[Exposure to diethylstilbestrol during intrauterine life. Signs that should suggest this. Therapeutic implications]

From now on it is general knowledge that there is marked increase in the frequency of clear cell cancers of the cervix and of the vagina in daughters whose mothers were given diethylstilboestrol (DES) during their pregnancies. Equally well known is the high fréquency of vaginal adenosis in these patients. Since 1977, moreover, several North American writers have commented on the lowering in reproductive capacity of these women. It seems that women who were exposed to DES in utero had a greater frequency of extra-uterine pregnancies, spontaneous abortions, and perinatal mortality of their offspring as compared with carefully selected control series. These complications seem to have a predilection for women who have abnormal cervices of who have a T-shaped hypoplastic uterus found on hysterosalpingography. Recently it has been found that there is a higher level of female sterility as compared with male sterility in these patients. Reviewing the literature and describing the principal abnormalities has made it possible for us to produce a hypothesis. This should explain how the action of DES on the mesonephric canals of Wolff causes changes in the shape of the uterus.