Question

Most common congenital anomaly associated with lithium:

• A. Cardiac malformations
• B. Neural tube defects
• C. Renal anomaly
• D. Fetal hydantoin syndrome

Hint:

Think Ebstein anomaly of the tricuspid valve.

Answer 1

The Correct Option is A

Step 1: Lithium taken in the first trimester is a recognised cardiac teratogen.

Step 2: The classic association is Ebstein anomaly, a malformation in which the tricuspid valve is displaced downward into the right ventricle. This is a cardiac defect, so the broad category of congenital cardiac malformations is the most common lithium-related anomaly. Option A is correct.

Step 3: Neural tube defects are linked to valproate and carbamazepine, not lithium. Option B is wrong.

Step 4: Renal anomalies are not the characteristic teratogenic effect of lithium in the fetus, though lithium does affect adult kidneys. Option C is wrong.

Step 5: Fetal hydantoin syndrome is caused by phenytoin, not lithium. Option D is wrong.

Conclusion: The most common congenital anomaly with lithium is cardiac malformation, classically Ebstein anomaly, option A.