title: A case of delayed onset of threatened premature labor in association with electroconvulsive therapy in the third trimester of pregnancy.
abstract: Electroconvulsive therapy (ECT) is recommended by the American Psychiatric Association Task Force on ECT as a safe and effective treatment of depression throughout pregnancy. We report here administration of ECT in the third trimester of pregnancy in a 33-year-old patient with severe bipolar depression. The patient had a good antidepressant response to ECT. She experienced, however, delayed onset premature uterine contractions at home after her sixth session of ECT (10 hours post-ECT administration). After receiving tocolytics, the patient's contractions did not progress to premature labor. In consultation with the obstetrics team, it was decided to terminate the ECT course earlier than planned. The patient is delivered of a healthy female newborn infant spontaneously at 37 weeks' gestational age. Four months after delivery, the baby's development is progressing normally. This case illustrates that premature contractions in association with ECT during the third trimester of pregnancy may be delayed in onset. Patients and treatment team need to be aware of this possibility, particularly when ECT is conducted on an outpatient basis.
authors.affiliation: ECT Service, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. a.pesiridou@gmail.com
authors.forename: Angeliki
authors.initials: A
authors.lastname: Pesiridou
authors.forename: Giselle
authors.initials: G
authors.lastname: Baquero
authors.forename: Pilar
authors.initials: P
authors.lastname: Cristancho
authors.forename: Laura
authors.initials: L
authors.lastname: Wakil
authors.forename: Murat
authors.initials: M
authors.lastname: Altinay
authors.forename: Deborah
authors.initials: D
authors.lastname: Kim
authors.forename: John P
authors.initials: JP
authors.lastname: O'Reardon
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third; D016896:Treatment Outcome