Valproic acid during pregnancy: Case report of a child with congenital malformations due to fetal valproate syndrome, and a high unbound serum level of valproic acid at birth

We present a child in utero exposed to valproic acid with congenital malformations due to fetal valproate syndrome and with toxic effects. Directly postnatal, a high-unbound serum level of valproic acid was measured. The total serum level of valproic acid was in the therapeutic range. Measuring unbound serum levels during pregnancy and postnatal period in the child provides more information about real-time exposure than measuring total serum levels.