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Teratogenicity of first trimester ACE inhibitors

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Fetal urine production begins towards the end of the first trimester. Angiotensin converting enzyme (ACE) inhibitors are thought to produce a fetopathy by inhibiting fetal urine production and therefore only do so when taken in the second and third trimesters: the drugs have been considered safe in the first trimester. Features of the fetopathy include renal dysplasia and renal failure, oligohydramnios, hypoplastic calvaria, and intrauterine growth retardation. [Perhaps strangely, if the condition is secondary to fetal anuria or oliguria, they do not seem to …

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