Which anti-hypertensive drug class is not typically the first choice for pregnant women?

The classification of anti-hypertensive drugs used during pregnancy is critically guided by safety profiles established through research and clinical experience. ACE inhibitors are not typically the first choice for pregnant women due to their association with significant fetal risks, particularly during the second and third trimesters. These risks include fetal renal dysfunction, oligohydramnios (low amniotic fluid), and potential harm to fetal tissues, including the development of congenital malformations.

In contrast, methyldopa is often used as a first-line treatment for hypertension in pregnancy due to its long history of safety. β-blockers and thiazides may also be utilized, considering individual patient needs and potential benefits, although their usage can vary based on specific circumstances and further studies. Overall, the safety of both the mother and the fetus is paramount when selecting antihypertensive therapy during pregnancy, making ACE inhibitors a contraindicated choice.