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A Systematic Review of the Safety of Electroconvulsive Therapy Use During the First Trimester of Pregnancy.
J ECT. 2016 Dec; 32(4):230-235.JE

Abstract

OBJECTIVES

Because of the lack of focus on the safety of electroconvulsive therapy (ECT) during the first trimester of pregnancy in current literature, we set out to assess the safety of ECT use during this vital period of fetal development.

METHODS

A systematic review was conducted, and a case where ECT was employed during the first trimester was presented. Cochrane Library, Ovid MEDLINE, PsycINFO, and PubMed were independently searched by 2 authors using the following search terms: "ECT," "electroconvulsive therapy," "electroshock" combined with "pregnancy," "first trimester of pregnancy," and "teratogenicity."

RESULTS

Of the 97 articles reviewed, 13 met inclusion criteria. We identified 32 first-trimester patients as cases or case series. Adverse outcomes, including miscarriage with previous vaginal bleeding, vaginal bleeding, self-limited abdominal pain, and self-limited fetal spasms, were observed. We added 1 case of a pregnant patient at approximately 9 weeks gestation who experienced a threatened abortion after the administration of ECT.

CONCLUSIONS

Although the data are limited, they suggest that ECT is relatively safe when administered during the first trimester of pregnancy. The possible adverse consequences of ECT during the first trimester of pregnancy should be carefully weighed against the potential benefits of ECT on untreated mental illness.

Authors+Show Affiliations

From the Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27327556

Citation

Calaway, Katherine, et al. "A Systematic Review of the Safety of Electroconvulsive Therapy Use During the First Trimester of Pregnancy." The Journal of ECT, vol. 32, no. 4, 2016, pp. 230-235.
Calaway K, Coshal S, Jones K, et al. A Systematic Review of the Safety of Electroconvulsive Therapy Use During the First Trimester of Pregnancy. J ECT. 2016;32(4):230-235.
Calaway, K., Coshal, S., Jones, K., Coverdale, J., & Livingston, R. (2016). A Systematic Review of the Safety of Electroconvulsive Therapy Use During the First Trimester of Pregnancy. The Journal of ECT, 32(4), 230-235.
Calaway K, et al. A Systematic Review of the Safety of Electroconvulsive Therapy Use During the First Trimester of Pregnancy. J ECT. 2016;32(4):230-235. PubMed PMID: 27327556.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Systematic Review of the Safety of Electroconvulsive Therapy Use During the First Trimester of Pregnancy. AU - Calaway,Katherine, AU - Coshal,Shana, AU - Jones,Kristin, AU - Coverdale,John, AU - Livingston,Robin, PY - 2016/6/22/pubmed PY - 2017/10/24/medline PY - 2016/6/22/entrez SP - 230 EP - 235 JF - The journal of ECT JO - J ECT VL - 32 IS - 4 N2 - OBJECTIVES: Because of the lack of focus on the safety of electroconvulsive therapy (ECT) during the first trimester of pregnancy in current literature, we set out to assess the safety of ECT use during this vital period of fetal development. METHODS: A systematic review was conducted, and a case where ECT was employed during the first trimester was presented. Cochrane Library, Ovid MEDLINE, PsycINFO, and PubMed were independently searched by 2 authors using the following search terms: "ECT," "electroconvulsive therapy," "electroshock" combined with "pregnancy," "first trimester of pregnancy," and "teratogenicity." RESULTS: Of the 97 articles reviewed, 13 met inclusion criteria. We identified 32 first-trimester patients as cases or case series. Adverse outcomes, including miscarriage with previous vaginal bleeding, vaginal bleeding, self-limited abdominal pain, and self-limited fetal spasms, were observed. We added 1 case of a pregnant patient at approximately 9 weeks gestation who experienced a threatened abortion after the administration of ECT. CONCLUSIONS: Although the data are limited, they suggest that ECT is relatively safe when administered during the first trimester of pregnancy. The possible adverse consequences of ECT during the first trimester of pregnancy should be carefully weighed against the potential benefits of ECT on untreated mental illness. SN - 1533-4112 UR - https://www.unboundmedicine.com/medline/citation/27327556/A_Systematic_Review_of_the_Safety_of_Electroconvulsive_Therapy_Use_During_the_First_Trimester_of_Pregnancy_ L2 - https://doi.org/10.1097/YCT.0000000000000330 DB - PRIME DP - Unbound Medicine ER -