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Epilepsy in pregnancy — DRCOG MCQ

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HardAntenatal CareEpilepsy in pregnancyDRCOG

A 30-year-old woman with epilepsy presents at 8 weeks' gestation. She takes sodium valproate and has been seizure-free for 2 years. She has not seen a neurologist recently. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Arrange urgent specialist review without abruptly stopping valproate

Valproate is highly teratogenic, but abrupt discontinuation can provoke seizures and harm mother and fetus. Urgent specialist review is needed to assess safer alternatives, seizure risk and fetal counselling. Continuing unchanged without review is unsafe. Prior exposure warrants informed counselling and screening, not automatic termination.

Reference: NICE CG137; MHRA valproate pregnancy prevention programme; BNF