J Hofmeyr

Publications (8)23.4 Total impact

• Article: Intrapartum amnioinfusion for meconium-stained amniotic fluid: a systematic review of randomised controlled trials.

  H Xu, J Hofmeyr, C Roy, W D Fraser
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  ABSTRACT: Amnioinfusion (AI) is thought to dilute meconium when present in the amniotic fluid and so reduces the risk of meconium aspiration. To evaluate if AI reduces meconium aspiration syndrome (MAS) and other indicators of morbidity in babies born to women with meconium-stained amniotic fluid (MSAF). PubMed, Medline, EMBASE, and the Cochrane Controlled Trials Register from January 1980 to May 30, 2005, using the keywords 'amnioinfusion' and 'meconium'. Randomised trials comparing AI with no AI for women in labour with MSAF. Trial quality was evaluated using pre-established criteria. The following morbidity indicators were assessed: MAS, 5-minute Apgar score < 7, arterial cord pH < 7.2, and caesarean section. Studies were stratified according to the level of peripartum surveillance (standard versus limited). Typical relative risks (RRs) with their 95% confidence intervals were calculated for each outcome using a random effects model. In clinical settings with standard peripartum surveillance, we found no evidence that AI reduced the risk of MAS (RR 0.59, 95% CI 0.28-1.25), 5-minute Apgar score < 7 (RR 0.90, 95% CI 0.58-1.41), or caesarean delivery (RR 0.89, 95% CI 0.73-1.10). In clinical settings with limited peripartum surveillance, AI appeared to reduce the risk of MAS (RR 0.25, 95% CI 0.13-0.47). In clinical settings with standard peripartum surveillance, the evidence does not support the use of AI for MSAF. In settings with limited peripartum surveillance, where complications of MSAF are common, AI appears to reduce the risk of MAS. However, this finding requires confirmation by further studies.
  BJOG An International Journal of Obstetrics & Gynaecology 05/2007; 114(4):383-90. · 3.41 Impact Factor
• Article: [Multicenter randomized trial of amnioinfusion].

  W Fraser, S Marcoux, W Prendiville, S Petrou, J Hofmeyr, D Reinharz, C Goulet, A Ohlsson
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  ABSTRACT: Meconium staining of the amniotic fluid in labor is a frequent problem that is associated with an increase in the risk of neonatal and maternal morbidity. Amnioinfusion is a simple technique that is designed to prevent neonatal and maternal morbidity associated with meconium. Preliminary studies indicate that amnioinfusion is a promising approach to the prevention of such complications of labor. However, further research is required. The primary objective of this multi-centre randomized controlled study is to determine if amnioinfusion for thick meconium stained amniotic fluid results in a reduction in perinatal death or moderate to severe meconium aspiration syndrome. We will also assess the effects of amnioinfusion on other indicators of neonatal morbidity and on cesarean section. The study includes an evaluation of womens views on their childbirth experience and an economic evaluation of a policy of amnioinfusion The study will be achieved with the collaboration of approximately 50 obstetrical centres from across Canada, US, Europe, South America and South Africa. This multicentre trial will provide urgently needed information on the efficacy and effectiveness of amniofusion for the indication of meconium stained amniotic fluid.
  Journal de Gynécologie Obstétrique et Biologie de la Reproduction 06/2000; 29(3):312-5. · 0.42 Impact Factor
• Article: Misoprostol dose-related shivering and pyrexia in the third stage of labour. WHO Collaborative Trial of Misoprostol in the Management of the Third Stage of Labour.

  P Lumbiganon, J Hofmeyr, A M Gülmezoglu, A Pinol, J Villar
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  ABSTRACT: To select the misoprostol dose to be used in a large multicentre randomised trial comparing misoprostol with oxytocin in the routine management of the third stage of labour. Randomised pilot trial, double-blinded with the use of double placebos. Two of the nine hospitals that will participate in the main multicentre trial. The hospitals were located in Johannesburg, South Africa and Khon Kaen, Thailand. Women during second stage of labour about to be delivered vaginally. The trial had three arms: misoprostol 400 microg versus misoprostol 600 microg versus intramuscular oxytocin 10 IU. Each group received an injection and three tablets immediately after the birth of the baby. Shivering and pyrexia rates were the main outcome measures. Data on other side effects and characteristics of the third stage of labour were also collected. Side effects were noted as none, mild, moderate or severe. Both shivering and pyrexia (temperature > 38 degrees C) were most common in the 600 microg misoprostol group (28% and 7.5% for shivering and pyrexia, respectively) compared with 400 microg misoprostol (19% and 2%), and the oxytocin group (12.5% and 3%). The increase in shivering in the misoprostol 600 microg group was due primarily to a higher rate of moderate shivering. None of the women had a temperature > 40 degrees C. There were no increases in severe side effects and other adverse events in the misoprostol 600 microg group. When used in the management of the third stage of labour oral misoprostol is associated with an increase in the rate of moderate shivering and pyrexia which seems to be dose-related. Based on the results of this pilot trial, the Steering Committee has decided to use 600 microg misoprostol in the main trial, comparing it with oxytocin, in order to achieve higher effectiveness.
  British Journal of Obstetrics and Gynaecology 05/1999; 106(4):304-8.
• Article: Randomised trials in maternal and perinatal medicine: global partnerships are the way forward.

  M Gülmezoglu, J Villar, J Hofmeyr, L Duley, J M Belizan
  British Journal of Obstetrics and Gynaecology 01/1999; 105(12):1244-7.
• Source

  Available from: nih.gov

  Article: WHO is producing a reproductive health library for developing countries.

  A M Gülmezoglu, J Villar, G Carroli, J Hofmeyr, A Langer, K Schulz, R Guidotti
  BMJ 07/1997; 314(7095):1695. · 14.09 Impact Factor
• Article: Breast-feeding: current knowledge, attitudes and practices of paediatricians and obstetricians.

  A Videlefsky, C Nikodem, J Hofmeyr
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  ABSTRACT: To assess the current knowledge, attitudes and practices of Paediatricians and Obstetricians in the greater Johannesburg area, using WHO/UNICEF 10 Steps to Successful Breastfeeding as a guideline. Survey. All Paediatricians and Obstetricians registered with the SAMDC and practising in the greater Johannesburg area. Most Paediatricians and Obstetricians advocate breastfeeding, but very few conform adequately to recommended guidelines. Doctors, as part of the healthcare team, can have a significant impact on the successful initiation and maintenance of breastfeeding. There is a need for ongoing education and intervention programmes to update current knowledge on breastfeeding management.
  Curationis 07/1996; 19(2):2-6.
• Article: Suppression of lactation. A comparison of bromocriptine and prostaglandin E2.

  M J England, A Tjallinks, J Hofmeyr, J Harber
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  ABSTRACT: Women in the puerperium who requested lactation suppression were randomly allocated to receive bromocriptine from puerperal day 1 to 14 or prostaglandin E2 from day 3 or 4 for 24 hours. Subjectively, lactation suppression was satisfactory in all cases. Objective measurements showed a trend toward more-effective early suppression with bromocriptine. After discharge from the hospital, 3 of the 21 women who received prostaglandin E2 complained of mild breast tenderness, whereas 10 of the 22 who received bromocriptine reported severe "rebound" breast tenderness.
  The Journal of reproductive medicine 08/1988; 33(7):630-2. · 0.87 Impact Factor
• Article: Perianal actinomycosis complicating pilonidal sinus.

  A R ANSCOMBE, J HOFMEYR
  British Journal of Surgery 06/1954; 41(170):666. · 4.61 Impact Factor