***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a prospect i ve study 265 patients with threatened abortions were divided into 2 groups . One group of 134 patients received treatment with Oestradiol benzoat and hydroxyprogesterone capronat . The other group of 131 patients received no hormonal treatment . Of the group treated with hormones 40.7 % of the women had an abortion . Of the group treated with placebos 39.7 % of the patients had an abortion . There was therefore no difference in the success rate of the treatment of threatened abortion irrespective of the administration of hormones or placebos . The value of hormonal therapy in the treatment of threatened abortion is therefore question able This follow-up study presents the effects of DES on the genital tract of male and female offspring of mothers who were part of a double-blind , placebo-controlled investigation during 1951 and 1952 aim ed at determining the effect of DES on pregnancy . Epididymal cysts , hypotrophic testes , and capsular in duration were the more common genital lesions found in 25 % of 163 DES-exposed males as compared to 6 % in 168 control males .  Semen analysis data on 39 subjects of the DES-exposed group and 25 subjects of the control group showed that 26 % of the DES-exposed group produced an ejaculate volume under 1.5 ml ; no such cases were observed in the control group . The average values for sperm density and total motile spermatozoa per ejaculate , although in the normal range , were more than two times lower in the DES-exposed group as compared to the controls . A quality score of > 10 ( “ severely pathologic semen ” ) was found in 28 % of the DES-exposed group as compared to 0 in the control group . An association of pathologic semen quality with physical abnormalities was found only in the DES-exposed group . Two cases of azoospermia , one without genital abnormalities on physical examination and one with bilateral hypotrophic testes were observed so far in the DES-exposed group . Eighteen percent of 229 DES-exposed female patients had irregular menstrual cycles ( oligomenorrhea ) as compared to 10 % of 136 controls . The history of pregnancy revealed a lower incidence of pregnancy in the DES-exposed group ( 18 % ) than in the control group ( 33 % ) . Circumferential ridges of the vagina and cervix were seen in 40 % of 229 DES-exposed females but in none of 136 controls . Colposcopic findings in the vagina revealed adenosis in 66.8 % of the DES-exposed females and in 3.6 % of the control group . Dysplastic lesions were more prevalent in the vagina and cervix of the DES-exposed subjects . No cases of cancer were observed in either the male or female offspring Reproductive histories were compared for 226 DES-exposed and 203 -unexposed daughters whose mothers participated in a double-blind evaluation 27 years before .  Irregular menstruation was slightly more common among the exposed ( 10 % ) than among the unexposed ( 4 % ) . Nineteen of the exposed and only four of the unexposed had primary infertility . Among those at risk , 86 % of the unexposed and 67 % of the exposed had become pregnant . The reasons for these differences are not known . Comparison of evaluable first pregnancy outcome revealed full-term live birth to be more common among the unexposed ( 85 % ) than the exposed ( 47 % ) . Premature live birth was experienced by 22 % of the exposed but only 7 % of the unexposed . Nonviable outcomes of stillbirth , neonatal death , miscarriage and ectopic pregnancy occurred in 31 % of the exposed and 8 % of the unexposed . The difference in pregnancy outcomes between the groups is highly significant . The DES-exposed with transverse cervicovaginal ridges were more likely to experience a nonviable outcome . Overall 82 % of the exposed and 93 % of the unexposed had at least one live offspring The 27-year follow-up is reported of 136 children whose mothers were involved in a r and omised trial of high doses of stilboestrol and ethisterone therapy during pregnancy . The children were not contacted directly . Information about them was obtained from hospitals , general practitioners , and other official sources ; and the persons who responded to our inquiries were unaware of who had been exposed to hormones in utero and whose mothers had received an inactive tablet . All children were traced .  