A woman with chronic hypertension conceived while taking atenolol 50 mg daily and continues it through the second trimester. Which combination of fetal and neonatal complications is this drug most specifically linked to?
- A Oligohydramnios and fetal calvarial hypoplasia
- B Neonatal seizures and hyperbilirubinemia
- C Fetal growth restriction and neonatal hypoglycemia with bradycardia ✓
- D Congenital cataract and sensorineural deafness
Correct answer: C. Fetal growth restriction and neonatal hypoglycemia with bradycardia
Explanation
Atenolol crosses the placenta efficiently and chronic use has been shown to be associated with fetal growth restriction, while beta blockade in general produces neonatal bradycardia, hypoglycemia, and apnea from sustained sympathetic blockade. This is why labetalol, with its alpha-blocking vasodilator component and comparatively less fetal exposure, is preferred among beta blockers in pregnancy. Oligohydramnios with calvarial hypoplasia points to ACE inhibitor fetotoxicity, not atenolol.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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