Sunday, March 16, 2014

ACEI and first trimester


  1. I'm coming in late here ... but the conventional wisdom of "no ACEi in pregnancy EVER" is being challenged lately. The Cooper NEJM study was heavily flawed, and teratogenicity of first-trimester exposure is not clearly established. It may be reasonable to continue your high-risk patients (ie, diabetic nephropathy) on ACEi until their first missed menstrual period (ie, into the first trimester).