A 30-year-old woman at 26 weeks gestation presents to her obstetrician for a routine prenatal visit and is found to have persistent blood pressures of 156/98 mm Hg on three separate measurements taken 15 minutes apart. Her pregnancy has otherwise been uncomplicated, and she denies headache, visual changes, or epigastric pain. Urinalysis shows no proteinuria, and her baseline laboratory values including serum creatinine, liver enzymes, and platelet count are all within normal limits. She is started on an oral antihypertensive medication considered safe for use in pregnancy. Six weeks later, she returns complaining of mild fatigue, and repeat laboratory workup reveals a positive direct Coombs test with a mild normocytic anemia. Which of the following medications is the most likely cause?
- A)MethyldopaGABARITO
- B)Aliskiren
- C)Losartan
- D)Nitroprusside
- E)Lisinopril
Explicação
Methyldopa is a central alpha 2 agonist commonly used for chronic hypertension during pregnancy. A positive direct Coombs test due to autoimmune hemolytic anemia is a classic adverse effect. Ver explicação completa e trilha adaptativa →