Problems of Birth Defects

From Hippocrates to Thalidomide and After

From Hippocrates to thalidomide and after : original papers with commentaries by T.V.N. Persaud

A collection of 57 papers and commentaries, arranged in eight sections, discuss the historical aspects, epidemiology, mechanisms, genetics, etiology, prenatal diagnosis, management, and social aspects of birth defects.

  • Paperback: 399 pages
  • Publisher: University Park Press (1977).
  1. Beliefs, Mythology, Magic and Superstition.
    • Congenital malformations in the past.
    • A brief history of teratology to the early 20th century.
  2. Epidemiology of Birth Defects.
    • Classification and nomenclature of morphological defects.
    • Epidemiologic aspects of the problem of congenital malformations.
    • Congenital malformations. A report of a study of series of consecutive births in 24 centres. (Extracts).
    • The incidence of developmental and other genetic abnormalities.
  3. Teratological Mechanisms.
    • Interrelation of the common congenital malformations. Some aetiological implications.
    • Defective regulatory mechanisms in teratogenesis.
    • Mechanisms of teratogenesis.
    • Congenital postural deformities: perinatal associations.
  4. Cytogenetic and Chromosomal Studies.
    • A morphological distinction between neurones of the male and female, and the behaviour of the nucleolar satellite during accelerated nucleoprotein synthesis.
    • The detection of chromosomal sex in hermaphrodites from a skin biopsy.
    • The chromosome number of man.
    • Retrospective and prospective epidemiological studies of 1500 karyotyped spontaneous human abortions.
    • Chromosome abnormality and perinatal death.
    • Cytogenetics of fetal wastage.
    • Spontaneous abortion and aging of human ova and spermatozoa.
    • Where have all the conceptions gone?
    • Genetics of common disorders.
    • Genetic hazards to man from environmental agents.
  5. Environmental Influences and Congenital Abnormalities.
    • Pigs born without eye balls.
    • Congenital cataract following German measles in the mother.
    • The role of viruses in congenital defects.
    • Congenital toxoplasmosis. A prospective study of 378 pregnancies.
    • Therapeutic abortions with a folic acid antagonist, 4-aminopteroyl-glutamic acid (4-amino P.G.A.) administered by the oral route. (Extract).
    • Diskussionsbemerkung von Privatdozent Dr. W. Lenz, Hamburg, zu dem Vortrag von R. A. Pfeiffer und K. Kosenow: Zur Frage der exogenen Entstehung schwerer Extremitatenmissbildungen.
    • Thalidomide and congenital abnormalities.
    • Foetal malformations due to thalidomide.
    • Nonadrenal female pseudohermaphrodism after administration of testosterone to mother during pregnancy.
    • Masculinization of female fetus due to use of orally given progestins.-
    • Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women.
    • Are anti-epileptics harmful in pregnancy? (Extract).
    • Anticonvulsant drugs and congenital abnormalities.
    • Congenital abnormalities and anticonvulsant drugs.
    • A clinical look at the problem of drugs in pregnancy and their effect on the fetus.
    • Intra-uterine methylmercury poisoning in Iraq.
    • Assessing the impact of low level chemicals on development: behavioral and latent effects.
    • A preliminary report of cigarette smoking and the incidence of prematurity. (Extract).
    • Effect of mothers’ smoking habits on birth weight of their children.
    • The fetal alcohol syndrome.
    • Potatoes and spina bifida.
    • The outcome of 625 pregnancies in women subjected to pelvic radium or roentgen irradiation. (Extract).
    • Radiation and pregnancy.
  6. Detection of Environmental Teratogens.
    • Environmental factors in the etiology of human malformations: perspectives and problems of evaluation.
    • Hazards of the first nine months: an epidemiologist’s nightmare.
  7. Prenatal Diagnosis and Management of Congenital Abnormalities.
    • Prenatal diagnosis of genetic disorders. An analysis of experience with 600 cases.
    • Prenatal diagnosis of mongolism by X-ray.
    • Diagnosis of congenital fetal abnormalities by sonography.
    • Amniography for detection of congenital malformations.
    • Diagnosis of human fetal abnormalities by fetography.
    • Genetic counselling-or what can we tell parents?.
    • Pre-, peri- and postnatal prevention of major neuropediatric handicaps.
  8. Social, Ethical, and Medico-Legal Problems.
    • Moral and ethical problems of pre-natal diagnosis.
    • Attitudes toward defective newborns.
    • Ethical and social aspects of treatment of spina bifida.
    • Moral and ethical dilemmas in the special-care nursery.
    • Further References.
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Diethylstilbestrol geschiedenis, nog geen historie

