Saving the Fetus in Maternal Schizophrenia: The Role and Safety of Electroconvulsive Therapy (ECT) in Pregnancy.

Othman Abdul Karim,Anisah J,Noraslawati R,Syaratul Emma H

doi:10.18314/cogo.v1i1.1071

Abstract

Introduction: Managing schizophrenia during pregnancy often presents a clinical dilemma. Although pharmacological interventions are mostly effective for these disorders during pregnancy, there are few drawbacks for this approach. The potential teratogenicity and long duration of interventions required to control the symptoms somehow limits its usage during pregnancy.Here we described a case report of treatment-resistant schizophrenia successfully treated with ECT without obvious complication to the mother and her baby.Conclusion: Electroconvulsive therapy is an ideal alternative treatment for a patient with schizophrenia during pregnancy. ECT also will eliminate the potential side effects of antipsychotic medications on the mother and teratogenicity effect to the fetus, especially during the first trimester.

Highlights

Schizophrenia is one of the major psychiatric illnesses that have a high incidence in Malaysian population
It is not uncommon to have patients with schizophrenia who is pregnant and these maternal schizophrenia require urgent attention and treatment, especially when there are potential adverse-effect of the psychotropic to the fetus. Another method of therapy like electroconvulsive therapy (ECT) can be recommended to maternal schizophrenia who is disturbed mentally and physically
Psychiatric illness during pregnancy often presents a clinical delemma to psychiatrist and obsterician. This is because pharmacologic interventions that are usually effective for these disorders have a teratogenic potential and are almost contraindicated during pregnancy

Summary

Introduction

Schizophrenia is one of the major psychiatric illnesses that have a high incidence in Malaysian population. With a better care and increased use of atypical (second generation) antipsychotic, 50-60% of the women with schizophrenia will become pregnant; 50% of these pregnancies will be unmarried, have less social supports and they are at greater risk of being an incompetent mother and having the added burden of having to give up their children. It is not uncommon to have patients with schizophrenia who is pregnant and these maternal schizophrenia require urgent attention and treatment, especially when there are potential adverse-effect of the psychotropic to the fetus. Another method of therapy like ECT can be recommended to maternal schizophrenia who is disturbed mentally and physically. The aim of this report is to highlight the role of ECT as a safety intervention to treat a pregnant patient with schizophrenia in the second trimester

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Discussion

Conclusion