امرأة عمرها ٣٣ سنة حامل في الأسبوع ١٢، عندها ضغط مزمن من ٤ سنوات وتأخذ ليسينوبريل. جاءت لأول زيارة حمل، وضغطها ١٣٦/٨٦، والتحاليل طبيعية. ما التصرف الصحيح؟

A 33-year-old woman at 12 weeks’ gestation has had chronic hypertension for 4 years and takes lisinopril. At her first antenatal visit BP is 136/86 and labs are normal. What is the correct action?

1. Continue it because chronic hypertension needs it in pregnancy
2. Ask the prescriber to change it; ACE inhibitors are unsafe in pregnancy
3. Double the dose because pressure rises in pregnancy
4. Stop all antihypertensives without replacement until delivery

Answer: B) Ask the prescriber to change it; ACE inhibitors are unsafe in pregnancy. ACE inhibitors and ARBs are contraindicated in pregnancy because they harm fetal kidneys and growth. The drug is switched under medical supervision to a safe alternative such as labetalol or extended-release nifedipine.