Chisholm C A, Chescheir N C, Kennedy M
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
Am J Perinatol. 1997 Oct;14(9):511-3. doi: 10.1055/s-2007-994324.
The use of angiotensin-converting enzyme inhibitors during pregnancy has been associated with poor fetal outcomes, including oligohydramnios, renal tubular dysplasia, cranial malformations, and fetal death. A 35-year-old woman with chronic hypertension was treated with the angiotensin-converting enzyme inhibitor benazepril until 27 weeks' gestation, when severe oligohydramnios was noted. After hospitalization for bed rest, fetal surveillance, and discontinuation of the agent, amniotic fluid rapidly reaccumulated, and a healthy infant was delivered at term. Although the use of angiotensin-converting enzyme inhibitors should be avoided during pregnancy, patients whose fetuses are inadvertently exposed in utero need not be given a uniformly poor prognosis. Oligohydramnios induced by the use of angiotensin-converting enzyme inhibitors during pregnancy may be reversible if the agent is discontinued. This case underscores the need for obstetricians to review carefully the medication regimens of all pregnant women and to be familiar with generic and proprietary names of medications to avoid the use of potentially harmful agents during pregnancy.
孕期使用血管紧张素转换酶抑制剂与不良胎儿结局相关，包括羊水过少、肾小管发育异常、颅骨畸形和胎儿死亡。一名35岁的慢性高血压女性在妊娠27周前一直使用血管紧张素转换酶抑制剂贝那普利治疗，当时发现严重羊水过少。住院卧床休息、进行胎儿监测并停用该药物后，羊水迅速重新积聚，足月时分娩出一名健康婴儿。尽管孕期应避免使用血管紧张素转换酶抑制剂，但胎儿在子宫内意外接触该药物的患者预后不一定都很差。孕期使用血管紧张素转换酶抑制剂引起的羊水过少如果停药可能是可逆的。该病例强调产科医生需要仔细审查所有孕妇的用药方案，并熟悉药物的通用名和商品名，以避免在孕期使用潜在有害药物。
