Recurrent preeclampsia has also been associated with increased rates of preterm delivery, delivery of a small-for-gestational-age (SGA) infant, and perinatal death in women with recurrent preeclampsia when compared with preeclampsia in a first pregnancy. Therefore, it is critical to prevent recurrence of preeclampsia with customized optimal drug treatment particularly in elderly women of childbearing age. Angiotensin-converting enzyme (ACE) inhibitors are widely used for controlling hypertension. The use of ACE inhibitors in pregnant women is not without risk to the fetus, including renal failure, renal dysplasia, hypotension, oligohydramnios, pulmonary hypoplasia, and hypocalvaria. We describe a case exposed in utero to ACE inhibitors who had adverse outcomes leading to neonatal death. Women with previous preeclampsia require special obstetric care with close liaison with physicians or cardiologists and management guidelines during pregnancy should be available and observed.