A 30-year-old woman develops heart failure in the last month of pregnancy with LVEF 32%. She has no prior cardiac disease. Which management is contraindicated until after delivery?

• A Enalapril ✓
• B Metoprolol succinate
• C Furosemide
• D Low molecular weight heparin if thrombus present

Explanation

Peripartum cardiomyopathy is defined as LV dysfunction (EF below 45%) developing between late pregnancy and five months postpartum without another cause. ACE inhibitors are teratogenic and fetotoxic, causing renal agenesis, oligohydramnios, and fetal renal failure, so they are withheld until delivery. Beta-blockers, diuretics, and anticoagulation are all used safely when indicated during pregnancy.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.