Stichting DES-aktie en informatiecentrum, Utrecht, 1991

Video published on 23 August 2016 by DES in Belgium.

DES (diëthylstilbestrol) is een kunstmatig vrouwelijk hormoon (oestrogeen). Het werd in Nederland voorgeschreven aan zwangere vrouwen in de periode tussen 1947 en 1976. Het middel zou miskramen moeten voorkomen. Dat deed het niet, maar het zorgde wel voor gezondheidsproblemen bij de dochters van deze vrouwen. Ook werd bekend dat DES schadelijke gevolgen kan hebben voor de moeders zelf, hun zonen en mogelijk zelfs kleinkinderen.

DES DiEthylStilbestrol Resources

Van Wondermiddel tot Nachtmerrie ; het DES Hormoon

Hier en nu (29-03-1985, NCRV)

Video published on 1 November 2016 by DiEthylStilbestrol DES.

Het actualiteiten programma Hier en Nu van de NCRV maakte in 1985 een reportage over de gevolgen van het DES-hormoon.

Het was een kleine pil, met grote gevolgen. Zestig jaar geleden schreven artsen massaal een middel voor dat een zwangerschap zonder problemen beloofde, het DES-hormoon. Het leek een wondermiddel. Maar later bleek het preparaat nutteloos en vooral ook heel schadelijk. Tot op de dag van vandaag ondervinden in Nederland alleen al 220.000 moeders en hun kinderen de wrange gevolgen; misvormde baarmoeders, problemen met vruchtbaarheid en baarmoederkanker. Al in 1971 bleek uit Amerikaans onderzoek hoe ernstig de gevolgen waren en onmiddellijk is datzelfde jaar gestopt met voorschrijven in de Verenigde Staten. In Nederland drongen de feiten vier jaar later door en werd het middel in 1975 verboden. Intussen werden langzaam de gevolgen zichtbaar bij dochters van moeders die DES hadden geslikt. En inmiddels is gebleken dat ook kleinkinderen afwijkingen vertonen. Een medicijndrama waarvan het einde voorlopig niet in zicht is.

DES DiEthylStilbestrol Resources

Stilbestrol Tab 1mg

Taipei Veterans General Hospital, Taiwan

image of des-stilbestrol-1mg
Taipei Veterans General Hospital, Taiwan.

DES was sold under many names including Distilbène®, Stilbetin®, Stilboestrol-Borne®, Benzestrol®, Chlorotrianisene®, Estrobene® and Estrosyn® to name just a few.

Many different companies manufactured and marketed this drug under more than 200 different brand names.

These Stilbestrol tablets are current Taipei-VGH drugs marketed by Taipei Veterans General Hospital.

DES Drugs Pictures
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Apex Stilboestrol Tablets 1mg

DES Tablets, Veterinary Products, Male Dog Neutering

image of apex-stilboestrol-tablets
DES is still sold under different names.

DES was sold under many names including Distilbène®, Stilbetin®, Stilboestrol-Borne®, Benzestrol®, Chlorotrianisene®, Estrobene® and Estrosyn® to name just a few.

Many different companies manufactured and marketed this drug under more than 200 different brand names.

These Apex Stilboestrol tablets are current veterinary products.

DES Drugs Pictures
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Stilbestrol Tablets 1mg

Taipei Veterans General Hospital, Taiwan

image of stilbestrol-1mg
Taipei Veterans General Hospital, Taiwan.

