Corrina Oxford - Academia.edu (original) (raw)

Papers by Corrina Oxford

American Journal of Perinatology, 2011

Critical care medicine, 2015

Reviews in obstetrics & gynecology, 2012

The doctrine of informed refusal may become difficult to adhere to in obstetric practice, especia... more The doctrine of informed refusal may become difficult to adhere to in obstetric practice, especially in situations in which the fetus's life is at risk. One rare yet potentially problematic situation of informed refusal is the case of a pregnant woman who refuses to undergo a medically indicated cesarean delivery that would ensure the well-being of her fetus. Although some would argue that patient autonomy takes precedence and the woman's informed refusal should be respected, others would argue that beneficence, justice, and doing no harm to the viable fetus should ethically overrule the refusal of a surgery. This article explores the profound conflict between maternal autonomy and the rights of the fetus, provides a framework to address when the two diverge, and poses suggestions for how providers can better navigate this dilemma.

Journal of Minimally Invasive Gynecology, 2009

Clinical Obstetrics and Gynecology, 2009

In the United States, trauma is the leading nonobstetric cause of maternal death. The principal c... more In the United States, trauma is the leading nonobstetric cause of maternal death. The principal causes of trauma in pregnancy include motor vehicle accidents, falls, assaults, homicides, domestic violence, and penetrating wounds. The managing team evaluating and coordinating the care of the pregnant trauma patient should be multidisciplinary so that it is able to understand the physiologic changes in pregnancy. Blunt trauma to the abdomen increases the risk of placental abruption. Evaluation of the pregnant trauma patient requires a primary and secondary survey with emphasis on airway, breathing, circulation, and disability. The use of imaging studies, invasive hemodynamics, critical care medications, and surgery, if necessary, should be individualized and guided by a coordinating team effort to improve maternal and fetal conditions. A clear understanding of gestational age and fetal viability should be documented in the record.

American Journal of Perinatology, 2011

American Journal of Perinatology, 2010

We sought to determine if antenatal corticosteroid treatment administered prior to 24 weeks&a... more We sought to determine if antenatal corticosteroid treatment administered prior to 24 weeks' gestation influences neonatal morbidity and mortality in extremely low-birth-weight infants. A retrospective review was performed of all singleton pregnancies treated with one complete course of antenatal corticosteroids prior to 24 weeks' gestation and delivered between 23(0)/(7) and 25(6)/(7) weeks. These infants were compared with similar gestational-age controls. There were no differences in gender, race, birth weight, and gestational age between the groups. Infants exposed to antenatal corticosteroids had lower mortality (29.3% versus 62.9%, P = 0.001) and grade 3 or 4 intraventricular hemorrhage (IVH; 16.7% versus 36%, P < 0.05; relative risk [RR]: 2.16). Grade 3 and 4 IVH was associated with significantly lower survival probability as compared with no IVH or grade 1 and 2 IVH (P < 0.001, RR: 10.6, 95% confidence interval [CI]: 4.4 to 25.6). Antenatal steroid exposure was associated with a 62% decrease in the hazard rate compare with those who did not receive antenatal steroids after adjusting for IVH grade (Cox proportional hazard model, hazard ratio 0.38, 95% CI: 0.152 to 0.957, P = 0.04). The rates of premature rupture of membranes and chorioamnionitis were higher for infants exposed to antenatal corticosteroids. Exposure to a single course of antenatal corticosteroids prior to 24 weeks' gestation was associated with reduction of the risk of severe IVH and neonatal mortality for extremely low-birth-weight infants.

American Journal of Obstetrics and Gynecology, 2006

American Journal of Obstetrics and Gynecology, 2008

OBJECTIVE: Unexplained stillbirth remains the largest contributor to perinatal mortality in the W... more OBJECTIVE: Unexplained stillbirth remains the largest contributor to perinatal mortality in the Western world; its etiology is frequently unknown, but likely varies by gestational age (GA) and maternal characteristics. Our purpose was to examine the influence of GA and maternal characteristics on prospective risk of stillbirth.

American Journal of Obstetrics and Gynecology, 2011

low TSH and normal fT 4 were designated to have subclinical hyperthyroidism. All other women were... more low TSH and normal fT 4 were designated to have subclinical hyperthyroidism. All other women were considered euthyroid and served as the referent group. The prevalence of diabetes was compared between the three groups. RESULTS: 25,687 pregnant women were eligible for this study. Of these 22,223 (86%) were considered normal, 1,934 (7%) were identified with subclinical hyperthyroidism, and 1530 (6%) were identified with subclinical hypothyroidism. depicts the prevalence of various types of diabetes according to diagnosis. CONCLUSIONS: 1. Diabetes during pregnancy appears less common in women with subclinical hyperthyroidism. This remains true for both GDM (aOR 0.69, 95% CI 0.53, 0.91) and overt DM (aOR 0.35, 95% CI 0.14, 0.86) after adjustment for maternal age, race, and parity. 2. Diabetes during pregnancy appears more common in women with subclinical hypothyroidism. This remains true for only overt DM (aOR 2.13, 95% CI 1.36, 3.36) after adjustment for maternal age, race, and parity.

