Prenatal exposure to methyldopa leading to hypertensive crisis and cardiac failure in a neonate.
A 2-week-old infant with normal intracardiac anatomy presented to the emergency department in a hypertensive crisis with acute cardiac failure. Despite extensive evaluation, no underlying disease was found. The patient's hypertension and cardiac dysfunction resolved after 1 week of supportive care in the PICU, and she was discharged within 2 weeks of presentation. The patient's history revealed transplacental exposure to the α-adrenergic agonist methyldopa for 10 weeks before delivery. Her age at presentation and the self-limited nature of cardiac sequelae with complete resolution of cardiac dysfunction suggest withdrawal effects from this exposure. Whereas the rebound hypertensive effects of α-adrenergic agonists are well established in the adult population, this report shows an unusual adverse outcome of in utero exposure to methyldopa.
['Su|Jennifer A|JA|', 'Tang|William|W|', 'Rivero|Niurka|N|', 'Bar-Cohen|Yaniv|Y|']
D000322:Adrenergic Agonists D005260:Female D006333:Heart Failure D006801:Humans D006973:Hypertension D046110:Hypertension, Pregnancy-Induced D007231:Infant, Newborn D008750:Methyldopa D011247:Pregnancy D011297:Prenatal Exposure Delayed Effects D013375:Substance Withdrawal Syndrome
methyldopa hypertension withdrawal heart failure newborn