Lower conception rates overall are reported for DES daughters. See
Infertility. Of those who do conceive, spontaneous miscarriages, including
tragic, mid-trimester losses, ectopic pregnancies, and preterm births are greatly
increased. The risk is greatest for women with demonstrated structural abnormalities such
as hypoplasia, a T-shaped uterus or cervical deformities. There
is a five-fold increase in ectopic (tubal) pregnancies for DES daughters. This is a
pregnancy that implants in the tube as opposed to the uterus. All DES daughters should be
considered at risk for an ectopic pregnancy. Early confirmation of pregnancy and vigilance
in treatment is essential, since an undiagnosed tubal pregnancy can rupture and be
life-threatening.
A "T-shape" or other uterine abnormality may inhibit
or prevent implantation of a fertilized egg, resulting in infertility or miscarriage. A
small uterus or one with a thin or irregular lining may prohibit the uterus from
undergoing the extensive expansion necessary during pregnancy to accommodate the growing
fetus. This in turn may result in the increased preterm labor experienced among DES
daughters. A small or deformed cervix may become "incompetent" meaning that it
dilates prematurely, often resulting in early rupture of the membranes and a precipitous
delivery of a very premature baby. DES daughters have a two- to three-fold increased risk
of miscarriage and a four- to five-fold increased risk in premature deliveries. For these
reasons, you should seek out obstetrical care as soon as you suspect you are pregnant, if
not before. Your physician should be either a perinatologist or an obstetrician familiar
with high-risk pregnancies. You will likely to need to see your doctor on a more frequent
basis during your pregnancy and special tests or procedures may be necessary. If your
doctor diagnoses an "incompetent cervix", he may recommend that your cervix be
stitched shut during the pregnancy. This may help prevent the cervix from dilating too
early. You may also be advised to stay off your feet as much as possible, or even to
maintain bedrest.
While as many as half of all DES daughters may have no problem
getting pregnant and delivering healthy children, you should be aware of the risks
associated with your exposure and see a doctor skilled in handling them. Preparation, good
medical care and paying attention to your own body go a long way towards a successful
pregnancy.