Mood disorders: ECT in pregnancy: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Psychiatry · Mood disorders: ECT in pregnancy

Sample item

A woman in the second trimester of pregnancy has severe psychotic depression with refusal of food and fluids and active suicidal intent. Medicines carry concerns and she is losing weight rapidly. What is the most appropriate treatment?

ALithium and valproate togetherBECT with obstetric monitoring and anaesthetic precautionsCWithholding all treatment until deliveryDLong-term benzodiazepines alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. ECT with obstetric monitoring and anaesthetic precautions

ECT is an effective and relatively safe treatment for severe depression in pregnancy, especially when there is psychosis, suicidality or refusal of food. It is given with precautions such as fetal monitoring, aspiration prevention and avoidance of aortocaval compression.

Option by option

A. Lithium and valproate together
Both lithium and valproate carry teratogenic risk and are not first choices here.
B. ECT with obstetric monitoring and anaesthetic precautions (correct)
Correct. ECT is the rapid and relatively safe option in life-threatening depression in pregnancy.
C. Withholding all treatment until delivery
Delay is dangerous because of the risk of suicide and starvation.
D. Long-term benzodiazepines alone
Benzodiazepines do not treat psychotic depression and are not appropriate as sole treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, ECT with obstetric monitoring and anaesthetic precautions. ECT is an effective and relatively safe treatment for severe depression in pregnancy, especially when there is psychosis, suicidality or refusal of food.

Why is "Lithium and valproate together" not the answer?

Both lithium and valproate carry teratogenic risk and are not first choices here.

Why is "Withholding all treatment until delivery" not the answer?

Delay is dangerous because of the risk of suicide and starvation.

Why is "Long-term benzodiazepines alone" not the answer?

Benzodiazepines do not treat psychotic depression and are not appropriate as sole treatment.

What concept does this question test?

It tests Mood disorders: ECT in pregnancy in Psychiatry. It is given with precautions such as fetal monitoring, aspiration prevention and avoidance of aortocaval compression.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mood disorders: ECT in pregnancy?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.