary survey and transfer to the emergency department for non-time-critical conditions.
- Empathy, support, and pain relief should be offered in all cases.

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Description

Explore the critical topics of genital trauma and female genital mutilation (FGM) in this quiz. Learn about the types of injuries, the implications of trauma, and the legal considerations surrounding FGM. This quiz is essential for understanding safeguarding practices related to these sensitive issues.