ECT in Pregnancy: New Review

Out on PubMed, from authors in Italy, is this review:

Safety of electroconvulsive therapy (ECT) in pregnancy: a systematic review of case reports and case series.

Cipolla S, Catapano P, Messina M, Pezzella P, Giordano GM.Arch Womens Ment Health. 2023 Nov 14. doi: 10.1007/s00737-023-01394-1. Online ahead of print.PMID: 37957411 Review.

The abstract is copied below:

Pregnancy and the immediate postpartum period are considered at high risk for women who have already received a previous psychiatric diagnosis and might represent a stressful event favoring the onset of new psychiatric disorders. The electroconvulsive therapy (ECT) is effective for the treatment of severe, treatment-resistant mental disorders, and it could represent a therapeutic choice for psychiatric conditions during pregnancy. The purpose of this systematic review is to evaluate the safety of ECT during pregnancy and to update the state of the art of its use. An extensive literature search on PubMed, APA PsycInfo, and Scopus databases for relevant articles published from inception to September 2023 has been performed. A final number of 45 articles (34 case reports and 11 case series, for a total of 130 pregnant women) were included in the present review. The limited evidence confirmed that ECT is effective in determining a partial remission of symptoms in women suffering from severe mental disorders, especially in the presence of suicidal ideation or psychosis, during all pregnancy epochs. However, ECT is not free from side effects, although the majority of possible complications were of low- or moderate-grade and not life-threatening for the women. Exposure to pharmacological treatment before or during the ECT or to the anesthetic during ECT might have contributed to the onset of these complications. ECT techniques evolved over years, increasing the degree of its safety, and according to our review it appears to be relatively safe and effective during pregnancy in the majority of cases.

Keywords: Electroconvulsive therapy; Mental health; Pregnancy; Safety; Women.

The review is here.
And from the text:




It is always good to be reminded of the safety and efficacy of ECT in pregnancy. While there is nothing new here, the hope is that such a review introduces ECT to a new and wider audience.
Kudos to our Italian colleagues for that.

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