Cervical length at 23 weeks' gestation - relation to demographic characteristics and previous obstetric history in South African women

Objectives. To determine the distribution of cervical length in a routine population of singleton  pregnancies; to examine the relationship between cervical length, demographic characteristics, and previous obstetric history; and to compare these data with data from a similar study undertaken in the UK.Patients and methods. The study was conducted among women attending routine antenatal clinics at  Coronation, Johannesburg General and Chris Hani Baragwanath hospitals. Cervical length was measured by means of transvaginal ultrasound at 23 weeks' gestation in women with singleton pregnancies attending these clinics, as part of a multicentre randomised trial investigating the value of cerclage in a short cervix. The distribution of cervical length was determined and the significance of differences in median cervical lengths between subgroups was calculated according to maternal age, ethnic origin, maternal body mass index (BMI), cigarette smoking, alcohol intake, and previous obstetric history.Results. Cervical screening was offered to women (N = 2 173) attending clinics for a 23-week scan during the study period (July 1999- September 2002). Most women (N = 1 920) accepted, while 253 declined. Complete outcomes (date and mode of delivery; gestation at delivery, birth weight, Apgar scores,  maternal blood loss, whether the patient was cerclaged or not, and any complications) were obtained for 1 603 women who accepted screening. Cervical length was measured successfully in all cases. Median cervical length was 33.7 mm and in 64 cases (3.3%) the length was 15 mm or less. Significantly shorter cervical lengths were found in those with a history of previous miscarriage, preterm delivery, those aged less than 20 years and those with an abnormal BMI. Cervical length was not significantly shorter in black women than in coloured and white women.Conclusions. At 23 weeks' gestation the median cervical length in a South African population was 33.2 mm. In 3.3% of the population the length was 15 mm. There was an association between cervical length, demographic characteristics and previous obstetric history

FMR1 Genotype with Autoimmunity-Associated Polycystic Ovary-Like Phenotype and Decreased Pregnancy Chance

The FMR1 gene partially appears to control ovarian reserve, with a specific ovarian sub-genotype statistically associated with a polycystic ovary (PCO)- like phenotype. Some forms of PCO have been associated with autoimmunity. We, therefore, investigated in multiple regression analyses associations of ovary-specific FMR1 genotypes with autoimmunity and pregnancy chances (with in vitro fertilization, IVF) in 339 consecutive infertile women (455 IVF cycles), 75 with PCO-like phenotype, adjusted for age, race/ethnicity, medication dosage and number of oocytes retrieved. Patients included 183 (54.0%) with normal (norm) and 156 (46%) with heterozygous (het) FMR1 genotypes; 133 (39.2%) demonstrated laboratory evidence of autoimmunity: 51.1% of het-norm/low, 38.3% of norm and 24.2% het-norm/high genotype and sub-genotypes demonstrated autoimmunity (p = 0.003). Prevalence of autoimmunity increased further in PCO-like phenotype patients with het-norm/low genotype (83.3%), remained unchanged with norm (34.0%) and decreased in het-norm/high women (10.0%; P<0.0001). Pregnancy rates were significantly higher with norm (38.6%) than het-norm/low (22.2%, p = 0.001). FMR1 sub-genotype het-norm/low is strongly associated with autoimmunity and decreased pregnancy chances in IVF, reaffirming the importance of the distal long arm of the X chromosome (FMR1 maps at Xq27.3) for autoimmunity, ovarian function and, likely, pregnancy chance with IVF

Implementation intentions in the entrepreneurial process: concept, empirical findings, and research agenda

Prior studies find sizable gaps between entrepreneurial intentions and subsequent actions. We extend models of entrepreneurial intentions by drawing on action phase theory to better understand how entrepreneurial intentions translate into actions. Our study focuses on the effects of implementation intentions on taking entrepreneurial action. The analysis uses two waves of survey data on 422 individuals, from the Swedish general population, who had an explicit interest in starting a business and who reported on their actions 6 months later. We test and find support for a moderated mediation model in which implementation intentions mediate the effects of goal intentions on taking entrepreneurial action. We further find the mediated effect to be even stronger for those confirming a strong intention to start a new business. We provide an in-depth discussion of the concept of implementation intention and an extensive research agenda.Peer reviewe

Ultrasound, ethics and the law : opinion ethics

No Abstract Available Obstetrics and Gynaecology Forum Vol.15(2) 2005: 11-1