Urogenital anomalies were reported more frequently in the hormone-exposed than the unexposed children ( 14 % and 9 % respectively ) . The earlier in pregnancy the therapy began , the higher the prevalence rate of abnormalities ( X2 for trend , p less than 0.02 ) . No malignant tumours were reported . For males , the proportion reported to be married or living as married was lower in the exposed than in the unexposed group ( 32 % and 62 % respectively ) . The proportion was lower the earlier in pregnancy hormonal exposure occurred and the higher the total hormone dose to which they were exposed ( X2 for trend , p less than 0.02 ) . These findings suggest that some interference with sexual function may not be uncommon in males exposed to high doses of stilboestrol and ethisterone  while in utero We interviewed 542 women whose mothers were in a r and omized trial of diethylstilbestrol .  Effects of diethylstilbestrol on the third generation were explored by ascertaining age at menarche for the women 's daughters . A total of 123 daughters were > or = 10 years old ( 52 exposed and 71 unexposed ) .  Age at menarche was unaffected by mother 's prenatal diethylstilbestrol exposure Epididymal cysts and /or hypoplastic testes have been found in 31.5 per cent of 308 men exposed to diethylstilbestrol in utero , compared to 7.8 per cent of 307 placebo-exposed controls . Analyses of the spermatozoa have revealed severe pathological changes ( Eliasson score greater than 10 ) in 134 diethylstilbestrol-exposed men ( 18 per cent ) and 87 placebo-exposed men ( 8 per cent ) . Further investigation of the 26 diethylstilbestrol-exposed men with testicular hypoplasia has revealed that 65 per cent had a history of cryptorchidism . Only 1 of the 6 placebo-exposed  controls with testicular hypoplasia had a history of testicular maldescent . Although none of our Diekmann 's lying-in study group has had carcinoma to date one must keep in mind the reported increased risk of testicular carcinoma in testes that are or were cryptorchid . A 25-year-old man who was not part of the study group was treated recently by us for a testicular carcinoma ( mixed anaplastic seminoma plus embryonal cell carcinoma ) and he had a history of diethylstilbestrol exposure in utero and cryptorchidism The in utero effects of DES ( Diethylstilbestrol ) on the human male genital tract are reported in this follow-up study of male offspring of DES-treated mothers . Both anatomical and functional abnormalities were significantly greater in the  DES-exposed males as compared to control males whose mothers were all participants in a prospect i ve , r and omized double blind study of the effects of DES on pregnancy at the Chicago Lying-in Hospital during the early 1950s .  Epididymal cysts , hypotrophic testes and capsular in duration of the testes were among the more common genital lesions found in 27 % of 134 DES-exposed males as compared to a 7 % incidence in 119 control males . Spermatozoa analyses revealed severely pathologic changes ( Eliasson score greater than 10 ) in 29 % of 28 DES-exposed males and 0 % of 18 control males ( with or without genital i.e. , physical abnormalities ) . Abnormal findings on physical examination combined with sperm abnormalities ( Eliasson score greater than or equal to 5 ) were found in 29 % of DES-exposed males versus 0 % of 18 control males . Cytologic examinations did not reveal malignant cells from the following material s : urines before and after prostatic massage or ejaculation , prostatic fluids and aspirates from epididymal cysts Summary . In the early 1950s , a r and omized , double‐blind , controlled trial of the value of prophylactic stilboestrol therapy given antenatally to reduce the incidence of late pregnancy toxaemia and to improve perinatal mortality was conducted at University College Hospital , London . Women expecting their first baby were allocated to one or other of two groups . Those in the stilboestrol group started treatment at the 12th week of pregnancy on average and received a mean dose of about 11.5 g of the drug while those in the control group received placebo tablets . In spite of the fact that the original trial documentation was lost , it was possible to be fairly certain which was the treated group and follow‐up data from 650 mothers and 660 offspring were obtained from death certificates , cancer registration s and question naires sent to general practitioners . We found no indication of any harmful long‐term effect of stilboestrol exposure during pregnancy on the mothers — in particular 10 out of 331 women in the untreated group and 9 out of 319 women in the treated group were found to have developed breast cancer . Amongst the daughters , those in the treated group suffered an excess of minor benign lesions of the cervix uteri and an excess ( not statistically significant ) of unfavourable pregnancy outcomes . None of the daughters had developed clear cell adenocarcinoma of the vagina or cervix uteri . Amongst the sons , we discovered no evidence of any significant excess of genital tract disorders or of impaired reproductive performance in the treated