This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Pharmacotherapy In Psychiatry, Subject name: Psychiatry
Lithium use in pregnancy leads to which of the following effect on baby? 
Select and explain. 
A. CVS defect, B. Urogenital defect, C. Neural tube defect, D. Facial defects
A: CVS defect
Answer: A: CVS defect 
Explanation: Ans. A. CVS defectLithium is in FDA pregnancy category D, which includes drugs for which there is evidence of human fetal risk, but whose potential benefits may outweigh the risk in some pregnant women. Lithium appears to increase the risk of cardiovascular anomalies in humans (the incidence of Ebstein anomaly of the tricuspid valve is between 1 and 2 per 1,000 which is 10 to 20 times greater than in the general population). Although the teratogenic risk of lithium is still greater than that found in the general population, it is lower than that posed by carbamazepine and valproate. Fetal echocardiography is advised to screen for cardiovascular malformations in women exposed to lithium during the first trimester of pregnancy.