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Recurrent mild abruptio placentae occurring immediately after repeated electroconvulsive therapy in pregnancy.

Authors » Sherer DM , D'Amico ML , Warshal DP , Stern RA , Grunert HF , Abramowicz JS

Journal » American journal of obstetrics and gynecology

Year » 1991

Links » Pubmed

This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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We present a case in which electroconvulsive therapy was performed repeatedly in pregnancy because of severe depression with psychotic features and failure of chemical treatment. Each electroconvulsive treatment was immediately followed by uterine contractions and active uterine bleeding, possibly representing recurrent abruptio placentae occurring in association with the treatment. Transient acute episodes of maternal hypertension between 180/90 and 190/100 mm Hg, documented within minutes after application of each electroconvulsive treatment, might explain the abruptio placentae manifested by active uterine bleeding and uterine hyperstimulation.

Safe use of electroconvulsive therapy in pregnancy.

Authors » Yellowlees PM , Page T

Journal » The Medical journal of Australia

Year » 1990

Links » Pubmed

This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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A 22-year-old woman who was 32 weeks pregnant was given a course of electroconvulsive therapy (ECT) as a life-saving measure to treat a severe psychotic illness. The ECT was highly effective and careful monitoring of both the mother and the fetus demonstrated that this was a safe procedure.

Acute neurohumoral response to electroconvulsive therapy during pregnancy. A case report.

Authors » Griffiths EJ , Lorenz RP , Baxter S , Talon NS

Journal » The Journal of reproductive medicine

Year » 1989

Links » Pubmed

This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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The neurohumoral changes induced by electroconvulsive therapy (ECT) in pregnancy have not been described previously. In the nonpregnant adult, ECT causes an acute rise in prolactin, adrenocorticotropic hormone (ACTH), cortisol, norepinephrine, epinephrine and beta-endorphin. Because pregnancy alters the production and release of these hormones, consideration should be given to how ECT may further alter the neuroendocrine response, with possible implications for the success of treatment and the fetal response. A 30-year-old woman with a major affective disorder underwent a course of ECT beginning at 23 weeks' gestation. Serial hormonal assays of peripheral venous samples from -30 to +240 minutes were obtained during her first treatment. The prolactin, ACTH, norepinephrine, epinephrine, beta-endorphin, dopamine and oxytocin levels rose acutely and returned to baseline during observation. The maternal vital signs were stable. No increase in uterine activity or fetal heart rate abnormalities were observed during any treatment. A healthy infant weighing 2,900 g was delivered at term, with Apgar scores of 9 and 9 and no problems. We conclude that there are acute neurohumoral changes in specific hormones with ECT in pregnancy, but none of these changes appeared to adversely affect the fetus in our case.

ECT in an acutely psychotic pregnant woman with actively aggressive (homicidal) impulses.

Authors » Varan LR , Gillieson MS , Skene DS , Sarwer-Foner GJ

Journal » Canadian journal of psychiatry. Revue canadienne de psychiatrie

Year » 1985

Links » Pubmed

This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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The specific use of ECT to control homicidal impulses in a pregnant, acutely psychotic schizophrenic patient is described, with no adverse effects to the mother or the baby. Besides the relative safety of the procedure during pregnancy, the need for monitoring foetal effects is stressed. Although literature is abundant on various aspects of ECT (1-3) there has been little written on its use in pregnancy (4-6) for its value in treating severe depressive illness or certain types of schizophrenia; without adverse effect to the mother and the baby, and where there is a risk-benefit advantage to its use. Nineteen hundred and eighty-four marked 50 years in the history of the use of convulsive therapy (Metrazol) since its introduction into the realm of psychiatry by the Hungarian psychiatrist, Ladislas Meduna. Electro-convulsive therapy (ECT) has been the subject of much controversy among the lay public and some professionals alike in recent years, even though it is generally considered to be one of the most effective treatments available in psychiatry. The Canadian Psychiatric Association (7), the American Psychiatric Association (8), and the Royal College of Psychiatrists (U.K.) (9) have made their position clear on the issue. In a recent Canadian survey of the use of ECT, Smith concluded, "Some of the reported rates are below the predicted minimum levels" indicating that "certain patients have been deprived of the most effective treatment available" (10).

Case report of ECT during high-risk pregnancy.

Authors » Wise MG , Ward SC , Townsend-Parchman W , Gilstrap LC , Hauth JC

Journal » The American journal of psychiatry

Year » 1984

Links » Pubmed DOI

This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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The authors present the case of a depressed woman given ECT during pregnancy and list administrative and monitoring techniques for protection of both fetus and mother when ECT is administered during pregnancy.

Electroconvulsive therapy for the acutely psychotic pregnant patient: a review of 3 cases.

Authors » Loke KH , Salleh R

Journal » The Medical journal of Malaysia

Year » 1983

Links » Pubmed

This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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Arterial blood-gas analyses during electroconvulsive therapy in a parturient.

Authors » Levine R , Frost EA

Journal » Anesthesia and analgesia

Year » 1975

Links » Pubmed

This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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Arterial blood gases and vital signs were monitored in a patient receiving electroconvulsive therapy (ECT) during the third trimester of pregnancy. Alterations in blood pressure and heart rate were similar to those noted in prior studies. Pretreating with 100 percent oxygen (02) and assisting ventilation until return of adequate spontaneous respirations, prevented hypoxemia, significant hypercarbia, and cardiovascular changes. The administration of succinylcholine prevented the systemic manifestations of the electrically-induced seizure. One fetal arrhythmia occurred, apparently unrelated to changes in maternal Pa02, and resolved spontaneously. This technic of anesthesia would appear to be acceptable for ECT in the parturient.