缬沙坦的胎儿毒性及可能的可逆性不良反应。
Fetal toxicity of valsartan and possible reversible adverse side effects.
作者信息
Berkane Nadia, Carlier Patrick, Verstraete Lieve, Mathieu Emmanuelle, Heim Nazbanou, Uzan Serge
机构信息
Department of Gynecology-Obstetrics and Reproductive Medicine, Hôpital Tenon, AP-HP, Paris 75020, France.
出版信息
Birth Defects Res A Clin Mol Teratol. 2004 Aug;70(8):547-9. doi: 10.1002/bdra.20047.
BACKGROUND
Published cases suggest that the use of angiotensin II receptor antagonists is fetotoxic during the third trimester, but not in early pregnancy.
CASE
We report a case in which the adverse fetal effect of angiotensin II receptor antagonist treatment was reversed. A woman with chronic hypertension was treated with valsartan until gestation week (GW) 20, when a complete anhydramnios was observed. Six days after interruption of the treatment, amniotic fluid reappeared. It reached a normal level at GW 23.5. The plasmatic creatinine level and the renal ultrasound examination were within normal limits at the six-month follow-up.
CONCLUSIONS
Whereas angiotensin-II-receptor antagonist generates a severe renal toxicity, this case suggests that, at least in the first half of pregnancy, these effects can be reversed.
背景
已发表的病例表明，血管紧张素II受体拮抗剂在妊娠晚期具有胎儿毒性，但在妊娠早期则无此毒性。
病例
我们报告了一例血管紧张素II受体拮抗剂治疗的不良胎儿效应得以逆转的病例。一名患有慢性高血压的女性在妊娠20周前接受缬沙坦治疗，此时观察到完全无羊水。治疗中断6天后，羊水重新出现。在妊娠23.5周时羊水达到正常水平。在六个月的随访中，血浆肌酐水平和肾脏超声检查均在正常范围内。
结论
尽管血管紧张素II受体拮抗剂会产生严重的肾脏毒性，但该病例表明，至少在妊娠前半期，这些效应是可以逆转的。
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