DES was sold under many names including Distilbène®, Stilbetin®, Stilboestrol-Borne®, Benzestrol®, Chlorotrianisene®, Estrobene® and Estrosyn® to name just a few.

Many different companies manufactured and marketed this drug under more than 200 different brand names.

These Stilbestrol tablets are current Taipei-VGH drugs marketed by Taipei Veterans General Hospital.

DES Drugs Pictures
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Stilbestrol for veterinary use

0.5 mg and 1.0 mg DES tablets manufactured by Ormond Veterinary Supply Inc., Canada

image of stillbestrol
Stilbestrol Tablets manufactured by Ormond Veterinary Supply Inc., Canada.

DES was sold under many names including Distilbène®, Stilbetin®, Stilboestrol-Borne®, Benzestrol®, Chlorotrianisene®, Estrobene® and Estrosyn® to name just a few.

Many different companies manufactured and marketed this drug under more than 200 different brand names.

These Stilbestrol tablets – 0.5 mg and 1.0 mg – are manufactured at Ormond Veterinary Supply Inc. facility, Canada.

DES Drugs Pictures
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Upper genital tract changes associated with exposure in utero to diethylstilbestrol

American journal of obstetrics and gynecology, 1977

woman-in-the-dark
1977 study : in none of the control subjects were defects noted which could be considered comparable with those seen in the DES-exposed patient.

1977 Study Abstract

Hysterosalpingograms of 60 young women exposed in utero to diethystilbestrol were obtained.

In 46 instances, documentation of this exposure was obtained from the mother’s chart review or confirmed by the attending physician. In 14 instances, the patients’ mothers were sure they had received stilbestrol, but documentation could not be specifically confirmed.

  • In 40 women exposed to stilbestrol, changes in the uterus which differed significantly from those seen in the past in nonexposed individuals were noted. These changes consisted of:
    • a ‘T-shaped appearance of the uterus,
    • ‘ constricting bands in the uterine cavity,
    • a hypoplastic uterus,
    • and less frequently, intrauterine polypoid defects,
    • synechiae,
    • and in one instance a unicornuate uterus.
  • In 36 of the 40 women gross defects were also noted in the cervix.

Hysterosalpingograms of 23 women being investigated for infertility during the same period that the current study was conducted were also reviewed.

  • By comparison, in none of the control subjects were defects noted which could be considered comparable with those seen in the DES-exposed patient.
Sources and more information

Upper genital tract changes associated with exposure in utero to diethylstilbestrol, American journal of obstetrics and gynecology, NCBI PMID: 851159, 1977 May 1.

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Wyeth’s Estrogens – American Journal of Obstetrics and Gynecology, 1940s advert

Diethylstilbestrol (DES) was the first synthetic estrogen to be marketed to women

Wyeth's-Estrogens advert image
Diethylstilbestrol (DES), the first synthetic estrogen to be marketed to women.
  • An ad from the American Journal of Obstetrics and Gynecology from 1943.
  • Image sources: Protecting Our Bodies from Hormone-Disrupting Chemicals: A Precautionary Tale, thesolutionsjournal, Feb 2011.
  • Watch our diaporama and DES adverts album on Flickr.
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The Newest Knowledge of Nutrition

Wise Burroughs, DES, and Modern Meat

agricultural history book cover image
Alan I. Marcus. Agricultural History, Vol. 67, No. 3 (Summer, 1993), pp. 66-85.

Presents an historical account of animal nutrition research focusing on the 1954 discovery of animal husbandry professor Wise Burroughs of stilbestrol (DES) as a growth-promoting cattle feed additive.

DES feeds’ implications for beef-feeding practices; Burroughs’s research; Ban of DES animal feed due to carcinogenic properties.

By Marcus, Alan I, June 1993.

Sources and book reviews:

  • JSTOR: Agricultural History,
    Vol. 67, No. 3 (Summer, 1993), pp. 66-85.
  • EBSCOhost, 9402020134.
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