Which class of antihypertensive medications is strictly contraindicated during all trimesters of pregnancy due to fetal renal dysgenesis risks?
Answer and explanation
Correct answer: B. ACE Inhibitors and Angiotensin Receptor Blockers (ARBs)
- Step 1: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) disrupt the fetal renin-angiotensin-aldosterone system that is vital for maintaining fetal renal perfusion and organogenesis.
- Step 2: Exposure during gestation causes serious fetopathy, including oligohydramnios, fetal calvarial hypoplasia, pulmonary hypoplasia, and neonatal renal failure, making ACE Inhibitors and Angiotensin Receptor Blockers (ARBs) strictly contraindicated across all trimesters of pregnancy.
Answer
ACE Inhibitors and Angiotensin Receptor Blockers (ARBs).
Why not the others: Methyldopa is a centrally acting alpha-2 agonist widely used in pregnancy, hydralazine is a direct arteriolar vasodilator safe in pregnancy, and labetalol is an alpha/beta blocker with established safety in gestational hypertension.
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