A pregnant woman with bipolar disorder is exposed to lithium during the first trimester. Which congenital malformation is classically associated with this exposure?

• A Neural tube defect
• B Craniofacial cleft and microtia
• C Ebstein anomaly of the tricuspid valve ✓
• D Renal agenesis

Explanation

First-trimester lithium exposure is classically linked to Ebstein anomaly, a downward displacement of the tricuspid valve producing an atrialised right ventricle. The absolute risk is low but the association is examinable and specific. Neural tube defects are associated with valproate, craniofacial defects with retinoids, and renal anomalies with ACE inhibitors, so each distractor maps to a different classic teratogen.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.