group but one son developed a ( fatal ) teratoma of the testis . Unexpectedly , psychiatric disease ( especially depression and anxiety ) was reported by general practitioners about twice as often in the treated group offspring ( sons and daughters ) as in the untreated group . This result can not be due to bias , and is unlikely to be due to confounding or chance , and may thus represent an adverse effect of exposure to stilboestrol in utero In 1950 a trial was set up to evaluate the effects of large doses of stilboestrol and ethisterone on rates of fetal loss in pregnant diabetic women . Eighty women were allocated at r and om to receive the hormonal treatment and 76 to receive inactive tablets of identical appearance .  At follow-up 27 years later , information was obtained about 97 % of the women , all but four being traced . All respondents were unaware of who had received hormones . The overall mortality was 4.5 times that of women of comparable age in Engl and and Wales , most deaths being from complications of diabetes . More tumours , mainly benign , of the reproductive tract were reported in the hormone-exposed than the non-exposed group ( 14 ( 18 % ) and two ( 3 % ) respectively ) . Four cases of malignant breast disease were reported in the hormone-exposed women and none in the non-exposed . These findings support other evidence linking oestrogen treatment and breast cancer and suggesting that the latent period before the tumour becomes clinical ly apparent may be 15 years or longer Immunotoxicology studies of prenatal or neonatal exposure to diethylstilbestrol ( DES ) show effects on immune function of the adult animal . Prenatally exposed humans are known to be at increased risk of vaginal adenocarcinoma , but little research has been done to assess immunologic function . A placebo-controlled clinical trial of DES was conducted in the early 1950s . The sons and daughters born to participants of this clinical trial were traced and interviewed about immune-related health problems . Symptom and disease rates for the DES exposed ( 253 sons and 296 daughters ) were compared with rates for the unexposed ( 241 men and 246 women ) . DES-exposed men and women reported rates of allergy , infection , and autoimmune disease similar to the unexposed . However , because autoimmune diseases are rare , a larger sample is needed to evaluate further DES-associated risk of autoimmunity Abstract Objective : To estimate the miscarriage rate in a cohort of pregnant women and the final outcome of pregnancy . Design : Two year prospect i ve community study . Setting : Women registered with four semirural practice s at one health centre . Subjects : 626 pregnant women from a population 21 448 , 5140 of whom were women aged 15 - 44 years . Main outcome measures : Vaginal bleeding and outcome of pregnancy . Results : 76 of the 89 women with an unwanted pregnancy requested a termination . In the 550 ongoing pregnancies bleeding occurred before the 20th week in 117 ( 21 % ) , and 67 ( 12 % ) ended in miscarriage . The risk of miscarriage was not significantly increased after a miscarriage in the previous pregnancy ( 11 ( 15 % ) women had miscarriage v 55 ( 12 % ) women who had not had miscarriage ) who had previously had a live birth ) . Of the 117 women with  bleeding  , 64 were not admitted to hospital by the general practitioner ; 42 of these women had an ultrasound examination at the health centre and 19 subsequently miscarried at home . In hospital 41 of 46 women who miscarried had evacuation of the uterus . Conclusions : Bleeding occurred in one fifth of recognised pregnancies before the 20th week and over half of these miscar 
    Output:
    
MAIN RESULTS Miscarriage , preterm labour , low birthweight and stillbirth or neonatal death were not positively influenced by the intervention ( diethylstilbestrol ) as compared to the control group .
Diethylstilbestrol in utero exposure led to increased rate of miscarriage and preterm birth .
There was also an increase in the numbers of babies weighing less than 2500 grams .
The maternal outcome in terms of pre-eclampsia was not influenced .
Exposed female offsprings have a non-significant trend towards more cancer of the genital tract and cancer other than of the genital tract .
Primary infertility , adenosis of the vagina/cervix in female offsprings , and testicular abnormality in male offsprings were significantly higher in those exposed to diethylstilbestrol before birth .
REVIEW ER 'S CONCLUSIONS There was no benefit with the use of diethylstilbestrol in preventing miscarriages .
Both short and long-term adverse outcomes in exposed offsprings were demonstration of the harm that this intervention caused women and their offspring during its usage