Genital Tract Microbiota Composition Profiles and Pre/Probiotic Utility in Gynaecological Cancer prevention: A review of the current evidence, The European Society of Gynaecological Oncology (ESGO) Prevention Committee Statement.

There is emerging interest in the female genital tract (FGT) microbiota’s role in health and disease. It has been suggested that the FGT microbiota may play a role in the development of gynaecological cancers, which raises the question of whether microbiota manipulation could be a tool for prevention. There is a wealth of data associating HPV infection and subsequent cervical dysplasia with a high-diversity microbiome deplete of Lactobacillus species. Studies of microbiota alterations in endometrial, ovarian, vulval and vaginal malignancies are now emerging and point towards the involvement of similar pathogenic anaerobes. Whilst there are plausible mechanisms through which the microbiota can promote neoplastic transformation, it remains unclear whether the microbiota or the disease are the drivers of those changes. A number of pre-, probiotics and other non-clinician prescribed agents have claimed a therapeutic role in cervical disease. Although some document some benefit, the studies are small, of varying design and high-quality evidence to support their use is lacking. Currently no studies have examined these therapeutics in other gynaecological malignancies. Microbiome manipulation for gynaecological cancer prevention remains a welcome prospect, and warrants larger, well-designed studies. However, at present, there is insufficient evidence to support clinical recommendations that promote their use

Female genital mutilation/cutting incidence, diagnostic capacities, and obstetric outcomes among migrant women: a single-center retrospective analysis in a 10-year birth cohort in Austria

Abstract Introduction Practical experience in the care of women with female genital mutilation/cutting (FGM/C) is uncommon in Austria. However, affected women require specialized gynecological and obstetric care. In our region, there is currently neither an official counseling center nor specially trained medical personnel to address the special needs of women after FGM/C. The aim of this study was to determine the potential need for obstetric care for women who have undergone FGM/C in our region. Methods We retrospectively reviewed women presenting for delivery at the LKH University Hospital Graz from 1.1.2010 until 31.12.2020 regarding the place of birth and/or the nationality of the mother to filter out women from a country with known FGM/C prevalence according to the UNICEF Global Database. Data on the documentation of FGM/C as well as demographic maternal data and peripartal parameters were gathered. Periods before and after the European refugee crisis in 2015 were compared. Results During the study period, a total of 35,628 deliveries took place at our hospital. 856 (2.4%) deliveries of 539 women were included due to nationality or birthplace in a country with known FGM/C prevalence. We found only 17/539 (3.2%) documented FGM/C cases. The estimated FGM/C prevalence among those patients was, however, 208/539 (38,6%). Women affected by FGM/C in our collective were most frequently from Nigeria, Egypt, Iraq, Ghana, and Somalia. No statistically significant increase in deliveries during the study period in the overall study cohort was observed, with the exception of deliveries of Somali women (p = 0.000). Discussion The discrepancy between documented and expected FGM/C rates (3,2% vs. 38,6%) in our collective suggests that most cases of FGM/C go undetected among women delivering in Austria. These data show the great need for special training for obstetricians and targeted contact points for affected women