[Use of sismotherapy during pregnancy for severe depression]

Electroconvulsive therapy (ECT), also known as electroshock, is a treatment option for patients with severe depression. It involves inducing a comitial crisis under short general anesthesia with curarization. Its use during pregnancy is a rare event and a poorly studied one. A primigravida with a prior bipolar disorder presented a major depressive episode during the second trimester, slightly improved by medical treatment. Electroshocks were performed (10 sessions planned from 26 to 30 weeks of amenorrhea [WA]), with the agreement of the patient. A marked improvement in her condition was recorded in the early sessions. Following a threat of premature birth, the last session was not carried out. She received antidepressant medical treatment in the months preceding childbirth. At 36 WA, the birth was natural and fast to a healthy child (3120 g, Apgar 10-10-10). The mother-child relationship was good. Even if publications are reassuring, the case of a child with multiple cerebral infarctions in a preeclamptic patient was recently reported. The occurrence of any superimposed obstetrical pathology (preeclampsia, premature delivery) should revise this treatment. Given the possible complications, it requires strict supervision of the pregnancy in a hospital setting.