Sodium valproate and the fetus: a case study and review of the literature.
Sodium valproate is a teratogen responsible for a wide range of abnormalities, including neural tube defects. It has traditionally been prescribed for epilepsy, but is increasingly used for such psychiatric conditions as bipolar disease. Women of childbearing age taking valproate should be warned of its teratogenicity and advised to plan pregnancies, take a higher dose of folate, discuss reducing the dose of valproate or changing the medication with their physician, and have antenatal screening. After birth, the infant should be examined for a wide range of reported abnormalities. Neurodevelopmental assessment should continue throughout childhood. We present a case that illustrates the need for better education of mothers taking valproate and the medical staff prescribing it.
Smith
Jacqueline
J
Level III Tertiary Neonatal Unit, Queensland, Australia. jacquelinej_smith@health.qld.gov.au
Whitehall
John
J
D000014:Abnormalities, Drug-Induced / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy; D005260:Female; D005492:Folic Acid; D006801:Humans; D007223:Infant; D008429:Maternal Welfare; D008431:Maternal-Fetal Exchange; D008591:Meningomyelocele / Q000139:chemically induced* / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011295:Prenatal Care / Q000379:methods; D011297:Prenatal Exposure Delayed Effects; D013723:Teratogens; D014635:Valproic Acid / Q000009:adverse effects*
D014150:Antipsychotic Agents; D013723:Teratogens; D014635:Valproic Acid; D005492:Folic Acid