Gynecologic operative experience in women exposed to DES in utero.

A review of 309 women exposed to DES in utero revealed 43 major gynecologic procedures, excluding cesarean section, in 33 women (11%) with a mean age of 24.3 years. Pelvic adhesions (54%), ovarian cysts (36%), and ectopic pregnancies (21%) were the major operative findings; no invasive gynecologic malignancies were identified. Eight of the women required at least one additional operative procedure, primarily for pelvic adhesions. In those with DES-related cervicovaginal changes, the incidence of operative procedures was 23%. New problems associated with in utero DES exposure continue to be revealed as affected progeny are studied in more detail. These findings suggest an additional problem--an increased incidence of clinically evident adnexal disease involving adhesions, benign ovarian cysts, and ectopic pregnancies.