Key result
Exposure to renin-angiotensin system blockers during pregnancy resulted in adverse fetal renal outcomes in 20 of 21 cases, particularly when complicated by persistent oligohydramnios.
Why the study?
Does exposure to renin-angiotensin system blockers during pregnancy cause adverse fetal renal outcomes?
Observational (n=21)
Does exposure to renin-angiotensin system blockers during pregnancy cause adverse fetal renal outcomes?
Exposure to renin-angiotensin system blockers during pregnancy is associated with severe adverse fetal renal outcomes, particularly when complicated by oligohydramnios.
Answers are grounded in this paper and cite their sources.
Warrants reinforced counseling against RAS blockers in pregnancy; leaves open generalizability and mechanisms in larger studies.
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.
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Spaggiari et al. (2012) conducted an observational in Pregnancy exposed to renin-angiotensin system blockers (n=21). Renin-angiotensin system blockers was evaluated on Poor renal prognosis (based on postnatal glomerular filtration rate or renal histologic lesions). Exposure to renin-angiotensin system blockers during pregnancy resulted in adverse fetal renal outcomes in 20 of 21 cases, particularly when complicated by persistent oligohydramnios.
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