Abstract
Modified Electroconvulsive Therapy (ECT) is a highly effective treatment in psychiatry despite variable community views. It is considered a first-line treatment option for severe depression (associated with high suicide risk, catatonic signs, and/or psychotic symptoms), functional catatonia, and severe psychotic agitation (acute mania or psychosis). It is also an effective treatment option for depression that is unresponsive to multiple trials of antidepressant medications with response rates close to 70 % in some studies. The current evidence suggests that pregnant women who present with the above indications for ECT should not per se be excluded from accessing ECT. There are specific considerations associated with ECT use in pregnancy and this chapter will summarize the principles of safety and effective use of ECT in pregnant patients to optimize perinatal outcomes. The chapter will not go into details of ECT electrophysiology and techniques that can be accessed from other texts and guidelines.