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DES Daughters
Female children exposed to DES were the most frequently affected.
The most serious health problem that DES daughters are prone
to is called clear cell adenocarcinoma, a rare type of vaginal
and cervical cancer. Daughters of patients who took DES are
also likely to develop structural changes in their reproductive
organs, infertility and pregnancy problems. Ectopic pregnancies,
miscarriage, premature labor and delivery are also common
difficulties for "DES daughters." DES daughters
are also likely to develop abnormal cells in the cervix and
vagina. These abnormal cells are termed "dysplasia,"
"cervical intraepithelial neoplasia," or "squamous
intraepithelial lesions," and they can evolve into cancer
without careful observation and treatment.
DES and Clear Cell Adenocarcinoma
Clear Cell Adenocarcinoma, a rare form of vaginal and cervical
cancer, was the first health problem identified as being associated
with DES exposure (Herbst, 1971; Noller, 1972). Clear Cell
Adenocarcinoma of the vagina and cervix occurs more frequently
in DES Daughters than in women not exposed to DES. DES Daughters
are 40 times more likely to develop Clear Cell Adenocarcinoma
of the vagina and cervix than women not exposed to DES. This
means that approximately one of every 1,000 women exposed
to DES before birth (in the womb) will be diagnosed with Clear
Cell Adenocarcinoma of the vagina and/or the cervix.
Before the use of DES, Clear Cell Adenocarcinoma of the vagina
and cervix only occurred in women past childbearing age. In
contrast, DES Daughters have been diagnosed with Clear Cell
Adenocarcinoma of the vagina and cervix at as early as age
8 and up to their late teens and early 20s. In addition, recent
studies have indicated that some DES Daughters have been diagnosed
with Clear Cell Adenocarcinoma of the vagina and cervix in
their 30s and 40s (Hatch, 1998). Therefore, DES Daughters
should have regular cancer screenings as they grow older.
DES and Reproductive Tract Structural Differences
Some studies have shown that up to one third of DES Daughters
have had some form of reproductive tract abnormality of the
cervix, uterus, or fallopian tubes, including vaginal adenosis
or cervical changes (such as collars, hoods, septae, and cockscombs)
(Jeffries, 1984; Herbst, 1984). Many of these changes are
harmless and had no effect on physical development, risk of
disease, or ability to conceive a child. However, some DES
Daughters experienced health problems as a result of reproductive
tract abnormalities. DES Daughters should talk with their
health care providers about the possibility of reproductive
tract structural differences so they can work together to
identify and treat any potential problems.
DES and Pregnancy Complications and Infertility
Most DES Daughters will be able to conceive and carry a healthy
baby to term. However, DES Daughters are at an increased risk
of reproductive problems, including complications during pregnancy
and infertility.
Consistently, research shows that DES Daughters are at an
increased risk for problems during pregnancy. These problems
are primarily associated with an increased risk for premature
(early) delivery. Of DES Daughters, 64% deliver a full-term
baby in their first pregnancy, compared with 85% of unexposed
women. Approximately 20% of DES Daughters experience pre-term
labor, compared with 8% of unexposed women (Kaufman, 2000).
* source - Center for Disease Control and
Prevention
DES Daughters / Clear Cell Adenocarcinoma
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