Can high blood pressure during my pregnancy cause problems?
Uncontrolled high blood pressure in pregnancy could affect the placenta (organ that develops in pregnancy to help get food and oxygen to the baby). This can then cause problems for the developing baby, such as: slow growth (infant smaller overall), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), or preterm delivery (birth before 37 weeks of pregnancy). Uncontrolled high blood pressure in pregnancy can also affect multiple organs like heart, kidneys or the liver in pregnant individual.
Does taking ACE inhibitors increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if ACE inhibitors alone increase the chance for miscarriage.
Does taking ACE inhibitors in the first trimester increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like ACE inhibitors, might increase the chance of birth defects in a pregnancy.
The majority of studies have not found birth defects to occur more often in those who took or were prescribed an ACE inhibitor in the first trimester of their pregnancy. However, few recent reviews have reported an increased chance of birth defect with the use of ACE inhibitors. Nonetheless, it is difficult to study medications as a group because even though the ACE inhibitors work in similar ways, there are some differences among the individual medications. When drugs are studied as a group, differences for individual drugs could be missed. Also, problems reported in studies may be related to the high blood pressure or medical condition being treated and might not be due to the medication.
As a precaution, Canadian recommendations generally suggest stopping ACE inhibitors as soon as a pregnancy is confirmed. If you are taking this type of medication, your healthcare professional may suggest a treatment that is more suitable for pregnancy.
Does taking ACE inhibitors in the second or third trimester cause other pregnancy related problems?
ACE inhibitors should be avoided during the second and third trimester of pregnancy.
When used after the first trimester, ACE inhibitors can cause low levels of amniotic fluid (fluid that surrounds the baby). Low levels of amniotic fluid can lead to health problems for the developing baby. Some of these problems include poor lung development, poor growth, poor development of the skull bones, birth defects, problems with the development of the kidneys and in the most severe cases, death of the developing baby.
Talk to your healthcare provider right away if you are pregnant and taking any ACE inhibitor.
Does taking ACE inhibitors in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if ACE inhibitors, in general, can cause behavior or learning issues for the child.
What screenings or tests are available to see if my pregnancy has birth defects or other issues?
Prenatal ultrasounds can be used to screen for some birth defects. Ultrasound can also be used to monitor the growth of the pregnancy and the level of amniotic fluid (fluid that surrounds the baby). There are no tests available during a pregnancy that can tell if there has been any effect on behavior or ability to learn. If you took an ACE inhibitor during pregnancy, talk to your healthcare provider about screening options, your healthcare provider can help to arrange any appropriate monitoring.
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