Pregnancy Use of Diethylstilbestrol
DES has been available since 1938. There is a definite association of intrauterine exposure to DES and clear cell adenocarcinoma in female offspring (DES daughters). Other DES daughters have developed benign vaginal adenosis. Mothers taking DES during pregnancy (DES mothers) have an increased incidence of breast and gynecologic cancers. Male offspring (DES sons) have an excess of external genital anomalies including cryptorchidism, hypoplastic testes, and decreased sperm.
The risk of adenocarcinoma in DES daughters is less than 2/1000. Adenosis rarely, if ever, progresses to carcinoma and should be followed rather than aggressively treated. DES daughters should have thorough pelvic examinations with special tests (Papanicolaou smear and iodine staining) yearly beginning at menarche with culposcopy for those with abnormal findings.
