Ultrasound detection of uterine abnormalities after diethylstilbestrol (DES) exposure.

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Abstract
Diethylstilbestrol (DES) was widely prescribed to pregnant women from 1940 to 1960. This resulted in multiple benign abnormalities of the genital tract and occasional malignant transformation in women who had been exposed to DES in utero. Over 300 cases of clear cell adenocarcinoma of the vagina have been described to date. In this study, 18 DES-exposed women and 20 normal age-matched controls were studied with ultrasound. An estimated uterine volume of 49.4 cm3 +/- 25.5 SD was found in the exposed subjects, compared with 90 cm3 +/- 22 SD in the normal subjects. Three out of 18 women (16%) had a T-shaped uterus. Ultrasound can detect some of the uterine abnormalities which occur due to DES exposure. 18 women exposed to DES (diethylstilbestrol) in utero and 20 normal controls, matched for age, were examined with ultrasound. The examination revealed that the uterine volume of exposed patients was significantly smaller than for the control patients. The average uterine volume was about 50 cm3 for the DES exposed patients and about 90 cm3 for the controls. 3 of the exposed women had T-shaped uteri. Findings from other studies indicated that females exposed in utero to DES were not only at increased risk of developing clear cell adenocarcinoma of the vagina but also had a higher incidence of non-neoplastic abnormalities of the genital tract than non-exposed women. None of the previous investigations reported differences in uterine volume. Although small uterine size may be due to a variety of factors, it was suggested that ultrasound detection of small uterine size should serve as a warning that the patient may have been exposed in utero to DES. Investigations need to be undertaken to determine if these abnormalities of the genital tract in DES exposed patients have an impact on the reproductive capacity of these patients.