Angiotensin II receptor blockers in pregnancy: A report of five cases

Objectives: To present cases exhibiting possible effects of angiotensin II receptor blockers (ARBs) received in pregnancy on the fetus. Methods: Retrospective analysis included women who delivered between 2002 and 2006 at Department of Obstetrics and Gynaecology Ljubljana. Results: Antihypertensive medications were prescribed to 346 of the 26,735 women. ARBs were given in only five pregnancies: two women received losartan, and three irbesartan. The therapy was stopped between 5 and 23 weeks of gestation. Two women delivered healthy babies at term; another term baby had one additional finger and toe. Other two pregnancies were complicated with oligohydramnios and ended in preterm delivery. One preterm infant had transient abnormal renal function tests. Conclusion: Women should be informed that ARB-antihypertensive therapy must be replaced/stopped before planning their pregnancy or at least as soon as the pregnancy is confirmed. Fetal morphology scan and monitoring of amniotic fluid volume should be obligatory, if ARBs are prescribed accidentally. (C) 2009 Elsevier Inc. All rights reserved.