Status epilepticus after electroconvulsive therapy in a pregnant patient

Status epilepticus after electroconvulsive therapy is a rare complication, and its occurrence during pregnancy has not been reported previously. We discuss the case of a 31-year-old primigravida at 22 weeks of gestation, with a history of bipolar disorder, who underwent electroconvulsive therapy under general anesthesia. Following three treatments she developed status epilepticus, requiring large doses of benzodiazepines, thiopental, propofol and diphenylhydantoin to control the seizure activity. She remained intubated and ventilated for several days after treatment with a complicated course. As a consequence, the fetus died. We discuss the possible causes and the management of status epilepticus after electroconvulsive therapy during pregnancy and its implications for maternal and fetal outcome.