In utero losartan withdrawal and subsequent development of fetal inferior vena cava thrombosis.
BACKGROUND
Angiotensin receptor blockers are antihypertensive medications prescribed by a wide variety of physicians, especially for patients with coexistent diabetes mellitus. Angiotensin receptor blockers, as well as angiotensin-converting enzyme inhibitors, are contraindicated in pregnancy.


METHODS
We describe the reversal of losartan-induced oligohydramnios at 27 weeks of gestation with subsequent development of fetal thrombosis and possible mechanism of action for this extremely rare in utero complication.


CONCLUSIONS
This theory may help explain the fetal stillbirths in women taking this class of medications during the second and third trimester of pregnancy.
Bakkum
Jamie N
JN
Section of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
Brost
Brian C
BC
Johansen
Keith L
KL
Johnston
Bruce W
BW
Watson
William J
WJ
D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D000075202:Contraindications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D005315:Fetal Diseases / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000150:complications; D019808:Losartan / Q000008:administration & dosage*; D008875:Middle Aged; D016104:Oligohydramnios / Q000139:chemically induced*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D013927:Thrombosis / Q000209:etiology*; D014682:Vena Cava, Inferior / Q000196:embryology*
D047228:Angiotensin II Type 1 Receptor Blockers; D019808:Losartan