Course and Outcome of Pregnancy After Maternal Exposure to Angiotensin-II-Receptor Blockers – Case Report and Review of the Literature

Introduction

Angiotensin II is the main effector in the renin-angiotensin system. By binding its angiotensin I receptor, it causes vasoconstriction and retention of fluid and sodium. Angiotensin II receptor blockers (ARB) are used in the treatment of arterial hypertension, heart failure, post-myocardial infarction and diabetic nephropathy. Several studies have shown that ARBs seem to have cardioprotective, cerebroprotective, and renoprotective effects. In pregnancy treatment with ARB or angiotensin-converting enzyme inhibitors, (ACE-I) is contraindicated due to negative reactions like oligohydramnios, fetal growth restriction, pulmonary hypoplasia, infant anuria and renal failure, limb contractures, calvarial hypoplasia and intrauterine death after maternal exposure (Celentano et al. Pediatr Nephrol 2008; 23: 333–334).