Obstetrics and Gynecology · 1990 · 15 citations · 0 references
Public HealthMaternal HealthObstetricsHigh-risk PregnancyObstetric ComplicationsReproductive ToxicologyFemale Reproductive ToxicologyIntrapartum ComplicationsMaternal ComplicationsPerinatal Risk FactorsPlacental ToxicologyPregnancyCervical Dilation MonitoringCervical Dilation ProgressionIntrauterine EnvironmentMatched Cohort DesignMaternal Adverse EffectsMaternal Exposure EffectsMaternal ToxicityMaternal-fetal Toxicity
Using a retrospective cohort design, we analyzed the effects of intrauterine diethylstilbestrol (DES) exposure on various antepartum and intrapartum events. Gravidas exposed to DES had a higher likelihood of being delivered abdominally, undergoing manual removal of the placenta, and hemorrhaging in the postpartum period. The increased risk for these events remained after controlling for age, race, and parity. We also constructed labor curves in DES-exposed women by plotting cervical dilation against time. The curves were similar for nulliparous DES-exposed women and nulliparous controls, but DES-exposed parous women experienced prolonged labors. These findings suggest that, in addition to the well-known adverse effects of intrauterine DES exposure, the interaction between the uterus and placenta is altered in some DES-exposed patients.