A 32-year-old woman at 31 weeks' gestation is admitted with severe psychotic depression. She has persistently refused food and fluids, is becoming

Question

A 32-year-old woman at 31 weeks' gestation is admitted with severe psychotic depression. She has persistently refused food and fluids, is becoming dehydrated and remains at high risk of suicide. A rapid therapeutic response is required, and electroconvulsive therapy (ECT) is being considered. Which statement most accurately reflects current UK practice?

Accepted Answer

ECT may be considered during pregnancy when severe illness creates serious maternal or fetal risk, following individualised specialist obstetric and anaesthetic assessment.

Answer

ECT must be deferred until all pharmacological strategies have failed, irrespective of the need for a rapid response.

Answer

ECT may be considered only when the fetus is compromised; serious maternal suicide or nutritional risk is insufficient.

Answer

ECT is contraindicated in the third trimester because the risk of premature labour necessarily outweighs any maternal benefit.

Answer

ECT should be delayed until after delivery unless the psychiatric presentation is catatonia rather than psychotic depression.

ECT Safety in Pregnancy — MRCPsych Paper B MCQ