Mothers whose embryos and fetuses are exposed to an angiotensin II receptor antagonist only during the first trimester should be so informed. In these rare cases, the mothers should be apprised of the potential hazards to their fetuses, and serial ultrasound examinations should be performed to assess the intra-amniotic environment. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Infants with histories of in utero exposure to an angiotensin II receptor antagonist should be closely observed for hypotension , oliguria, and hyperkalemia. If oliguria occurs, attention should be directed toward support of blood pressure and renal perfusion.
Thiazides cross the placental barrier and appear in cord blood.
There is a risk of fetal or neonatal jaundice , thrombocytopenia , and possibly other adverse reactions that have occurred in adults. Hypersensitivity Reaction Hypersensitivity reactions to hydrochlorothiazide may occur in patients with or without a history of allergy or bronchial asthma , but are more likely in patients with such a history. Systemic Lupus Erythematosus Thiazide diuretics have been reported to cause exacerbation or activation of systemic lupus erythematosus. No patient discontinued due to increases or decreases in serum potassium. Serum and urine electrolyte determinations are particularly important when the patient is vomiting excessively or receiving parenteral fluids.