Marechal-Ross Isabella, Austin Kathryn
Department of Obstetrics & Gynaecology, Royal North Shore Hospital, Clinical Services Building, 1 Westbourne St, St Leonards, NSW 2065, Australia.
Reports (MDPI). 2025 Aug 5;8(3):138. doi: 10.3390/reports8030138.
Brugada syndrome (BrS) is a rare inherited cardiac channelopathy, often associated with SCN5A loss-of-function mutations. Clinical presentations range from asymptomatic to malignant arrhythmias and sudden cardiac death. Physiological and pharmacological stressors affecting sodium channel function-such as pyrexia, certain medications, and possibly pregnancy-may unmask or exacerbate arrhythmic risk. However, there is limited information regarding pregnancy and obstetric outcomes. Obstetric management remains largely informed by isolated case reports and small case series. A literature review was conducted using OVID Medline and Embase, identifying case reports, case series, and one retrospective cohort study reporting clinical presentation, obstetric management, and outcomes in maternal BrS. A case is presented detailing coordinated multidisciplinary input, antenatal surveillance, and intrapartum and postpartum care to contribute to the growing evidence base guiding obstetric care in this complex setting. A 30-year-old G2P0 woman with asymptomatic BrS (SCN5A-positive) was referred at 31 + 5 weeks' gestation for multidisciplinary antenatal care. Regular review and collaborative planning involving cardiology, anaesthetics, maternal-fetal medicine, and obstetrics guided a plan for vaginal delivery with continuous cardiac and fetal monitoring. At 38 + 0 weeks, the woman presented with spontaneous rupture of membranes and underwent induction of labour. A normal vaginal delivery was achieved without arrhythmic events. Epidural block with ropivacaine and local anaesthesia with lignocaine were well tolerated, and 24 h postpartum monitoring revealed no abnormalities. This case adds to the limited but growing literature suggesting that with individualised planning and multidisciplinary care, pregnancies in women with BrS can proceed safely and without complication. Ongoing case reporting is essential to inform future guidelines and optimise maternal and fetal outcomes.
Brugada综合征（BrS）是一种罕见的遗传性心脏离子通道病，常与SCN5A功能丧失性突变相关。临床表现从无症状到恶性心律失常和心源性猝死不等。影响钠通道功能的生理和药理应激因素，如发热、某些药物以及可能的妊娠，可能会暴露或加重心律失常风险。然而，关于妊娠和产科结局的信息有限。产科管理在很大程度上仍基于个别病例报告和小病例系列。使用OVID Medline和Embase进行了文献综述，确定了病例报告、病例系列以及一项回顾性队列研究，这些研究报告了患有BrS的孕妇的临床表现、产科管理和结局。本文介绍了一个病例，详细说明了多学科的协同参与、产前监测以及产时和产后护理，以丰富在这一复杂情况下指导产科护理的证据基础。一名30岁、孕2产0、无症状的BrS（SCN5A阳性）女性在妊娠31 + 5周时因多学科产前护理前来就诊。由心脏病学、麻醉学、母胎医学和产科进行定期检查和协作规划，指导了一项在持续心脏和胎儿监测下进行阴道分娩的计划。在38 + 0周时，该女性出现胎膜自然破裂并接受引产。实现了正常阴道分娩，未发生心律失常事件。罗哌卡因硬膜外阻滞和利多卡因局部麻醉耐受性良好，产后24小时监测未发现异常。该病例补充了有限但不断增加的文献资料，表明通过个体化规划和多学科护理，患有BrS的女性妊娠可以安全进行且无并发症。持续的病例报告对于为未来指南提供信息并优化母婴结局至关重要。
