There is limited literature on the use of electroconvulsive therapy (ECT) during pregnancy. ECT is considered as a treatment of last resort during pregnancy. In this case series, we present the data of five patients who were administered ECT during pregnancy. The use of ECT required multidisciplinary approach involving psychiatrist, gynecologist, anesthetist and neonatologist. Two patients received ECT during the second trimester and three patients received ECT during the third trimester. In all the patients, ECT was administered by placing the patients in the left lateral position, glycopyrrolate was used for premedication, thiopentone was used for induction, and succinylcholine was used for muscle relaxation. Patients who were administered ECT close to the full-term were given injection betamethasone 12 mg intramuscularly on two consecutive days before starting of first ECT to promote fetal lung maturity. In all the five cases, no adverse maternal and fetal outcomes were encountered except for possible precipitation of labor in one case.
Aim:
The aim was to study the brain connectivity using diffusion tensor imaging (DTI) among patients with treatment-resistant schizophrenia (TRS) and compare the same with a group of patients without TRS.
Methods:
Twenty-three patients with TRS and 15 patients without TRS underwent DTI using a 3T magnetic resonance imaging machine. DTI data were processed with the calculation of fractional anisotropy (FA) and apparent diffusion coefficient. Patients were also assessed on Brief Psychiatric Rating Scale, Positive and Negative Symptom Scale, Global Assessment of Functioning Scale, and Clinical Global Impression severity scale.
Results:
Patients with TRS and non-TRS differed significantly in the FA values in the region of right superior longitudinal fasciculus and right uncinate fasciculus, with more integrity of tracts in the non-TRS group. However, these differences disappeared when Bonferroni correction was used for multiple comparisons.
Conclusion:
The present study suggests lack of significant difference in DTI findings between patients with TRS and non-TRS.
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