Angiotensin II‐receptor‐antagonists: Further evidence of fetotoxicity but not teratogenicity

Schaefer, Christof

doi:10.1002/bdra.10081

Cited by 114 publications

(85 citation statements)

References 12 publications

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“…Since very few infants with ACEI/ARB fetopathy survive, the information on long-term outcome of ACEI/ ARB fetopathy are very limited (Guignard and Gouyon, 1988;Pryde et al, 1993;Shotan et al, 1994;Schaefer, 2003). We experienced two children with ARB fetopathy who recovered from severe neonatal fetopathy.…”

Section: Long Term Prognosis Of Acei/arb Fetopathy: Renal Outcomes Ofmentioning

confidence: 94%

“…Most of the infants with ACEI/ARB fetopathy, progress to death or end-stage renal failure (ESRF) due to severely impaired renal function and hypoplastic lung due to oligohydramnion (Guignard and Gouyon, 1988;Pryde et al, 1993;Shotan et al, 1994;Schaefer, 2003). Taken together, it is apparent that RAS system inhibition severely impairs morphology and function of the kidney, which is often fatal.…”

Section: Effect Of Inhibition Of Ras System On Fetal Kidneymentioning

confidence: 99%

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Children's toxicology from bench to bed - Drug-induced Renal Injury (1): The toxic effects of ARB/ACEI on fetal kidney development

et al. 2009

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Section: Long Term Prognosis Of Acei/arb Fetopathy: Renal Outcomes Ofmentioning

confidence: 94%

Section: Effect Of Inhibition Of Ras System On Fetal Kidneymentioning

confidence: 99%

Children's toxicology from bench to bed - Drug-induced Renal Injury (1): The toxic effects of ARB/ACEI on fetal kidney development

et al. 2009

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“…Podczas ciąży inhibitory ACE, ARB oraz inhibitory reniny są przeciwwskazane [699,707]. U wszystkich pacjentek z HF zaleca się beta-adrenolityk, jeżeli takie leczenie jest tolerowane.…”

Section: Zaburzenia Rytmu Związane Z Kardiomiopatią Okołoporodowąunclassified

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Priori

Blomström‐Lundqvist²,

Mazzanti³

et al. 2015

Kardiol Pol

233

337

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“…[7][8]10,17,21,23,25,27,29,30,34,37,38,44,48,54,60,61,63,65,69 The mean age of the children described was 3.3Ϯ4.5 (range: 0.5 to 18) years. Fourteen children had prenatally been exposed to ACE-Is, and 12 had been exposed to ARBs.…”

Section: Follow-up At 6 or More Monthsmentioning

confidence: 99%

Pregnancy Outcome Following Exposure to Angiotensin-Converting Enzyme Inhibitors or Angiotensin Receptor Antagonists

Bullo

Tschumi²,

Bucher³

et al. 2012

Hypertension

283

152

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Abstract-The objective was to analyze the outcome following prenatal exposure to angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor antagonists (ARBs). For this purpose, a systematic review of published case reports and case series dealing with intrauterine exposure to ACE-Is or to ARBs using Medline as the source of data was performed. The publications retained for analysis included patients who were described individually, revealing, at minimum, the gestational age, substance used, period of medication intake, and the outcome. In total, 72 reports were included; 37 articles (118 well-documented cases) described the prenatal exposure to ACE-Is; and 35 articles (68 cases) described the prenatal exposure to ARBs. Overall, 52% of the newborns exposed to ACE-Is and 13% of the newborns exposed to ARBs did not exhibit any complications (PϽ0.0001). Neonatal complications were more frequent following exposure to ARBs and included renal failure, oligohydramnios, death, arterial hypotension, intrauterine growth retardation, respiratory distress syndrome, pulmonary hypoplasia, hypocalvaria, limb defects, persistent patent ductus arteriosus, or cerebral complications. The long-term outcome is described as positive in only 50% of the exposed children. Fetopathy caused by exposure to ACE-Is or ARBs has relevant neonatal and long-term complications. The outcome is poorer following exposure to ARBs. We propose the term "fetal renin-angiotensin system blockade syndrome" to describe the related clinical findings. Thirty years after the first description of ACE-I fetopathy, relevant complications are, at present, regularly described, indicating that the awareness of the deleterious effect of prenatal exposure to drugs inhibiting the renin-angiotensin system should be improved. A n undamaged renin-angiotensin system (RAS) is a prerequisite for normal prenatal renal development. Loss of function mutations in the genes encoding the RAS present with a disturbed renal development, characterized by reduced fetal diuresis, leading to oligohydramnios and, occasionally, skull-ossification defects. At birth, blood pressure is low, and death occurs in most cases.1 This clinical scenario resembles the findings, first reported by Guignard et al 2 and Duminy et al 3 in 1981, in infants exposed during pregnancy to drugs that block the RAS. This condition, which occurs following maternal treatment with either angiotensinconverting enzyme inhibitors (ACE-Is) or angiotensin receptor antagonists (ARBs), is usually termed fetal reninangiotensin system blockade syndrome (fetal RAS-blockade syndrome). Some data also indicate a possible association between the use of these drugs during the first trimester of pregnancy and congenital malformations.Because the adverse effects of drugs that block the RAS in the unborn child have been described only in single-case reports or in small case series, we performed a formal systematic analysis of the literature that addresses the intrauterine exposure to ACE-Is or ARBs. Our purposes in con...

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Angiotensin II‐receptor‐antagonists: Further evidence of fetotoxicity but not teratogenicity

Cited by 114 publications

References 12 publications

Children's toxicology from bench to bed - Drug-induced Renal Injury (1): The toxic effects of ARB/ACEI on fetal kidney development

Children's toxicology from bench to bed - Drug-induced Renal Injury (1): The toxic effects of ARB/ACEI on fetal kidney development

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Pregnancy Outcome Following Exposure to Angiotensin-Converting Enzyme Inhibitors or Angiotensin Receptor Antagonists

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