Effects of Angiotensin Converting Enzyme (ACE) Inhibitors on Fetus & Newborn

 

Example of ACE inhibitors: captopril, enalapril, lisinopril, quinapril, fosinopril

 

Timing of adverse effects: when taken during the second and third trimester (not the first)

 

Organs affected:

(1) renal

(2) pulmonary

(3) osseous (calvarium)

 

Renal effects:

(1) renal tubular dysplasia

(2) renal failure with oliguria or anuria

 

Respiratory effects: pulmonary hypoplasia

 

Osseous changes:

(1) decreased skull ossification

(2) hypocalvaria or acalvaria

 

Additional physiologic effects on the fetus:

(1) vasodilation and hypotension

(2) oligohydramnios

(3) limb deformities