What condition should caution the use of ACE inhibitors?

ACE inhibitors are medications commonly used for managing conditions such as hypertension and congestive heart failure. However, their use is associated with specific risks during pregnancy, particularly in the second and third trimesters. In these trimesters, the use of ACE inhibitors can lead to serious complications, including fetal renal dysfunction, oligohydramnios (decreased amniotic fluid), and even fetal death.

Research has shown that since ACE inhibitors can affect renal function and fetal development, they are contraindicated during these later stages of pregnancy. In contrast, the use of ACE inhibitors in the first trimester may still carry risks, but the potential complications are more pronounced in the later stages. Therefore, caution is strongly advised when prescribing these medications to pregnant individuals in the second or third trimester.

While chronic kidney disease and age over 65 may necessitate careful monitoring when using ACE inhibitors, they do not carry the same level of absolute contraindication as seen in later pregnancy. Understanding the specific risks associated with ACE inhibitors in pregnant patients is crucial for safe and effective medication management.