Angiotensin II receptor blockers in pregnancy: a report of five cases.
OBJECTIVE
To present cases exhibiting possible effects of angiotensin II receptor blockers (ARBs) received in pregnancy on the fetus.


METHODS
Retrospective analysis included women who delivered between 2002 and 2006 at Department of Obstetrics and Gynaecology Ljubljana.


RESULTS
Antihypertensive medications were prescribed to 346 of the 26,735 women. ARBs were given in only five pregnancies: two women received losartan, and three irbesartan. The therapy was stopped between 5 and 23 weeks of gestation. Two women delivered healthy babies at term; another term baby had one additional finger and toe. Other two pregnancies were complicated with oligohydramnios and ended in preterm delivery. One preterm infant had transient abnormal renal function tests.


CONCLUSIONS
Women should be informed that ARB-antihypertensive therapy must be replaced/stopped before planning their pregnancy or at least as soon as the pregnancy is confirmed. Fetal morphology scan and monitoring of amniotic fluid volume should be obligatory, if ARBs are prescribed accidentally.
Gersak
Ksenija
K
Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Slajmerjeva 3, SI-1000 Ljubljana, Slovenia. ksenija.gersak@mf.uni-lj.si
Cvijic
Marta
M
Cerar
Lilijana Kornhauser
LK
D000014:Abnormalities, Drug-Induced / Q000209:etiology; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001713:Biphenyl Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007231:Infant, Newborn; D000077405:Irbesartan; D007674:Kidney Diseases / Q000139:chemically induced; D019808:Losartan / Q000008:administration & dosage / Q000009:adverse effects*; D016104:Oligohydramnios / Q000139:chemically induced; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D047928:Premature Birth / Q000139:chemically induced; D012189:Retrospective Studies; D018570:Risk Assessment; D017524:Slovenia; D013777:Tetrazoles / Q000008:administration & dosage / Q000009:adverse effects*
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D013777:Tetrazoles; D000077405:Irbesartan; D019808:Losartan