Developmental Biology, AP-HP, Robert Debré Hospital, Paris, France.
Prenat Diagn. 2012 Nov;32(11):1071-6. doi: 10.1002/pd.3960. Epub 2012 Aug 18.
To study pregnancy outcomes and fetal renal prognosis markers in cases of exposure to renin-angiotensin system blockers.
We conducted a retrospective study of a series of 21 patients exposed to blockers of the renin-angiotensin system during pregnancy. Two markers were prenatally studied, fetal serum β2-microglobulin and amniotic fluid volume. Poor renal prognosis evaluation was based on postnatal glomerular filtration rate or on the presence of renal histologic lesions.
Of the 21 fetuses, only one had a normal postnatal renal function at birth (oligohydramnios regression and normal β2-microglobulin). All fetuses with persistent oligohydramnios or β2-microglobulin ≥ 5 mg/L presented an adverse renal outcome.
Exposure to renin-angiotensin system blockers complicated by oligohydramnios is associated with a very poor outcome. We propose a prenatal management based on amniotic fluid volume monitoring and fetal serum β2-microglobulin. However, our preliminary results have to be confirmed by a larger study.
研究妊娠期间接触肾素-血管紧张素系统阻滞剂的妊娠结局和胎儿肾脏预后标志物。
我们对 21 例妊娠期间接触肾素-血管紧张素系统阻滞剂的患者进行了回顾性研究。对胎儿血清β2-微球蛋白和羊水量进行了两项产前研究。不良肾功能预后的评估基于出生后的肾小球滤过率或肾组织学病变。
21 例胎儿中，仅有 1 例在出生时具有正常的肾功能（羊水过少缓解且β2-微球蛋白正常）。所有持续性羊水过少或β2-微球蛋白≥5mg/L 的胎儿均出现不良肾功能结局。
妊娠期间接触肾素-血管紧张素系统阻滞剂并伴有羊水过少与非常不良的结局相关。我们建议根据羊水量监测和胎儿血清β2-微球蛋白进行产前管理。然而，我们的初步结果需要通过更大的研究来证实。
