Fetal spasms after the administration of electroconvulsive therapy in pregnancy: our experience

Most psychotropic drugs are not approved for use during pregnancy. Electroconvulsive therapy (ECT) might be an effective and safe treatment option for several psychiatric disorders in pregnant women. This study assessed ECT for treating major psychoses during pregnancy, taking all possible adverse effects into account.

We scrutinized all biomedical reviews on ECT during pregnancy published within the past 10 years, and present our experience with 3 patients in different phases of pregnancy that were treated with ECT between December 2009 and July 2012. Four to 5 ECT sessions were administered to pregnant women (10th to 28th week of pregnancy) with severe psychoses, and fetal heartbeat and movements were monitored during ECT and for 2 hours afterward.

Bizarre fetal spasms occurred in pregnant women treated with ECT. The authors are not aware of any similar description in the published reviews on this topic, to date. Still, all 3 women had successful deliveries, and the infants remained healthy during follow-ups ranging from 1 to 3.5 years. These data fill a lacking gap in the literature regarding long-term infant outcomes after ECT administration to pregnant women. This supports the theory that ECT may be an excellent treatment solution for pregnant women with certain severe mental disorders.

Electroconvulsive therapy may be an acceptable approach for preventing pharmacotherapy risks or danger arising from injuries associated with mental illnesses in pregnant women. Nonetheless, careful monitoring of both mother and baby is absolutely necessary when considering ECT during pregnancy.