Zeitschrift für Neonatalbiologie

Abstrakt

Early development of arterial hypertension in an infant with valsartan fetopathy

Christina Schindera, Benedikt M. Huber, Mathias Nelle, Boris Utsch, Sybille Tschumi and Roland Gerull

The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in normal renal development. We present the case of a 34-year-old woman in the second month of pregnancy, treated with valsartan throughout pregnancy, who presented with preterm labor and complete anhydramnios at 35 weeks of gestation. After spontaneous delivery, the eutrophic male infant showed typical signs of sartan fetotoxicity, including neonatal anuria, enlarged hyperechogenic kidneys, initial arterial hypotension, limb contractures, skull hypoplasia, and a narrow chest. Arterial hypertension developed during the first days of life and persisted until the last follow-up at 24 months. Antihypertensive therapy with amlodipine was required from the 7th month of life until the last follow-up.

Valsartan exposure, particularly during the second half of pregnancy, causes valsartan fetotoxicity, which may lead to progressive arterial hypertension requiring antihypertensive medication. Close monitoring of patients with valsartan fetopathy is essential.