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A Case of Delayed Onset of Threatened Premature Labor in Association With Electroconvulsive Therapy in the Third Trimester of Pregnancy

Pesiridou, Angeliki MD; Baquero, Giselle MD; Cristancho, Pilar MD; Wakil, Laura MD; Altinay, Murat MD; Kim, Deborah MD; O'Reardon, John P. MD

Journal of ECT:
doi: 10.1097/YCT.0b013e3181c3aef3
Case Reports
Abstract

Electroconvulsive therapy (ECT) is recommended by the American Psychiatric Association Task Force on ECT as a safe and effective treatment of depression throughout pregnancy. We report here administration of ECT in the third trimester of pregnancy in a 33-year-old patient with severe bipolar depression.

The patient had a good antidepressant response to ECT. She experienced, however, delayed onset premature uterine contractions at home after her sixth session of ECT (10 hours post-ECT administration). After receiving tocolytics, the patient's contractions did not progress to premature labor. In consultation with the obstetrics team, it was decided to terminate the ECT course earlier than planned. The patient is delivered of a healthy female newborn infant spontaneously at 37 weeks' gestational age. Four months after delivery, the baby's development is progressing normally.

This case illustrates that premature contractions in association with ECT during the third trimester of pregnancy may be delayed in onset. Patients and treatment team need to be aware of this possibility, particularly when ECT is conducted on an outpatient basis.

Author Information

From the ECT Service, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA.

Received for publication May 11, 2009; accepted July 6, 2009.

Reprints: Angeliki Pesiridou, MD, Suite 4005, 3535 Market St, Philadelphia, PA 19104 (e-mail: a.pesiridou@gmail.com).

© 2010 Lippincott Williams & Wilkins, Inc.