Fukuchi Takahiko, Okada Yoshifumi, Katayama Hitoshi, Nishijima Kouichi, Kato Satoshi, Netsu Sachiho, Fukuda Hirokazu
Dept. of Psychiatry, Jichi Medical School.
Seishin Shinkeigaku Zasshi. 2003;105(7):927-32.
Obsessive-compulsive disorder (OCD) is rare psychiatric disorder during pregnancy, and is often therapy-resistant. We report a 36-year-old pregnant woman with severe obsessive-compulsive disorder successfully treated by modified-electroconvulsive therapy. During the pregnancy, severe mysophobia and compulsive washing appeared, so severely that she was unable to lie down, endangering the life of the fetus. Since the pharmacotherapy was ineffective, modified electroconvulsive therapy (m-ECT) was performed in cooperation with the obstetrician and the anesthesiologist, along with monitored cardiotocography throughout the procedure. During the second therapy late deceleration on the fetal cardiotocogram occurred, but rapid intravenous administration of ritodrine led to the cessation of abnormal uterine contraction. Two courses of m-ECT markedly diminished her symptoms, and she delivered a healthy infant without complications. M-ECT can be an alternative treatment for pregnant patients with OCD.
强迫症(OCD)在孕期是一种罕见的精神疾病,且往往对治疗有抵抗性。我们报告了一例36岁患有严重强迫症的孕妇,通过改良电休克疗法成功治愈。孕期出现了严重的洁癖和强迫性洗涤行为,严重到她无法躺下,危及胎儿生命。由于药物治疗无效,在产科医生和麻醉医生的配合下进行了改良电休克疗法(m-ECT),整个过程中进行了胎心监护。第二次治疗期间,胎儿心电图出现晚期减速,但快速静脉注射利托君导致异常宫缩停止。两个疗程的m-ECT显著减轻了她的症状,她顺利产下一名健康婴儿,无并发症。m-ECT可以作为孕期强迫症患者的一种替代治疗方法。