Sacubitril–valsartan is a first-in-class angiotensin receptor neprilysin inhibitor that has been used in both HF and hypertension.[10,11] This neprilysin inhibitor has vasodilating effects and facilitates sodium excretion, and when combined with the inhibition of the renin-angiotensin system, it has superior effects over ACE inhibitors or ARBs alone. Here, ACE is linked to hydrops fetalis.