A 24-year-old woman with epilepsy is planning conception and is taking sodium valproate. Counselling about teratogenicity should include which specific risk?

• A Limb reduction defects in about 10 percent of pregnancies
• B Ebstein anomaly of the tricuspid valve
• C Persistent pulmonary hypertension of the newborn
• D Neural tube defects occurring in approximately 1 to 2 percent of exposed pregnancies ✓

Explanation

Valproate carries the highest teratogenic potential among antiepileptics, with neural tube defect rates of roughly 1 to 2 percent, spina bifida being the classic lesion, along with fetal valproate syndrome and neurodevelopmental impairment, so folic acid 5 mg daily and drug review before conception are advised. Ebstein anomaly is the signature lesion of lithium, and PPHN is linked to late-trimester SSRIs, not valproate.

Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.