This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Medical, surgical and gynaecological illness complicating pregnancy, Subject name: Gynaecology & Obstetrics
True statement regarding use of antiepileptic drugs in pregnancy 
Select and explain. 
A. valproate is associated with NTD, B. Multiple drug should be given, C. carbamazepine is used as monotherapy, D. phenytoin can produce foetal hydantoin syndrome
A: valproate is associated with NTD
Answer: A: valproate is associated with NTD 
Explanation: Neural tube defects are associated with valproate. fetal anticonvulsant syndrome or fetal hydantoin syndrome :risk is increased with the number of drugs.the cause is thought to be folate defeciency as these drugs interfere with folate metabolism monotherapy is associated with lower risk TEXTBOOK OF GYNECOLOGY,SHEILA BALAKRISHNAN,Pg no:330,2nd edition