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Oligohydramnios sequence and renal tubular malformation associated with maternal enalapril use
C Cunniff1, K L Jones, J Phillipson
1Department of Pediatrics, University of California, San Diego.
Insights
Maternal use of angiotensin converting enzyme inhibitors during pregnancy may harm fetal renal development, leading to conditions like pulmonary hypoplasia and neonatal anuria. This case highlights the potential risks of these medications on unborn infants.
Area of Science:
- Perinatology
- Nephrology
- Pharmacology
Background:
- Systemic lupus erythematosus (SLE) in pregnancy poses risks to both mother and fetus.
- Hypertension is a common complication in pregnancies with SLE.
- Certain antihypertensive medications may have teratogenic effects.
Abstract:
We present the case of a child who died of pulmonary hypoplasia as a result of the oligohydramnios sequence. The mother was taking enalapril, as well as propranolol and hydrochlorothiazide, for treatment of hypertension associated with systemic lupus erythematosus. Autopsy examination revealed severe renal tubular malformation. Correlation of animal data with previous case reports of neonatal anuria in association with maternal angiotensin converting enzyme inhibitors suggests that these agents may have a deleterious effect on fetal renal development and general well-being.