Incompetent cervix in offspring exposed to diethylstilbestrol in utero.

Five patients with malformation and hypoplasia of the cervix due to diethylstilbestrol (DES)-exposure in utero developed cervical incompetency during the second trimester. Four of the patients were managed successfully during pregnancy with a modified Shirodkar cerclage procedure which was performed at the first sign of cervical effacement and dilitation. The fifth patient, who had lost 2 pregnancies because of cervical incompentency, underwent a modified Lash procedure and permanent cerclage in the nonpregnant state and was delivered at term by primary cesarean section. In view of the large number of women exposed to DES who have grossly abnormal-appearing and hypoplastic cervices, it is important for obstetricians to be aware of this potential complication in order to avoid second trimester losses which could be prevented by prompt surgical intervention.