Transvaginal ultrasound studies of vascular and morphological changes in uteri exposed to diethylstilbestrol in utero, Human reproduction (Oxford, recipe England), NCBI PubMed PMID: 8981149, 1996 Nov. Full text: Human Reproduction vol 11 no 11 pp 2531-2536, oxfordjournals, 1996.
The aim of this prospective study was to establish complementary data of uteri exposed to diethylstilbestrol (DES) in utero for transvaginal analysis and vascularity changes during the menstrual cycle.
A total of 28 women with DES-exposed uteri were compared with 60 non-exposed women. Transvaginal ultrasound and colour Doppler imaging were performed on days 5 and 22 of the menstrual cycle. Uteri were measured on sagittal and transverse scans. Uterine length, width, thickness and uterine cavity length and width were measured.
- Uterine volume and uterine cavity area were calculated. DES-exposed uterine volume was equal to 31.84 +/- 3.37 cm3.
- The cavity area of DES-exposed uterus was equal to 35.85 +/- 3.93 cm2.
- Cervix length of DES-exposed uterus was significantly smaller than that of non-exposed uterus.
- The uterine artery pulsatility index (PI) of DES-exposed uterus was significantly higher than that of normal uterus. Blood flow remained stable throughout the menstrual cycle.
- The PI of DES-exposed uterus remained stable during the menstrual cycle, as in non-exposed uterus, and it decreased during the luteal phase. This lack of modification in vascularity of DES-exposed uterus may explain miscarriages and obstetric complications such as intrauterine growth retardation or pre-eclampsia.
The data may have implications for the assessment of reproductive status and the design of future studies on disorders of implantation in DES-exposed uterus. Based on these results, we now propose a study by Doppler transvaginal sonography and hysterography for all patients exposed in utero to DES Colour Doppler echography gives an appreciation of the implantation chances of DES patients. A high PI may in part explain repetitive miscarriages. We suggest low doses of aspirin for these patients from the beginning of pregnancy.
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