Upper genital tract changes and pregnancy outcome in offspring exposed in utero to diethylstilbestrol.

ABSTRACT

PIP: This study reviews the physical findings and results of hysterosalpingography in 267 women exposed in utero to diethylstilbestrol (DES); pregnancy outcome of 93 of these exposed women was correlated with the x-ray findings. Of the 267, 185 (69%) showed an upper genital tract abnormality and 82 showed normal genitalia according to the x-ray technique used. The abnormal hysterosalpingography findings found were correlated with structural abnormalities of the cervix and vaginal epithelium alterations particularly. 144 pregnancies had occurred in the 93 women who were studied by roentgenography, and pregnancy outcome in these 93 women was significantly worse in women with upper genital tract abnormalities as visualized by x-ray. For example, those with abnormal hysterosalpingograms had 78 pregnancies (vs. 66 among normal x-ray women), with 12 elective abortions (vs. 23), 5 (8%) ectopic pregnancies (vs. 2, i.e., 4%), a total of 24 spontaneous abortions (39% of pregnancies vs. only 12 or 23% in normal x-ray women), 38% (n=14) premature deliveries (vs. 8), and 23 (34%) term deliveries (vs. 58% in normals. Women with abnormal x-rays had more ectopic pregnancies and premature deliveries than normals also, though the differences were not statistically significant. Significantly fewer women with abnormal findings vs. women with normal x-ray delivered term infants.