Obstetrics & Gynecology, 2015

American Journal of Perinatology, 2011

Critical care medicine, 2015

Reviews in obstetrics & gynecology, 2012

The doctrine of informed refusal may become difficult to adhere to in obstetric practice, especia... more The doctrine of informed refusal may become difficult to adhere to in obstetric practice, especially in situations in which the fetus's life is at risk. One rare yet potentially problematic situation of informed refusal is the case of a pregnant woman who refuses to undergo a medically indicated cesarean delivery that would ensure the well-being of her fetus. Although some would argue that patient autonomy takes precedence and the woman's informed refusal should be respected, others would argue that beneficence, justice, and doing no harm to the viable fetus should ethically overrule the refusal of a surgery. This article explores the profound conflict between maternal autonomy and the rights of the fetus, provides a framework to address when the two diverge, and poses suggestions for how providers can better navigate this dilemma.

Journal of Minimally Invasive Gynecology, 2009

Clinical Obstetrics and Gynecology, 2009

In the United States, trauma is the leading nonobstetric cause of maternal death. The principal c... more In the United States, trauma is the leading nonobstetric cause of maternal death. The principal causes of trauma in pregnancy include motor vehicle accidents, falls, assaults, homicides, domestic violence, and penetrating wounds. The managing team evaluating and coordinating the care of the pregnant trauma patient should be multidisciplinary so that it is able to understand the physiologic changes in pregnancy. Blunt trauma to the abdomen increases the risk of placental abruption. Evaluation of the pregnant trauma patient requires a primary and secondary survey with emphasis on airway, breathing, circulation, and disability. The use of imaging studies, invasive hemodynamics, critical care medications, and surgery, if necessary, should be individualized and guided by a coordinating team effort to improve maternal and fetal conditions. A clear understanding of gestational age and fetal viability should be documented in the record.

American Journal of Perinatology, 2011

American Journal of Perinatology, 2010

We sought to determine if antenatal corticosteroid treatment administered prior to 24 weeks&a... more We sought to determine if antenatal corticosteroid treatment administered prior to 24 weeks' gestation influences neonatal morbidity and mortality in extremely low-birth-weight infants. A retrospective review was performed of all singleton pregnancies treated with one complete course of antenatal corticosteroids prior to 24 weeks' gestation and delivered between 23(0)/(7) and 25(6)/(7) weeks. These infants were compared with similar gestational-age controls. There were no differences in gender, race, birth weight, and gestational age between the groups. Infants exposed to antenatal corticosteroids had lower mortality (29.3% versus 62.9%, P = 0.001) and grade 3 or 4 intraventricular hemorrhage (IVH; 16.7% versus 36%, P < 0.05; relative risk [RR]: 2.16). Grade 3 and 4 IVH was associated with significantly lower survival probability as compared with no IVH or grade 1 and 2 IVH (P < 0.001, RR: 10.6, 95% confidence interval [CI]: 4.4 to 25.6). Antenatal steroid exposure was associated with a 62% decrease in the hazard rate compare with those who did not receive antenatal steroids after adjusting for IVH grade (Cox proportional hazard model, hazard ratio 0.38, 95% CI: 0.152 to 0.957, P = 0.04). The rates of premature rupture of membranes and chorioamnionitis were higher for infants exposed to antenatal corticosteroids. Exposure to a single course of antenatal corticosteroids prior to 24 weeks' gestation was associated with reduction of the risk of severe IVH and neonatal mortality for extremely low-birth-weight infants.

American Journal of Obstetrics and Gynecology, 2006

American Journal of Obstetrics and Gynecology, 2008

OBJECTIVE: Unexplained stillbirth remains the largest contributor to perinatal mortality in the W... more OBJECTIVE: Unexplained stillbirth remains the largest contributor to perinatal mortality in the Western world; its etiology is frequently unknown, but likely varies by gestational age (GA) and maternal characteristics. Our purpose was to examine the influence of GA and maternal characteristics on prospective risk of stillbirth.

American Journal of Obstetrics and Gynecology, 2011

low TSH and normal fT 4 were designated to have subclinical hyperthyroidism. All other women were... more low TSH and normal fT 4 were designated to have subclinical hyperthyroidism. All other women were considered euthyroid and served as the referent group. The prevalence of diabetes was compared between the three groups. RESULTS: 25,687 pregnant women were eligible for this study. Of these 22,223 (86%) were considered normal, 1,934 (7%) were identified with subclinical hyperthyroidism, and 1530 (6%) were identified with subclinical hypothyroidism. depicts the prevalence of various types of diabetes according to diagnosis. CONCLUSIONS: 1. Diabetes during pregnancy appears less common in women with subclinical hyperthyroidism. This remains true for both GDM (aOR 0.69, 95% CI 0.53, 0.91) and overt DM (aOR 0.35, 95% CI 0.14, 0.86) after adjustment for maternal age, race, and parity. 2. Diabetes during pregnancy appears more common in women with subclinical hypothyroidism. This remains true for only overt DM (aOR 2.13, 95% CI 1.36, 3.36) after adjustment for maternal age, race, and parity.

Obstetrics & Gynecology, 2015