A newborn boy is evaluated for tachypnea, immediately after birth. He was delivered at 31 weeks' gestation via spontaneous vaginal delivery. She did not receive prenatal care. She has a poor controlled hypertension and takes multiple medications. Examination of the infant shows an intubated and sedated boy whose weight is at the third percentile. The temporal, occipital, and parietal bones are underdeveloped, and the right lower limb is shortened and contracted. Which of the following mechanisms is the most likely cause of this neonate's abnormalities?

Question

A newborn boy is evaluated for tachypnea, immediately after birth. He was delivered at 31 weeks' gestation via spontaneous vaginal delivery. She did not receive prenatal care. She has a poor controlled hypertension and takes multiple medications. Examination of the infant shows an intubated and sedated boy whose weight is at the third percentile.  The temporal, occipital, and parietal bones are underdeveloped, and the right lower limb is shortened and contracted.  Which of the following mechanisms is the most likely cause of this neonate's abnormalities?

Quizplus · Accepted Answer

Eductional Objective: ACE inhibitors and angiotensin II receptor blockers are teratogens.  Both decrease angiotensin II activity, leading to abnormal fetal renal development, oligohydramnios, and potential neonatal Potter sequence (ie, pulmonary hypoplasia, limb deformity).

A Newborn Boy Is Evaluated for Tachypnea, Immediately After Birth