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MRCOG PART 2 SBAs and EMQs

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EMQ1469
SBA2065
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Epilepsy in pregnancy

Epilepsy in pregnancy Posted by PAUL A.

Question

A 26 year old woman with epilepsy attends the antenatal clinic at 6 weeks gestation. She has been taking sodium valproate and this has been the most effective anti-epileptic drug for her. She should be informed that the risk of her baby having a major congenital anomaly is

 

A.    1-2% above background

B.    3-4%

C.   5-7%

D.   3-4% above background

E.    10-12%                      

Posted by Farrukh G.

Correct answer = E

  • Lamotrigine, and carbamazepine monotherapy at lower doses have the least risk of major congenital malformation. Risk highest for sodium valproate (10.7%) or AED polytherapy (16.8%) compared with the 2.3% background rate