This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
Patient of juvenile myoclonic epilepsy on valproate comes to you at 5 months of pregnancy with level H scan normal what will you advise? 
Select and explain. 
A. Change the drug, B. Continue the drug in same dose, C. Decrease the dose of drug, D. Increase the dose of drug
B: Continue the drug in same dose
Answer: B: Continue the drug in same dose 
Explanation: Ans. is 'b' i.e., Continue the drug in same dose Valproic acid has the risk of fetal malformations during the first trimester of pregnancy. This patient has normal level II scan at 5 months of pregnancy so the risk period of valproate is already over and valproate is the drug of choice in juvenile myoclonic epilepsy. Thus the drug shoud be continued in the same doses.