**Core Concept**
Pregnancy and seizure management require careful consideration of the risks and benefits associated with antiepileptic drugs (AEDs) like phenytoin. Phenytoin is a teratogenic AED that can increase the risk of major congenital malformations, particularly craniofacial and cardiac defects.

**Why the Correct Answer is Right**
During pregnancy, the goal of AED therapy is to minimize the risk of congenital malformations while maintaining seizure control. Folic acid supplementation is essential for all pregnant women, especially those on AEDs like phenytoin. However, phenytoin has a unique teratogenic profile, and switching to a safer alternative like lamotrigine or levetiracetam is recommended. Monitoring of phenytoin levels and adjusting the dose accordingly is crucial during pregnancy.

**Why Each Wrong Option is Incorrect**
**Option A:** Continuation of phenytoin without any adjustments is not advisable due to its teratogenic potential.
**Option B:** Adding folic acid alone will not mitigate the risks associated with phenytoin use in pregnancy.
**Option C:** Stopping phenytoin abruptly can lead to seizures and is not a recommended approach.

**Clinical Pearl / High-Yield Fact**
A mnemonic to remember the teratogenic AEDs is "FELONIES": F - fosphenytoin, E - ethosuximide, L - lamotrigine, O - oxcarbazepine, N - nimodipine, I - imipramine, E - ethosuximide, S - sodium valproate.

**Correct Answer: D. Switch to a safer alternative like lamotrigine or levetiracetam and monitor phenytoin levels.**