Abnormality to check if lithium is given to a pregnant female -

Ans. is 'a' i.e., Cardiac anomaly Lithium is a weak teratogen in human.The main effects attributable to lithium are increased cardiac malformation in the fetus especially "Ebsteins anomaly".Lithium may increase the incidence of Ebstein9s anomaly in fetus but it is not contraindicated during pregnancy.Lithium is not considered a major human teratogen and the risk for Ebstein's anomaly is only .5% for babies whose mother takes lithium during pregnancy.Therefore lithium is not contraindicated during pregnancy. It is however advisable to perform a "fetal echocardiography" to exclude the possibilities of cardiac anomaly.Evaluation of studies on lithium in pregnancy shows that lithium therapy throughout pregnancy does not seem to increase the general rate of major anomalies and apparently add only a small risk for cardiovascular defects notably Ebstein's anomaly.It can be concluded that whenever lithium is the drug of choice in women with bipolar disorder, it may be continued even in pregnancy.Moreover it is advised not to discontinue lithium as it may subsequently lead to relapse of the disorder.In addition, pregnancy of lithium treated women should be considered high risk and therefore monitoring during pregnancy has to include "fetal echocardiography".Pregnancy interruption in lithium treated mothers can probably be considered only if severe cardiac anomaly is diagnosed.According to K.D.T.Lithium is contraindicated during pregnancy.But all other books states that lithium can be administered is during pregnancy.