Women’s Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21699
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Browsing Women’s Health by Author "Felini, Martha"
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Item Association of Trauma on Chronic, Infectious, and Reproductive-related Disease Prevalence among Women in Substance Abuse Treatment(2017-03-14) Guardado, Annie; Dokpesi, Philip; Bakre, Sulaimon; Felini, Martha; Keck, ErinBackground: Previous literature demonstrates that individuals with co-occurring substance use disorders (SUDCs) often have comorbid conditions. Although SUDCs have been linked to higher use of medical management, there are few studies of the burden of disease types across and within high risk women in substance abuse treatment. The purpose of this cross-sectional study was to analyze the prevalence of chronic, infectious, and reproductive-related disease separately among women in substance abuse treatment and further explore whether prior trauma history was associated with disease prevalence. Methods: As part of a larger cancer prevention project conducted in Dallas from 2012-2016, 1076 women in treatment at the largest substance abuse treatment center in North Texas received education regarding cancer prevention, and were offered a well woman cancer screening exam. Data collected from a self-administered questionnaire included demographics, medical health history, reproductive history, substance use history, and trauma experience (physical, sexual, verbal/emotional) within the last 6 months. Participants were from 119 counties across Texas, including border counties. Descriptive and stratified analyses were performed to determine disease prevalence by trauma history. Results: Exposure to trauma was correlated with a higher prevalence of chronic disease (p Conclusions: Findings suggest comorbid disease and adverse reproductive outcomes are prevalent in this population. An exceptional window of opportunity exists to integrate preventive and preconception care interventions within treatment recovery centers, but the key challenge will be determining how it can be best delivered to women with significant trauma histories.Item Outcomes Associated with a Trial of Labor After Cesarean Section (2017)(2017-03-14) Anderson, Ralph; Felini, Martha; Baker, Austin; Papa, Tracy; Benson, Meagan; Flood-Shaffer, Kellie; Zimmerman, Leah; Westbrook, BrettObjective: To examine the outcomes of women attempting a trial of labor after cesarean section (TOLAC). Methods: A retrospective chart review was performed on all patients who attempted a TOLAC from June 2012 to May 2016 at John Peter Smith Hospital (JPS). Delivery characteristics and prevalence of adverse delivery outcomes were assessed and then compared to a previous TOLAC study at JPS (2004-2008). Stratified analysis was performed and statistical significance was calculated with χ2 and fishers exact statistics (α Results: 660 patients attempted a trial of labor during the study period. This was 2% of the total births at the hospital during the time period. 444/660 delivered vaginally (67%). Successful VBAC was significantly more likely when the patient presented in spontaneous labor versus when the patient was induced (74% vs 49%, p= Conclusions: The overall success rate of 67% is within the expected range based on public data. However, the success rate at JPS Hospital had decreased from the previous study. This decrease in success coincides with an increase in the rate of induction of labor. Indeed, the success rates for patients who are induced is lower than the patients who present in spontaneous labor. Based on this data, we will reevaluate our practice of induction of labor in trial of labor candidates.