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Prognosis and outcome of pregnancies exposed to renin–angiotensin system blockers
Author(s) -
Spaggiari Emmanuel,
Heidet Laurence,
Grange Gilles,
Guimiot Fabien,
Dreux Sophie,
Delezoide AnneLise,
Muller Françoise
Publication year - 2012
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.3960
Subject(s) - oligohydramnios , medicine , renal function , amniotic fluid , beta 2 microglobulin , renin–angiotensin system , fetus , pregnancy , obstetrics , amniotic fluid index , endocrinology , urology , blood pressure , biology , genetics
Objective To study pregnancy outcomes and fetal renal prognosis markers in cases of exposure to renin–angiotensin system blockers. Methods We conducted a retrospective study of a series of 21 patients exposed to blockers of the renin–angiotensin system during pregnancy. Two markers were prenatally studied, fetal serum β2‐microglobulin and amniotic fluid volume. Poor renal prognosis evaluation was based on postnatal glomerular filtration rate or on the presence of renal histologic lesions. Results Of the 21 fetuses, only one had a normal postnatal renal function at birth (oligohydramnios regression and normal β2‐microglobulin). All fetuses with persistent oligohydramnios or β2‐microglobulin ≥5 mg/L presented an adverse renal outcome. Conclusion Exposure to renin–angiotensin system blockers complicated by oligohydramnios is associated with a very poor outcome. We propose a prenatal management based on amniotic fluid volume monitoring and fetal serum β2‐microglobulin. However, our preliminary results have to be confirmed by a larger study. © 2012 John Wiley & Sons, Ltd.