Long-term effects in children. Literature examining the long-term effects of ECT treatment during pregnancy is limited. Smith (1956) examined 15 children between the ages of 11 months and five years whose mothers had undergone ECT during pregnancy. None of the children demonstrated intellectual or physical abnormalities. Sixteen children, aged 16 months to six years, whose mothers had received ECT during the first or second trimester of pregnancy, were examined by Forssman (1955). None of the children was found to have a defined physical or mental defect. Impastato et al. (1964) describes follow-up on eight children whose mothers had received ECT during pregnancy. The children ranged in age from two weeks to 19 years at the time of examination. No physical deficits were noted; however, mental deficiencies were noted in two and neurotic traits in four. Whether ECT contributed to the mental deficits is questionable. The mothers of the two mentally deficient children had received ECT after the first trimester, and one received insulin coma treatment during the first trimester, which could have contributed to the mental deficit.

Summary

ECT offers a valuable alternative for treating the pregnant patient suffering from depression, mania, catatonia, or schizophrenia. Pharmacological therapy for these psychiatric illnesses carries inherent risks of side effects and adverse consequences to the unborn child. Medications often require a long time to take effect, or the patient may be refractory to them. Additionally, these psychiatric conditions themselves are a risk to the mother and fetus. An effective, expeditious, and relatively safe alternative for pregnant patients requiring psychiatric treatment is ECT. The risk of the procedure can be minimized by modifying the technique. Medications used during the procedure are reportedly safe to use during pregnancy. In addition, complications reported in pregnant patients who received ECT during pregnancy have not been conclusively associated with the treatment. Research conducted to date suggests that ECT is a useful resource in psychiatric treatment of the pregnant patient.

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Brattleboro Retreat Psychiatry Review
Volume 5 - Number 1 - June 1996
Publisher Percy Ballantine, MD
Editor Susan Scown
Invited Editor Max Fink, MD

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