Electroconvulsive therapy with thiamylal or propofol during pregnancy

Iwasaki, Kanako; Sakamoto, Atsuhiro; Hoshino, Takeshi; Ogawa, Ryo

doi:10.1007/bf03020541

Cited by 11 publications

(9 citation statements)

References 2 publications

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“…Although 13 % of these later date studies (1970 to 2013) were missing anesthesia data, a trend was seen for the following being most used: thiopental (22 %), methohexital (15 %), and propofol (17 %). Anesthesia induced reduced fetal heart rate (FHR) was noted with propofol but not thiamylal in an ECT pregnancy case by Iwasaki et al ( 2002 ). In addition, severe fetal bradycardia by methohexital but not with following propofol anesthesia during ECT administration by De Asis et al ( 2013 ).…”

Section: Resultsmentioning

confidence: 99%

Electroconvulsive therapy during pregnancy: a systematic review of case studies

Leiknes

Cooke

Schweder

et al. 2013

Arch Womens Ment Health

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This study aims to explore practice, use, and risk of electroconvulsive therapy (ECT) in pregnancy. A systematic search was undertaken in the databases Medline, Embase, PsycINFO, SveMed and CINAHL (EBSCO). Only primary data-based studies reporting ECT undertaken during pregnancy were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria and extracted detailed use, practice, and adverse effects data from full text retrieved articles. Studies and extracted data were sorted according to before and after year 1970, due to changes in ECT administration over time. A total of 67 case reports were included and studies from all continents represented. Altogether, 169 pregnant women were identified, treated during pregnancy with a mean number of 9.4 ECTs, at mean age of 29 years. Most women received ECT during the 2nd trimester and many were Para I. Main diagnostic indication in years 1970 to 2013 was Depression/Bipolar disorder (including psychotic depression). Missing data on fetus/child was 12 %. ECT parameter report was often sparse. Both bilateral and unilateral electrode placement was used and thiopental was the main anesthetic agent. Adverse events such as fetal heart rate reduction, uterine contractions, and premature labor (born between 29 and 37 gestation weeks) were reported for nearly one third (29 %). The overall child mortality rate was 7.1 %. Lethal outcomes for the fetus and/or baby had diverse associations. ECT during pregnancy is advised considered only as last resort treatment under very stringent diagnostic and clinical indications. Updated international guidelines are urgently needed.

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Section: Resultsmentioning

confidence: 99%

Electroconvulsive therapy during pregnancy: a systematic review of case studies

Leiknes

Cooke

Schweder

et al. 2013

Arch Womens Ment Health

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“…Propofol was used for the following ECT treatment with shorter seizure duration and no transient fetal bradycardia. Other case reports have used thiamyal without reports of fetal bradycardia [37]. As shown in the table, methohexital was used as the induction agent in 7/8 patients with a single subject receiving propofol.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy and Electroconvulsive Therapy

et al. 2016

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Objective To scrutinize a series of pregnant women treated with electroconvulsive therapy (ECT) at a tertiary treatment center and combine this data with a literature review to refine the treatment guidelines for ECT during pregnancy. Methods A retrospective chart review of mentally ill pregnant patients treated with ECT since the establishment of a formal women’s mental health program. Results A total of eight pregnant women treated with ECT were identified from 01/2012–08/2014. Information was extracted from the medical record from a total of 30 ECT treatments across this group. Subjects received an average of 3.75 ECT treatments (range 1–7). All women were diagnosed with a mood disorder (either unipolar or bipolar), and five of the eight women had suicidal ideation. The treatment team for ECT was consistent across all treatments. Two women experienced significant complications following the initial treatment: 1) an acute episode of complete heart block; and 2) acute onset of mania following ECT. Obstetrical complications included two women with pre-term delivery – one secondary to premature rupture of membranes. No other complications or adverse outcomes were recorded. The five women with suicidal ideation had symptom resolution, and significant symptom improvement was noted in six of the eight women. Conclusions Electroconvulsive therapy is a safe and effective treatment during pregnancy and of particular benefit in the acute treatment of suicidal ideation.

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“…The pharmacodynamic properties of propofol and methohexital are relatively constant throughout pregnancy and neither drug is associated with teratogenicity. However, maternal administration of methohexital or propofol immediately before delivery can lead to fetal heart rate slowing (59) and temporary sedation in the newborn. These side effects can be minimized by administering low doses of anesthetic, i.e., 0.5 to 1 mg/kg of methohexital or 0.75 to 1.5 mg/kg of propofol (2,81).…”

Section: Anesthetic Agentsmentioning

confidence: 97%

ECT in Pregnancy: A Review of the Literature From 1941 to 2007

Anderson

Reti

2009

Psychosomatic Medicine

172

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Objective: To review the literature on the use of electroconvulsive therapy (ECT) during pregnancy and to discuss its risks and benefits for treating severe mental illness during pregnancy. Method: PubMed and PsycINFO databases were searched for English or English-translated articles, case reports, letters, chapters, and Web sites providing original contributions and/or summarizing prior data on ECT administration during pregnancy. Results: A total of 339 cases were found. The majority of patients were treated for depression and at least partial remission was reported in 78% of all cases where efficacy data were available. Among the 339 cases reviewed, there were 25 fetal or neonatal complications, but only 11 of these, which included two deaths, were likely related to ECT. There were 20 maternal complications reported and 18 were likely related to ECT. Conclusions: Although there are limited available data in the literature, it seems that ECT is an effective treatment for severe mental illness during pregnancy and that the risks to fetus and mother are low.

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Electroconvulsive therapy with thiamylal or propofol during pregnancy

Cited by 11 publications

References 2 publications

Electroconvulsive therapy during pregnancy: a systematic review of case studies

Electroconvulsive therapy during pregnancy: a systematic review of case studies

Pregnancy and Electroconvulsive Therapy

ECT in Pregnancy: A Review of the Literature From 1941 to 2007

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