Which heart failure medication is contraindicated during pregnancy?

ACE inhibitors are contraindicated during pregnancy primarily due to their association with significant adverse effects on fetal development. These medications can cause teratogenic effects, particularly during the second and third trimesters, leading to serious complications such as renal dysfunction, oligohydramnios, and fetal skull deformities. Additionally, exposure to ACE inhibitors in utero can result in life-threatening hypotension and other complications for the newborn after delivery.

In contrast, while beta-blockers and diuretics may have risks associated with their use during pregnancy, they are not as strongly contraindicated as ACE inhibitors. Beta-blockers can sometimes be prescribed if the potential benefits outweigh the risks, and thiazide and loop diuretics are often used cautiously to manage conditions like hypertension or fluid overload in pregnant patients, albeit with careful monitoring.

Therefore, the clear contraindication of ACE inhibitors during pregnancy highlights the importance of selecting heart failure medications that ensure the safety of both the mother and the developing fetus.