CASE HISTORY – July – August 2010

Risks of the use of an angiotensinconverting enzyme inhibitor and an angiotensin receptor blocker during pregnancy: a case report and a literature review


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The paper describes the course of pregnancy and the state of the newborn of a woman  who used an angiotensin converting enzyme inhibitor (ACE inhibitor) and angiotensin  II receptor blockers (ARB) for the whole duration of pregnancy. The medication that affects the renin-angiotensin system was prescribed to the woman with type 2 diabetes three years before pregnancy. The treatment remained unchanged during pregnancy. In the 37th gestational week, oligohydramnion, fetal distress and intrauterine growth restriction were  diagnosed and pregnancy was brought to an end with an emergency caesarian section. The newborn died of pulmonary hypoplasia and kidney failure at the age of 38 hours. According to literature data, ACE inhibitor and ARB use during pregnancy is known to cause the described disorders, therefore the use of these medications should be avoided in pregnant women.