The Journal of ECT

Skip Navigation LinksHome > December 2011 - Volume 27 - Issue 4 > Anesthesia for Electroconvulsive Therapy in Early Pregnancy
Journal of ECT:
doi: 10.1097/YCT.0b013e318213cd00
Case Reports

Anesthesia for Electroconvulsive Therapy in Early Pregnancy

Lovas, András MD*; Álmos, Péter Z. MD; Pető, Zoltán MD*; Must, Anita MD, PhD†‡; Horváth, Szatmár MD, PhD†‡

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Abstract: Pharmacological treatment of major psychiatric conditions (eg, schizophrenia, bipolar disorder) is exceptionally difficult during pregnancy. Despite all efforts, medication-resistant life-threatening mental deterioration can emerge with the urgent need for rapid and effective intervention. In these cases, electroconvulsive therapy (ECT) may represent the only valid and safe therapeutic option. Here, we present the challenging medical case of a 31-year-old primigravida with a general medical history of obesity and hypertension, previously diagnosed with bipolar affective disorder, now presenting with severe, therapy-resistant manic agitation. Full symptomatic remission was achieved and preserved with ECT given between the 7th and 22nd gestational weeks, the pregnancy reached full term, and a healthy child was born by cesarean delivery performed because of preeclampsia. Although it is unusual to start ECT this early in pregnancy, with the thorough assessment of potential risk factors and preventive measures taken, it can be the most effective and presumably the least risky treatment approach. By delineating key aspects of both the psychiatric and anesthetic management of this case, we aim to highlight the importance of a close cooperation between all medical fields involved in clinical practice.

© 2011 Lippincott Williams & Wilkins, Inc.


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