Diethylstilboestrol (DES) exposure in utero

A clinical review of the first 200 patients who attended the DES Referral Clinic at The Royal Women's Hospital, Melbourne, has been undertaken. To date, clear-cell adenocarcinoma has not been detected in patients attending the Clinic. Fifteen per cent of patients who allegedly were exposed in utero to diethylstilboestrol (DES) showed no clinical stigmata. Vaginal adenosis was found in 41% of patients. On its own, cytological examination of vaginal smears was found to be unreliable as routine screening for detection of adenosis. Painting of the cervix and vagina with Lugol's iodine proved to be a more reliable screening test. Colposcopy is recommended in all patients who are suspected of having been exposed in utero to DES.