Valsartan exposure in pregnancy with resultant anhydramnios and chronic kidney disease in a late preterm infant

2021 ◽  
Vol 14 (5) ◽  
pp. e240810
Author(s):  
Sarah Petch ◽  
Emily O'Connor ◽  
Ailbhe McGrath ◽  
Sean Daly
Keyword(s):  
In Utero ◽  
Lung Hypoplasia ◽  
In Utero Exposure ◽  
Late Preterm Infant ◽  
Angiotensin Ii Receptor ◽  
Childbearing Age ◽  
Paediatric Hospital ◽  
Spontaneous Preterm Delivery ◽  
Receptor Blockers

In utero exposure to angiotensin II receptor blockers (ARBs) has fetotoxic effects including renal failure, oligohydramnios and lung hypoplasia. We present the case of a 24-year-old woman who presented to the maternity services in the 34th week of her first pregnancy. She was taking valsartan for hypertension. Ultrasound showed a structurally normal fetus with anhydramnios. The patient was admitted and valsartan was discontinued. She had spontaneous preterm delivery at 35 weeks’ gestation of a baby girl. The baby’s urine output was minimal in the first week of life and she was transferred to a paediatric hospital for specialist nephrology input. At 6 months of age, she requires ongoing nephrology follow-up and she remains on treatment for hypertension and anaemia. This case demonstrates the serious adverse effects resulting from ARB exposure in utero, and highlights the importance of avoiding fetotoxic medications in women of childbearing age.

scholarly journals Reversible Fetal Renal Impairment following Angiotensin Receptor Blocking Treatment during Third Trimester of Pregnancy: Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Tal Saar ◽  
Lorinne Levitt ◽  
Hagai Amsalem
Keyword(s):  
Renal Impairment ◽  
Enzyme Inhibitors ◽  
Late Pregnancy ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Third Trimester ◽  
Converting Enzyme Inhibitors ◽  
Normal Delivery ◽  
Receptor Blockers

Background. Late pregnancy usage of angiotensin converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARB) may cause severe oligohydramnios due to fetal renal impairment. Affected neonates will often suffer from fatal, renal, and respiratory failure.Case. A 39-year-old multigravida admitted due to anhydramnios secondary to valsartan (ARB) exposure at 30 weeks’ gestation. Following secession of treatment amniotic fluid volume returned to normal. Delivery was induced at 34 weeks’ gestation following premature rupture of membranes and maternal fever. During the two-year follow-up, no signs of renal insufficiency were noted.Conclusions. This description of reversible fetal renal damage due to ARB intake during pregnancy is the first to show no adverse renal function in a two-year follow-up period. This case may help clinicians counsel patients with pregnancies complicated by exposure to these drugs.

scholarly journals Growth and Thyroid Function in Children With In Utero Exposure to Dioxin: A 5-Year Follow-Up Study

2010 ◽  
Vol 67 (2) ◽  
pp. 205-210 ◽  
Author(s):  
Pen-Hua Su ◽  
Jia-Yuh Chen ◽  
Jein-Wen Chen ◽  
Shu-Li Wang
Keyword(s):  
Thyroid Function ◽  
In Utero ◽  
In Utero Exposure ◽  
Follow Up Study

scholarly journals Long‐term Follow Up of Children with in utero Exposure to Sulfonylurea Medications

2021 ◽  
Author(s):  
Marissa S. Rodenstein ◽  
Monica E. Bianco ◽  
Maegan U. Ramchal ◽  
Michael Murias ◽  
Rebecca L. Silton ◽  
...  
Keyword(s):  
In Utero ◽  
In Utero Exposure ◽  
Long Term Follow Up

scholarly journals Lead toxicity in a new-born due to in utero exposure

2017 ◽  
Vol 5 (1) ◽  
pp. 245
Author(s):  
Leanna Laor ◽  
Sharlene Sy ◽  
Ruchi Gupta ◽  
Joseph Torres ◽  
Lourdes Cohen
Keyword(s):  
Lead Level ◽  
Lead Toxicity ◽  
Blood Lead ◽  
In Utero ◽  
In Utero Exposure ◽  
Limited Data ◽  
Child Bearing ◽  
Lead Levels

Lead poisoning in a neonate is poorly defined, and limited data exists on appropriate follow-up and treatment of such infants. We are presenting the case of a newborn infant, who had a lead level of 63 mcg/dL. Treatment involved five days of intravenous chelation therapy. At discharge, no clinical sequelae of lead toxicity were found. However, due to the chronic nature of in utero exposure the infant requires close follow-up, in particular neurologic and developmental sequelae. Lead toxicity has many complications. Long-term complications include delays in growth and development. Furthermore, these complications may develop in children with minimal toxicity, let alone those with grossly abnormal values. Due to lack of data, perhaps it is worthwhile to screen those women of child-bearing age, who are of "high risk", for elevated blood lead levels to reduce the risk of in utero exposure.

IN UTERO EXPOSURE TO THE HIROSHIMA ATOMIC BOMB

PEDIATRICS ◽  
1967 ◽  
Vol 39 (3) ◽  
pp. 385-392
Author(s):  
James W. Wood ◽  
Kenneth G. Johnson ◽  
Yoshiaki Omori
Keyword(s):  
Early Childhood ◽  
Mental Retardation ◽  
Mortality Rate ◽  
Atomic Bomb ◽  
Adult Life ◽  
In Utero ◽  
In Utero Exposure ◽  
Normal Children ◽  
Small Head

A study was made by Miller in 1954 of children who were in utero and within 2,200 meters from the hypocenter at the time of the atomic bomb in Hiroshima. These earlier observations have with few exceptions been validated by this follow-up of the subjects at 20 years of age and the value and accuracy of clinical evaluation in early childhood is clearly indicated. The following conclusions are made. Both small head size (circumference minus 2 SD or more) and mental retardation are most closely related to (1) maternal exposure within 1,500 meters from the hypocenter, and (2) a gestational age of less than 15 weeks. The heads of infants with either small or normal circumferences at birth increase thereafter in circumference at the same rate and stop growing at the same age, thereby maintaining the same size relationships throughout childhood into adult life. Mortality in the mentally retarded group as a whole exceeds mortality in normal children. For the group of all subjects exposed within 1,500 meters the mortality rate is higher than for the subjects located beyond 1,500 meters.

In utero exposure to diagnostic ultrasound: a 6-year follow-up.

Radiology ◽  
1988 ◽  
Vol 166 (3) ◽  
pp. 687-690 ◽  
Author(s):  
E A Lyons ◽  
C Dyke ◽  
M Toms ◽  
M Cheang
Keyword(s):  
Diagnostic Ultrasound ◽  
In Utero ◽  
In Utero Exposure
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