David Zilles-Wegner1, Sarah Trost2, Karoline Walliser3, Leif Saager3, Sebastian Horn4, Mareike Ernst5. 1. Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Deutschland. david.zilles@med.uni-goettingen.de. 2. Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Deutschland. 3. Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland. 4. Klinik für Kinderheilkunde und Jugendmedizin, Pädiatrische Kardiologie, Intensivmedizin und Pneumologie, Universitätsmedizin Göttingen, Göttingen, Deutschland. 5. Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Abstract
BACKGROUND: Psychiatric disorders during pregnancy are common. Electroconvulsive therapy (ECT) can be indicated in severely affective or psychotic disorders with the necessity of a rapid response. Currently available review articles greatly differ in the methodology, leading to divergent conclusions concerning the use of ECT during pregnancy. OBJECTIVE: Description of a new clinical case and interdisciplinary treatment suggestions for the safe application of ECT in pregnancy. METHODS: Clinical case report and selective review of the literature with special consideration of existing systematic reviews. RESULTS AND CONCLUSION: This case report shows the potentially high effectiveness and safe administration of ECT in pregnancy for both mother and fetus. The undesired adverse events associated with ECT described in the literature are largely qualitatively congruent with the risks of severe psychotic disorders in pregnancy per se. For a better risk-benefit analysis, larger case control studies would be desirable. Under the premise of a thorough evaluation of the indications, good interdisciplinary coordination and consideration of the specific practical requirements, ECT is a useful therapeutic option in pregnancy.
BACKGROUND: Psychiatric disorders during pregnancy are common. Electroconvulsive therapy (ECT) can be indicated in severely affective or psychotic disorders with the necessity of a rapid response. Currently available review articles greatly differ in the methodology, leading to divergent conclusions concerning the use of ECT during pregnancy. OBJECTIVE: Description of a new clinical case and interdisciplinary treatment suggestions for the safe application of ECT in pregnancy. METHODS: Clinical case report and selective review of the literature with special consideration of existing systematic reviews. RESULTS AND CONCLUSION: This case report shows the potentially high effectiveness and safe administration of ECT in pregnancy for both mother and fetus. The undesired adverse events associated with ECT described in the literature are largely qualitatively congruent with the risks of severe psychotic disorders in pregnancy per se. For a better risk-benefit analysis, larger case control studies would be desirable. Under the premise of a thorough evaluation of the indications, good interdisciplinary coordination and consideration of the specific practical requirements, ECT is a useful therapeutic option in pregnancy.
Authors: Qiu-Yue Zhong; Bizu Gelaye; Gregory L Fricchione; Paul Avillach; Elizabeth W Karlson; Michelle A Williams Journal: BMC Pregnancy Childbirth Date: 2018-05-02 Impact factor: 3.007