A 29-year-old woman, gravida 1, para 0, aborta 0, presents to your clinic.

Ramipril, an ACE inhibitor, is contraindicated in pregnancy due to risks of fetal renal dysgenesis, oligohydramnios, and fetal death, especially in the second and third trimesters.

Toronto Notes 2023 – Obstetrics, Hypertensive Disorders of Pregnancy:

“ACE inhibitors and ARBs are contraindicated in pregnancy due to their teratogenic potential and adverse fetal effects.”

MCCQE1 Objectives – Obstetrics > Hypertension in Pregnancy:

“Candidates must identify safe antihypertensives during pregnancy and contraindicated medications such as ACE inhibitors and ARBs.”

Methyldopa, labetalol, nifedipine, and hydralazine are considered safe and are commonly used in pregnancy.

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