What is the primary reason ACE inhibitors should be avoided during pregnancy?

The primary reason ACE inhibitors should be avoided during pregnancy is that they are classified as teratogenic. Teratogenic substances can cause developmental abnormalities in a fetus, particularly during the first trimester when the organs are forming. ACE inhibitors are linked to a range of potential fetal complications, including renal dysfunction, oligohydramnios (low amniotic fluid), and a range of congenital abnormalities affecting the cardiovascular and central nervous systems. Due to these risks, healthcare providers recommend avoiding these medications in pregnant individuals to safeguard fetal health.

While dosage adjustments and considerations of fluid balance are important in managing pregnant patients, they are not the primary concern regarding the use of ACE inhibitors in this context. Additionally, existing research strongly supports the need to discontinue these medications during pregnancy due to their known risks.