Electroconvulsive Therapy Use in Pregnancy

Kasar, Muzaffer; Saatcioglu, Omer; Kutlar, Tarik

doi:10.1097/yct.0b013e318065b12f

Cited by 24 publications

(19 citation statements)

References 5 publications

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“…Fetal bradyarrhythmia is the most common problem in the fetus caused by ECT [ A change of anesthetic agent from methohexital to propofol attenuated the seizure duration resulting in the elimination of further events of fetal cardiac deceleration and a successful outcome for both mother and fetus [81] Gahr et al to rTMS [82] Salzbrenner et al [85] O'Reardon et al Mother: cesarean delivery Fetus: no complications ECT was effective and safe for treating severe major depression during pregnancy [86] Pesiridou et al ECT during the third trimester of pregnancy may be delayed. Patients and treatment team need to be aware of this possibility, particularly when ECT is conducted on an outpatient basis [87] Ghanizadeh et al Ceccaldi et al [90] Pinette et al ECT is effective and safe [94] DeBattista et al Fukuchi et al Inhalation anesthesia is beneficial for ECT in the last stage of pregnancy to reduce uterine contractions caused by potential uterine relaxation effect of anesthetics [97] Bhatia et al ECT during pregnancy improves maternal condition and does not adversely affect fetal wellbeing [102] Sherer et al Mother: no complications Fetus: no complications ECT was highly effective and careful monitoring of both the mother and the fetus demonstrated that this was a safe procedure [103] Griffiths et al Transient fetal heart rate decreases probably result mainly from hypoxia [68]. The electroconvulsive current does not pass through the uterus [69,70], and so other physiological and pathophysiological factors have to be considered as causes for this problem.…”

Section: Discussionmentioning

confidence: 99%

Electroconvulsive treatment during pregnancy: a systematic review

Pompili

Dominici

Giordano

et al. 2014

Expert Review of Neurotherapeutics

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Pharmacological treatment of severe psychiatric disorders during pregnancy is complicated by the potential harmful effects of treatment for the fetus. Electroconvulsive therapy (ECT) has been demonstrated to be effective for the treatment of several mental disorders. The aim of this study was to investigate the safety of ECT in the treatment of psychiatric disorders during pregnancy; to compare its efficacy with medication; and to identify the main indications for use in pregnancy. We performed a careful and systematic review of the literature on ECT and pregnancy was conducted. Almost all patients demonstrated total or at least partial remission of symptoms after ECT treatment. No deaths were reported in ECT-treated pregnant women. We conclude that ECT is probably currently under-used in many psychiatric settings because of its stigmatized perception by patients and by mental health professionals. ECT seems to be effective for treating major psychiatric disorders during pregnancy, and the risks of adverse events are low.

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Section: Discussionmentioning

confidence: 99%

Electroconvulsive treatment during pregnancy: a systematic review

Pompili

Dominici

Giordano

et al. 2014

Expert Review of Neurotherapeutics

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“…The complications included status epilepticus (63), hematuria (28), miscarriage (13,54), uterine contractions and/or preterm labor (21,25,34,39,48,55,57,58,67), vaginal bleeding (25,28), abdominal pain (39), and placental abruption (50). Both miscarriages were believed to be unrelated to ECT: one was a miscarriage after an MVA (13), and the other was preterm labor 8.5 weeks after the last ECT treatment (54).…”

Section: Maternal Adverse Effectsmentioning

confidence: 96%

ECT in Pregnancy: A Review of the Literature From 1941 to 2007

Anderson

Reti

2009

Psychosomatic Medicine

170

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Objective: To review the literature on the use of electroconvulsive therapy (ECT) during pregnancy and to discuss its risks and benefits for treating severe mental illness during pregnancy. Method: PubMed and PsycINFO databases were searched for English or English-translated articles, case reports, letters, chapters, and Web sites providing original contributions and/or summarizing prior data on ECT administration during pregnancy. Results: A total of 339 cases were found. The majority of patients were treated for depression and at least partial remission was reported in 78% of all cases where efficacy data were available. Among the 339 cases reviewed, there were 25 fetal or neonatal complications, but only 11 of these, which included two deaths, were likely related to ECT. There were 20 maternal complications reported and 18 were likely related to ECT. Conclusions: Although there are limited available data in the literature, it seems that ECT is an effective treatment for severe mental illness during pregnancy and that the risks to fetus and mother are low.

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“…Her ne kadar bu fötal kardiyak aritmilerin geçici olduğu bildirilse de EKT uygulamalarında fötal kardiyak monitörizasyon önerilmektedir. 20 Fakat fötal kardiyak monitörizasyondaki teknik zorluklar ve olgumuzun 16 haftalık gebe olması nedeniyle yapılamamıştır. Bu sebeble her EKT seansı öncesi ve sonrası hasta derlendikten sonra USG ile fötal kardiyak aktivite ve hareketler obstetrisyen tarafından değerlendirilmiş ve herhangi bir sorun tespit edilmemiştir.…”

Section: Discussionunclassified