PREGNANCY
Most DES daughters have no problems with pregnancy. However, some pregnancy
problems (ectopic pregnancy, premature labor, and possibly miscarriage)
occur more frequently in DES daughters, even among women who have already
had children. Fortunately, with the proper care, most DES daughters can
have safe and successful pregnancies.
WHAT TO DO
If you are a DES daughter and you are pregnant:
- Make sure you receive your medical care form someone familiar with taking
care of women at higher risk for pregnancy problems (see page 28 if you
need more information about finding a doctor).
- Tell your doctor that you are DES-exposed.
- Contact your doctor as soon as you suspect you are pregnant. You should
be examined right away to determine whether the pregnancy is in the uterus.
- Learn the symptoms of ectopic (tubal) pregnancy. For more information,
see page 18.
- Learn the symptoms of premature labor. For more information, see page
21.
- Visit your doctor at frequent intervals throughout your pregnancy. Your
doctor will suggest a schedule that is right for you.
Ectopic (tubal) Pregnancy
Most ectopic pregnancies are in the fallopian tube, although any pregnancy
that occurs outside the uterus is considered ectopic.
Because DES daughters are at a higher risk for ectopic pregnancy, you should
be examined as soon as you think you are pregnant to determine whether the
pregnancy is in a tube or in the uterus.
An early evaluation by your doctor often allows for early detection
of ectopic pregnancy. This evaluation includes vaginal ultrasound and a
pregnancy blood test. These simple steps could save your life and help save
your fallopian tube.
Three possible sites of an ectopic pregnancy in DES daughters
SYMPTOMS OF ECTOPIC PREGNANCY
Some women with an ectopic pregnancy may feel no symptoms, or only the normal
symptoms of early pregnancy. Many women, however, have additional symptoms.
These include:
- Vaginal bleeding or spotting
- Cramping or aching in the abdomen
- Abdominal or back pain
Vaginal ultrasound and a blood test can determine if your pregnancy is ectopic.
Call your doctor immediately if you think you have an ectopic pregnancy.
Premature Labor and Delivery
Because your risk for premature birth is also increased, you need to know
the symptoms of premature labor as well. You will also have to visit your
doctor at frequent intervals throughout your pregnancy. Premature labor
can sometimes be stopped if detected in time.
The most important step you can take to help prevent premature labor and
delivery is to see a doctor regularly throughout your pregnancy. If premature
labor occurs or threatens to occur, your doctor may recommend one of the
treatments below (keep in mind that treatment is always tailored to individual
problems and needs). Treatments for premature labor may include:
Bed Rest
Some women may be advised to rest in bed for part or most of their pregnancy.
If you are confined to your bed, there are support groups and telephone
hotlines to help you cope. Call a DES consumer organization for more information
(see page 33).
Tocolytics
Tocolytics are drugs to stop premature labor. They are often combined with
bed rest. Your doctor can give you more information on tocolytics.
Cervical Cerclage
Sometimes the cervix is stitched closed to stop it from opening too early.
Cerclage (as this procedure is called) may be more difficult in DES daughters
because of cervical abnormalities.
Medical experts do not recommend cerclage routinely for all DES daughters.
Your doctor will evaluate your individual situation to determine whether
cerclage is right for you.
PREMATURE LABOR
It is important to discuss the symptoms of premature labor (labor before
37 weeks of pregnancy) with your doctor, so that you know what to look for.
Watch for:
- Four or more contractions an hour, less than 15 minutes apart, while
lying down. Contractions may be "silent" (you may not feel them).
- Menstrual-like or abdominal cramps
- Low backache
- Pelvic pressure
- An increase or change in consistency or color of vaginal discharge
- Dilatation (opening) of the cervix, as assessed by your physician
- Rupture of membranes (often called "water breaking")
If you have any of these symptoms, call your doctor immediately
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