ECT in Third Trimester Pregnancy: New Case Report From Baylor University Medical Center

 Out on PubMed, from clinicians in Texas, is this report:

Safety and efficacy of ketamine-augmented electroconvulsive therapy in third trimester pregnancy complicated by COVID-19.

Patel A, Saucier AC, Hobday C, Chacko R.Proc (Bayl Univ Med Cent). 2022 Aug 8;35(6):874-875. doi: 10.1080/08998280.2022.2106415. eCollection 2022.PMID: 36304628 
The abstract is copied below:


Major depressive disorder during pregnancy can be detrimental to the fetus and patient. Treatments can include electroconvulsive therapy (ECT) for severe cases. The use of ketamine in ECT can provide symptomatic relief as well as induce anesthesia. Here, we describe the case of a 35-year-old gravid woman with a long-standing history of major depressive disorder who presented with treatment-resistant depression with suicidal ideation after an alteration in her antidepressant medication. After psychiatric evaluation, she was deemed to be a good candidate for ECT augmented with ketamine for symptomatic relief. This was complicated by an positive but asymptomatic COVID-19 status. Despite these factors, the patient experienced significant relief after an eight-treatment course of ECT, with a reduction of her PHQ-9 score from 22/27 to 4/27 points.

Keywords: Electroconvulsive therapy; high-risk pregnancy; ketamine; major depression; suicidal ideation; treatment-resistant depression.

The report is here.

And here:


This is a straightforward case of successful ECT for severe depression in pregnancy. The first author is a medical student who deserves our kudos and support, as well as our overlooking the idiosyncratic referencing and the mistake about lithium increasing the seizure threshold. The ketofol anesthesia and incidental COVID are largely noncontributory, but likely served as publishability "hooks." 

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