Which antihypertensive drugs are known for their teratogenic effects?

ACE inhibitors and ARBs (Angiotensin II Receptor Blockers) are well-documented for their teratogenic effects, particularly when used in pregnancy. The use of these medications in the first and second trimesters can lead to serious fetal complications, including renal dysfunction, hypotension, and even fetal death. In the third trimester, these drugs can cause oligohydramnios due to decreased fetal kidney perfusion, leading to complications such as pulmonary hypoplasia and skeletal deformities.

Because of these significant risks, ACE inhibitors and ARBs are contraindicated during pregnancy, especially in the second and third trimesters. As a result, healthcare providers typically switch patients to safer alternatives, such as methyldopa or labetalol if they have hypertension and are pregnant.

In contrast, the other categories of antihypertensive medications listed, including beta-blockers, calcium channel blockers, and diuretics, have different safety profiles in pregnancy, but they are not as closely associated with teratogenic effects as ACE inhibitors and ARBs. Some beta-blockers are used cautiously during pregnancy, and while diuretics can also be prescribed, they are generally not first-line due to concerns about placental perfusion. Thus