In utero losartan withdrawal and subsequent development of fetal inferior vena cava thrombosis.

Abstract

Angiotensin receptor blockers are antihypertensive medications prescribed by a wide variety of physicians, especially for patients with coexistent diabetes mellitus. Angiotensin receptor blockers, as well as angiotensin-converting enzyme inhibitors, are contraindicated in pregnancy. We describe the reversal of losartan-induced oligohydramnios at 27 weeks of gestation with subsequent development of fetal thrombosis and possible mechanism of action for this extremely rare in utero complication. This theory may help explain the fetal stillbirths in women taking this class of medications during the second and third trimester of pregnancy.