Which antihypertensive is contraindicated throughout pregnancy because of documented fetal renal injury, oligohydramnios, skull hypoplasia, and neonatal renal failure?
- A Enalapril ✓
- B Labetalol
- C Methyldopa
- D Nifedipine
Correct answer: A. Enalapril
Explanation
ACE inhibitors such as enalapril cross the placenta and block the fetal renin angiotensin system, which is essential for normal renal development. Exposure causes fetal renal tubular dysgenesis, oligohydramnios, calvarial hypoplasia, and neonatal anuria, so they are avoided in all trimesters. ARBs carry the same risk. Methyldopa remains a long established oral agent with decades of fetal safety data, labetalol is a first line agent, and nifedipine is widely used both orally for maintenance and for acute control. All three are acceptable in pregnancy.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.