I am having the exact same issue here. I need to go under a sewer with a water main, but I don't have room to do a 45-degree angle under the utility. I need to go straight down with a 90-degree bend, then have another 90-degree bend to get back to horizontal and then do a series of 45 degree bends after that to get back up to a decent depth. What I have found is that you can draw a vertical 90-degree bend. It will not look at all like a 90-degree vertical downward bend in profile, but if you look at the object in object viewer, you will see that it has done what you want. But, if you then try to attach a pipe to it, it will connect through the fitting. I suspect this is because it is impossible to draw vertical pressure pipes in profile view.
Overall, I have found that laying out pressure networks in plan view is pretty great. It could be a lot better, but its better than hand drawing them. Any editing of pressure networks in profile is a nightmare. Fittings don't look like the fittings that they are, pipe edit tools do not work, you get tons of errors, you can't draw vertical pipes, if you ask the main to follow the surface at a certain depth it breaks your pipe into a thousand different pipes which are then a nightmare to try to manipulate in profile, many times all of the pipes are located at rediculous elevations. It's pretty terrible.
All in all, I would recommend that no one use pressure networks for profiles. You will end up wasting so much time trying to get it to do what it is supposed to do that you should just draw it manually and skip the profile tools entirely.
It sucks because they say it will work, but it doesn't. Anyway, maybe someday they will overhaul this tool, but they didn't get to it in 2018...