We present a case of twin gestation complicated by severe depression a
nd psychotic behavior; the mother was treated with electroconvulsive t
herapy (ECT). She had received multiple medications for treatment of h
er depression earlier during the first part of the pregnancy. However,
frequent use of ECT later in the course of pregnancy did not result i
n adverse fetal outcome as is evident from normal fetal surveillance t
ests. We conclude that, when indicated, ECT during pregnancy improves
maternal condition and does not adversely affect fetal well-being.