A pregnant woman with bipolar disorder maintained on lithium delivers an infant diagnosed with a rare congenital cardiac malformation involving displacement of the tricuspid valve into the right ventricle. This malformation is:

• A Ebstein anomaly ✓
• B Transposition of the great arteries
• C Tetralogy of Fallot
• D Hypoplastic left heart syndrome

Explanation

Lithium exposure in the first trimester is associated with Ebstein anomaly, a downward displacement of the tricuspid valve leaflets producing atrialisation of the right ventricle. The absolute risk is low, but the association is strong enough that fetal echocardiography is advised after first-trimester exposure. Valproate is linked to neural tube defects, another lithium-valproate contrast frequently tested. Indian exam convention continues to emphasise this classical teratogenic pairing despite debate over the magnitude of modern risk estimates.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.