A 30-year-old woman with bipolar I disorder on sodium valproate plans to conceive. She is counselled about teratogenic risks. Which malformation is most strongly associated with first-trimester valproate exposure?
- A Ebstein anomaly
- B Neural tube defects ✓
- C Isolated cleft palate
- D Limb reduction defects
Correct answer: B. Neural tube defects
Explanation
Valproate is strongly associated with neural tube defects, particularly spina bifida, with a risk of approximately 1 to 2 percent when used in the first trimester. Ebstein anomaly is associated with lithium exposure. Folic acid supplementation is recommended for women of childbearing age on valproate.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.