Doctors urged to keep check on daughters of women who used pregnancy drug three decades ago Australia
Principal Medical Adviser with the TGA, Dr John McEwen, said that the Adverse Drug Reactions Advisory Committee (ADRAC) has reminded doctors in its latest Bulletin that daughters of women who took the drug in the 1950s and 1960s to prevent miscarriages should ensure that they follow the current national cervical and breast screening recommendations and should be reviewed by a gynaecologist, if they have not been previously.
Dr McEwen said in that in1971, an association was demonstrated between exposure in the womb to DES, and the development of the rare vaginal cancer CCAC in exposed daughters who were diagnosed at ages up to 22 years.
"In Australia there have only been 15 reported cases of the development of a rare cancer, clear cell adenocarcinoma (CCAC) of the vagina in women whose mothers had taken diethystilboestrol but it is considered that since the use of the drug for this purpose stopped in about 1972, all cancers should have been detected by now," Dr McEwen said.
He said, however that since the 1971 study other adverse effects associated with DES have been identified in DES daughters including:
-- vaginal and cervical adenosis is very common, with reported incidence as high as 90%
-- other histological and structural reproductive tract abnormalities have been reported (incidences range from 18% - 58%)
-- occurrence of cervical and vaginal dysplasia, squamous cell carcinoma-in-situ, and high grade squamous intraepithelial lesions is about doubled
-- infertility rates are slightly increased
-- pregnancy complication rates, such as premature deliveries, miscarriages, ectopic pregnancies and pre-eclampsia are increased
Dr McEwen said for the women who took DES ('DES mothers'), a small increase in the rate of breast cancer has been reported. The sons exposed to DES in utero ('DES sons') have an increased occurrence of epididymal cysts. Careful surveillance on the next generation is being maintained ('DES grandchildren'), but there is no clear evidence to date of adverse effects in the children of DES daughters or sons.
Therapeutic Goods Administration, Australia
Medicii îndemnat sã þinã verifica pe fiice de femei care au folosit droguri sarcinii trei decenii în urmã Australia - Doctors urged to keep check on daughters of women who used pregnancy drug three decades ago Australia - articole medicale engleza - startsanatate