Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.
Reprod Toxicol. 2010 Jun;29(3):381-2. doi: 10.1016/j.reprotox.2010.01.010. Epub 2010 Feb 2.
Despite data suggesting that angiotensin-receptor blockers (ARBs) are associated with increased risk to the fetus, there has been an increasing exposure of ARBs in pregnancy. We report a case report regarding a woman, who accidentally was treated with Candesartan during the first 22 weeks of pregnancy. At 22 weeks of gestation the fetal kidneys were oedematous with very little amniotic fluid. The prognosis for the fetus was considered poor. Five weeks after discontinuation of Candesartan normal quantities of amnionic fluid and a visible fetal bladder was registered. After delivery at week 31, creatinine clearance, diuresis and urine examination of the neonate were within normal limits. Ultrasound examinations of the kidneys showed bilaterally marked calices, small cysts and parenchymal increased echogenety at 1 week with complete sonographic normalization at 6 weeks. However, experimental studies raise the question of potential long-term adverse effects, including renal dysfunction and arterial hypertension in adulthood.
尽管有数据表明血管紧张素受体阻滞剂（ARBs）会增加胎儿的风险，但在怀孕期间，ARBs 的使用却越来越多。我们报告了一例孕妇在妊娠前 22 周意外使用坎地沙坦的病例。在妊娠 22 周时，胎儿肾脏水肿，羊水很少。胎儿的预后被认为很差。坎地沙坦停药 5 周后，羊水恢复正常，可见胎儿膀胱。在 31 周分娩后，新生儿的肌酐清除率、尿量和尿液检查均在正常范围内。肾脏的超声检查显示双侧肾盂明显扩张，小囊肿和实质回声增强，1 周时完全正常，6 周时完全正常。然而，实验研究提出了潜在的长期不良影响的问题，包括肾功能障碍和成年后的动脉高血压。
