Fetal toxicity of valsartan and possible reversible adverse side effects.
BACKGROUND
Published cases suggest that the use of angiotensin II receptor antagonists is fetotoxic during the third trimester, but not in early pregnancy.


METHODS
We report a case in which the adverse fetal effect of angiotensin II receptor antagonist treatment was reversed. A woman with chronic hypertension was treated with valsartan until gestation week (GW) 20, when a complete anhydramnios was observed. Six days after interruption of the treatment, amniotic fluid reappeared. It reached a normal level at GW 23.5. The plasmatic creatinine level and the renal ultrasound examination were within normal limits at the six-month follow-up.


CONCLUSIONS
Whereas angiotensin-II-receptor antagonist generates a severe renal toxicity, this case suggests that, at least in the first half of pregnancy, these effects can be reversed.
Department of Gynecology-Obstetrics and Reproductive Medicine, Hôpital Tenon, AP-HP, Paris 75020, France. nadia.berkane@tnn.ap-hop-paris.fr
Nadia
N
Berkane
Patrick
P
Carlier
Lieve
L
Verstraete
Emmanuelle
E
Mathieu
Nazbanou
N
Heim
Serge
S
Uzan
D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000633:toxicity*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007668:Kidney / Q000000981:diagnostic imaging / Q000187:drug effects; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome; D013777:Tetrazoles / Q000009:adverse effects / Q000633:toxicity*; D014463:Ultrasonography; D014633:Valine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000633:toxicity*; D000068756:Valsartan
D047228:Angiotensin II Type 1 Receptor Blockers; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine