Gevolgen van DES-blootstelling bij moeders en hun nakomelingen: een opinie ten aanzien van screening op basis van gekende literatuur

Abstract

Diethylstilbestrol exposure of mothers and their offspring: after the disillusion, a well-grounded recommended screening program Diethylstilbestrol (DES) is a synthetic estrogen, developed in 1938 and until 1978 prescribed to pregnant women in the prevention of miscarriages. Nowadays, DES is considered as a transplacental teratogenic and carcinogenic medicine associated with cancer, infertility, pregnancy complications and early menopause. In this article, the effects of DES exposure during pregnancy on mothers and their offspring are described and a screening is recommended. A literature study on the harmful effects of DES exposure during pregnancy was performed. DES mothers show a moderately increased risk of breast cancer. DES daughters have an elevated relative risk of 12 adverse events, such as anomalies of the reproductive system, infertility, adverse pregnancy outcomes, cervical dysplasia, and vaginal and cervical clear-cell adenocarcinoma. DES sons show a higher prevalence of urogenital malformations. DES might have an intergenerational influence on the third generation, but studies are still limited and ongoing. DES mothers should perform the standard breast cancer screening every 2 years, even after the age of 69. DES daughters should perform a yearly gynecological exam with cervical and vaginal cytology, as well as a clinical breast exam, supplemented with a mammography every 2 years, even after the age of 69. For DES sons, there is no standard screening. DES grandchildren need to follow the standard screening recommendations. The consequences of the use of DES in pregnancy are intergenerational. A screening should be performed, and increased vigilance and further reporting of health problems are necessary.