skip to main content

ACEi teratogenicity – counselling — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardNephrologyACEi teratogenicity – counsellingRACP Paediatrics

A 14-year-old girl with CKD stage 3 is started on an ACE inhibitor. She is of childbearing age. What critical counselling point must be discussed regarding ACE inhibitors?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — ACE inhibitor

ACE inhibitors (and ARBs) are TERATOGENIC – they cause renal agenesis/dysgenesis, oligohydramnios, and skull defects in the fetus, particularly in the 2nd/3rd trimester. All females of childbearing potential on ACE inhibitors must be counselled about this risk and use effective contraception. If pregnancy is planned, the ACE inhibitor should be stopped and switched to a pregnancy-safe alternative (e.g., labetalol, nifedipine).

Reference: RACP Paediatric Curriculum – Nephrology; Australian Therapeutic Guidelines – 2024