A woman who took lithium throughout the first trimester delivers an infant with downward displacement of the tricuspid valve into the right ventricle. This congenital defect is known as:

• A Total anomalous pulmonary venous connection
• B Truncus arteriosus
• C Transposition of the great arteries
• D Ebstein anomaly ✓

Explanation

First-trimester lithium exposure is classically linked to Ebstein anomaly, a malformation in which the septal and posterior leaflets of the tricuspid valve are displaced apically, creating an atrialized right ventricle. The absolute risk is low, but the association is specific enough that fetal echocardiography is advised. Neural tube defects are the signature teratogen signal of valproate, not lithium.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.