Valproic acid and pregnancy: clinical presentation of 3 cases with valproate embryopathy

Fetal Valproate Syndrome (FVS) is caused by prenatal exposure to valproic acid (VPA). Clinical phenotype of FVS includes characteristic facial dysmorphism, various congenital defects, developmental delay/mental retardation, and other neurologic deficits. The risk of congenital malfomation in the developing fetus is 2 or 3-fold higher (4-6%) than that of background population. In this report, we describe clinical characteristics of 3 infants with the diagnosis of FVS. We summarize important issues in the management of VPA-treated women at childbearing age. Measures that include: informed planning of pregnancy, VPA treatment optimization to the lowest effective dose, folic acid supplementation, prenatal ultrasonographic monitoring, and maternal serum alpha-fetoprotein testing, should help to diminish the risk of adverse pregnancy outcomes.