{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:21Z","timestamp":1756339401445,"version":"3.44.0"},"reference-count":28,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,7]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>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\u2019 gestation of a baby girl. The baby\u2019s 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.<\/jats:p>","DOI":"10.1136\/bcr-2020-240810","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T13:46:23Z","timestamp":1621431983000},"page":"e240810","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Valsartan exposure in pregnancy with resultant anhydramnios and chronic kidney disease in a late preterm infant"],"prefix":"10.1136","volume":"14","author":[{"given":"Sarah","family":"Petch","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Coombe Women and Infants University Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Coombe Women and Infants University Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1653-9556","authenticated-orcid":false,"given":"Ailbhe","family":"McGrath","sequence":"additional","affiliation":[{"name":"Molecular, Genetic and Population Health Science, The University of Edinburgh Edinburgh Medical School, Edinburgh, UK"},{"name":"General Paediatrics, Children's Health Ireland at Crumlin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Daly","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine, Coombe Women and Infants University Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"2025082701432635000_14.5.e240810.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.03.036"},{"key":"2025082701432635000_14.5.e240810.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0036171","article-title":"Hypertension in women of reproductive age in the United States: NHANES 1999-2008","volume":"7","author":"Bateman","year":"2012","journal-title":"PLoS One"},{"key":"2025082701432635000_14.5.e240810.3","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1080\/08998280.2003.11927893","article-title":"Angiotensin II receptor blockers","volume":"16","author":"Barreras","year":"2003","journal-title":"Baylor University Medical Center Proceedings"},{"key":"2025082701432635000_14.5.e240810.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2005.11.001"},{"key":"2025082701432635000_14.5.e240810.5","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2011.579197"},{"key":"2025082701432635000_14.5.e240810.6","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/S0140-6736(00)03648-5","article-title":"Losartan and fetal toxic effects","volume":"357","author":"Saji","year":"2001","journal-title":"The Lancet"},{"key":"2025082701432635000_14.5.e240810.7","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.10081"},{"key":"2025082701432635000_14.5.e240810.8","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20102"},{"key":"2025082701432635000_14.5.e240810.9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1055\/s-0030-1269895","article-title":"Angiotensin II receptor blocker induced Fetopathy: 7 cases","volume":"223","author":"H\u00fcnseler","year":"2011","journal-title":"Klinische P\u00e4diatrie"},{"key":"2025082701432635000_14.5.e240810.10","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1111\/j.1365-2125.2012.04388.x","article-title":"Angiotensin-II receptor 1 antagonist fetopathy - risk assessment, critical time period and vena cava thrombosis as a possible new feature","volume":"75","author":"Oppermann","year":"2013","journal-title":"Br J Clin Pharmacol"},{"key":"2025082701432635000_14.5.e240810.11","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1002\/pd.3960","article-title":"Prognosis and outcome of pregnancies exposed to renin-angiotensin system blockers","volume":"32","author":"Spaggiari","year":"2012","journal-title":"Prenat Diagn"},{"key":"2025082701432635000_14.5.e240810.12","doi-asserted-by":"crossref","unstructured":"Marchetto L , Sordino D , De Bernardo G , et al . Postnatal acute renal failure after fetal exposure to angiotensin receptor blockers. BMJ Case Rep 2015:bcr2014207450. doi:10.1136\/bcr-2014-207450","DOI":"10.1136\/bcr-2014-207450"},{"key":"2025082701432635000_14.5.e240810.13","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.112.196352"},{"key":"2025082701432635000_14.5.e240810.14","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-008-1091-8"},{"key":"2025082701432635000_14.5.e240810.15","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-007-0618-8"},{"key":"2025082701432635000_14.5.e240810.16","doi-asserted-by":"crossref","DOI":"10.4321\/S1886-36552008000100003","article-title":"Perception of teratogenic and foetotoxic risk by health professionals: a survey in Midi-Pyrenees area","volume":"6","author":"Damase-Michel","year":"2008","journal-title":"Pharmacy Practice"},{"key":"2025082701432635000_14.5.e240810.17","unstructured":"NICE Guideline . Hypertension in pregnancy: diagnosis and management, 2019."},{"key":"2025082701432635000_14.5.e240810.18","doi-asserted-by":"crossref","unstructured":"Whelton P , Carey R , Aronow W , et al . 2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American heart association Task force on clinical practice guidelines. Hypertension 2018;71.","DOI":"10.1161\/HYP.0000000000000076"},{"key":"2025082701432635000_14.5.e240810.19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055202"},{"key":"2025082701432635000_14.5.e240810.20","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/AOG.0000000000001775","article-title":"Angiotensin-Converting enzyme inhibitors and the risk of congenital malformations","volume":"129","author":"Bateman","year":"2017","journal-title":"Obstetrics Gynecology"},{"key":"2025082701432635000_14.5.e240810.21","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/796590"},{"key":"2025082701432635000_14.5.e240810.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.10.878"},{"key":"2025082701432635000_14.5.e240810.23","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1111\/j.1365-2710.2008.00938.x","article-title":"Use of ACE inhibitors and Arbs in hypertensive women of childbearing age","volume":"33","author":"Martin","year":"2008","journal-title":"J Clin Pharm Ther"},{"key":"2025082701432635000_14.5.e240810.24","doi-asserted-by":"crossref","first-page":"661","DOI":"10.3122\/jabfm.2012.05.120056","article-title":"Contraceptive methods and informed consent among women receiving medications with potential for adverse fetal effects: a Washington, Wyoming, Alaska, montana, Idaho (WWAMI) region study","volume":"25","author":"Force","year":"2012","journal-title":"The Journal of the American Board of Family Medicine"},{"key":"2025082701432635000_14.5.e240810.25","unstructured":"NICE Guideline . Hypertension in adults: diagnosis and management, 2019."},{"key":"2025082701432635000_14.5.e240810.26","unstructured":"National Heart Foundation of Australia . Guideline for the diagnosis and management of hypertension in adults, 2016."},{"key":"2025082701432635000_14.5.e240810.27","doi-asserted-by":"crossref","unstructured":"Faculty of Sexual & Reproductive Healthcare (FSRH) . Uk medical eligibility criteria for contraceptive use (UKMEC), 2016.","DOI":"10.12968\/indn.2016.13.16"},{"key":"2025082701432635000_14.5.e240810.28","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1007\/s40620-020-00717-0","article-title":"Contraception in chronic kidney disease: a best practice position statement by the kidney and pregnancy group of the Italian Society of nephrology","volume":"33","author":"Attini","year":"2020","journal-title":"J Nephrol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240810","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:43:38Z","timestamp":1756284218000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240810"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,19]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1136\/bcr-2020-240810"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240810","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}