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Related Concept Videos

Teratogenicity01:07

Teratogenicity

4.3K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Hormonal Regulation01:33

Hormonal Regulation

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The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

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Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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Related Experiment Video

Updated: Feb 19, 2026

A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
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Maternal olmesartan exposure causing neonatal failure.

Antonio Pérez-Iranzo1,2, Ana Nos Ferreres3, Aranzazu Jarque Bou4

  • 1NICU, Hospital General de Castellón, Castellón, Spain.

BMJ Case Reports
|November 3, 2017
PubMed
Summary
This summary is machine-generated.

Angiotensin II receptor blockers (ARBs) taken during pregnancy can cause severe harm to newborns, including kidney damage. This case highlights the critical need to avoid ARBs in pregnant individuals to prevent adverse neonatal outcomes.

Keywords:
materno-fetal medicineneonatal healthneonatal intensive carepreventative pediatricsunwanted effects / adverse reactions

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Area of Science:

  • Neonatal Medicine
  • Pharmacology
  • Nephrology

Background:

  • Angiotensin II receptor blockers (ARBs) are known teratogens and are contraindicated during pregnancy due to potential adverse effects on fetal development.
  • Despite contraindications, maternal use of ARBs during pregnancy continues to be reported, necessitating awareness of associated risks.

Observation:

  • A preterm neonate born at 32 weeks gestation presented with oligohydramnios, Potter phenotype, pulmonary hypoplasia, hypotension, and anuria following maternal olmesartan (an ARB) use throughout pregnancy.
  • The neonate required intensive respiratory support, inotropic agents, and experienced persistent renal failure, necessitating peritoneal dialysis.

Findings:

  • Maternal intake of olmesartan during pregnancy led to significant fetal renal injury and developmental anomalies in the neonate.
  • Peritoneal dialysis resulted in improved renal markers and progressive recovery of renal function, with a GFR of 58 mL/min/1.72 m² at 2 years of age.
  • ARBs, more so than ACE inhibitors, can severely impact nephrogenesis, leading to potentially irreversible renal damage.

Implications:

  • This case underscores the teratogenic effects of ARBs on fetal kidney development and the critical importance of avoiding their use during pregnancy.
  • While renal function may partially recover, the long-term consequences and potential for fatal outcomes emphasize the need for strict adherence to contraindications.
  • Increased awareness and education regarding the risks of ARBs in pregnancy are crucial to prevent future cases of neonatal kidney injury.