Fetal toxicity of valsartan and possible reversible adverse side effects

Abstract

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.