Which antihypertensive is NOT considered safe during pregnancy?

Which antihypertensive is NOT considered safe during pregnancy?

• A. Labetalol
• B. Nifedipine
• C. Hydralazine
• D. Enalapril

Answer: (D)

In pregnancy, choosing antihypertensives requires prioritizing fetal safety. ACE inhibitors such as enalapril are avoided because they can cause serious fetal harm, including kidney damage and oligohydramnios, with risks like fetal renal failure and even neonatal death, especially after the first trimester. That’s why enalapril is not considered safe during pregnancy. In contrast, medications like labetalol, nifedipine, and hydralazine have safer profiles for fetal outcomes and are commonly used to manage maternal blood pressure when needed. The key is controlling the mother's blood pressure while protecting the fetus, so ACE inhibitors are avoided throughout pregnancy.

In pregnancy, choosing antihypertensives requires prioritizing fetal safety. ACE inhibitors such as enalapril are avoided because they can cause serious fetal harm, including kidney damage and oligohydramnios, with risks like fetal renal failure and even neonatal death, especially after the first trimester. That’s why enalapril is not considered safe during pregnancy. In contrast, medications like labetalol, nifedipine, and hydralazine have safer profiles for fetal outcomes and are commonly used to manage maternal blood pressure when needed. The key is controlling the mother's blood pressure while protecting the fetus, so ACE inhibitors are avoided throughout pregnancy.