| Angiotensin-II-receptor-1-antagonist fetopathy - Risk assessment, critical time period, and vena cava thrombosis as a possible new feature. | |
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MedLine Citation:
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PMID: 22816796 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIMS: Angiotensin-II-receptor-1-antagonists (AT (1) -antagonists) may cause severe and even lethal fetopathy in late pregnancy; however, exposure still occurs in spite of warnings in package leaflets. This study aimed to assess the risk of fetopathy, the sensitive time window, and possible new symptoms in prospective as well as retrospective cases with AT (1) -antagonist treatment during the 2(nd) or 3(rd) trimester of pregnancy. METHODS: Patients were enrolled by the Berlin Institute for Clinical Teratology and Drug Risk Assessment in Pregnancy between 1999 and 2011 through risk consultation. Symptoms defined as indicative of AT1-antagonist fetopathy were: oligo-/anhydramnios, renal insufficiency, lung hypoplasia, joint contractures, skull hypoplasia, fetal/neonatal death. RESULTS: In 5/29 (17%) prospectively enrolled cases with AT (1) -antagonist exposure beyond the 1(st) trimester oligo-/anhydramnios was diagnosed. 2 infants showed additional symptoms of fetopathy. The risk is more than 30% if treatment continues beyond the 20th week of pregnancy. Oligo-/anhydramnios was reversible after AT(1) -antagonist withdrawal. Among 16 retrospective case reports, 3 infants presented with a thrombosis of the inferior vena cava in the vicinity of the renal veins. 4/13 live births did not survive. CONCLUSIONS: Our survey suggests that the risk increases with duration of AT (1) -antagonist treatment into late pregnancy, and oligo-/anhydramnios may be reversible after AT (1) -antagonist discontinuation. Thrombosis of inferior vena cava may be a new feature of AT (1) -antagonist fetopathy. AT (1) -antagonist medication during pregnancy constitutes a considerable risk and must be discontinued immediately. In case of indicative diagnostic findings in either the fetus or newborn, previous maternal AT (1) -antagonist exposure should be considered. |
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Authors:
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Marc Oppermann; Stephanie Padberg; Angela Kayser; Corinna Weber-Schoendorfer; Christof Schaefer |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-23 |
Journal Detail:
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Title: British journal of clinical pharmacology Volume: - ISSN: 1365-2125 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7503323 Medline TA: Br J Clin Pharmacol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 The Author. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society. |
Affiliation:
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Institute for Clinical Teratology and Drug Risk Assessment in Pregnancy, Charité -Universitätsmedizin Berlin, Spandauer Damm 130, Haus 10, 14050, Berlin, Germany. |
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