enalapril and Ductus-Arteriosus--Patent

To review reports on the use of angiotensin-converting enzyme inhibitors (ACE-I) during pregnancy in order to determine the incidence, nature, and potential mechanisms of fetal complications in an attempt to establish recommendations related to the use of these drugs during gestation.. Relevant English-language articles identified through a Medline search and bibliographies found in recent articles.. Large number of reports both on animals and on humans have consistently shown a high degree of morbidity and even mortality in fetuses or newborns exposed to ACE-I during pregnancy. The reported complications include oligohydramnios, intrauterine growth retardation, premature labor, fetal and neonatal renal failure, bony malformations, limb contractures, persistent patent ductus arteriosus, pulmonary hypoplasia, respiratory distress syndrome, prolonged hypotension, and neonatal death. A high incidence of fetal complications was related to the use of ACE-I at all trimesters of pregnancy.. The gestational use of ACE-I may be associated with a high degree of fetal and newborn morbidity and even mortality. The use of these drugs should be avoided at all trimesters of pregnancy.

Topics: Abnormalities, Drug-Induced; Animals; Blood Pressure; Captopril; Ductus Arteriosus, Patent; Enalapril; Female; Fetal Death; Fetus; Goats; Kidney; Maternal-Fetal Exchange; Oligohydramnios; Pregnancy; Rabbits; Regional Blood Flow; Renal Insufficiency; Risk Factors; Sheep; Uterus; Vascular Resistance

Immediately after surgical closure of a patent ductus arteriosus, a 12-year-old boy developed severe systemic arterial hypertension refractory to medication. The cause of hypertension could not be found, but it came under control 3 weeks postoperatively with a combination of angiotensin-converting enzyme inhibitor and chlorothiazide.

Topics: Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Child; Chlorothiazide; Drug Therapy, Combination; Ductus Arteriosus, Patent; Enalapril; Humans; Hypertension; Male; Postoperative Complications

Topics: Abortion, Spontaneous; Captopril; Ductus Arteriosus, Patent; Enalapril; Female; Fetal Death; Humans; Hypertension; Infant, Newborn; Infant, Small for Gestational Age; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Trimester, Third