A 26-year-old woman with newly diagnosed hypertension plans pregnancy. She has been on lisinopril for one year. What is the specific fetal risk that mandates discontinuing lisinopril before conception?
- A Fetal renal agenesis and oligohydramnios ✓
- B Neural tube defects
- C Congenital heart block
- D Cleft palate
Correct answer: A. Fetal renal agenesis and oligohydramnios
Explanation
ACE inhibitors and ARBs cause fetopathy in the second and third trimesters, characterized by renal tubular dysplasia, oligohydramnios, calvarial hypoplasia, and fetal growth restriction. They should be discontinued before conception. Neural tube defects are associated with valproate and folate deficiency. Heart block is linked to anti-Ro/SSA antibodies. Cleft palate is linked to corticosteroids and anticonvulsants.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.