Case Report Brugada Syndrome and Pregnancy: Highlights on Antenatal and Prenatal Management Laura Giambanco, Domenico Incandela, Antonio Maiorana, Walter Alio, and Luigi Alio Obstetric and Gynecology Department, Civico Hospital, Piazza N. Leotta 4, 90100 Palermo, Italy Correspondence should be addressed to Domenico Incandela; domenicoincandela@hotmail.it Received 28 November 2013; Accepted 12 February 2014; Published 22 May 2014 Academic Editors: R. P. Kaufman, M. G. Porpora, and S. Salhan Copyright © 2014 Laura Giambanco et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Brugada syndrome is characterized by a disruption of heart’s normal rhythm. It is an autosomal dominant disease due to a mutation of SNC5A gene. Its prevalence is low all over the world, but it is a lethal disease. Sudden cardiac death is the result of phenotypic manifestation of Brugada syndrome. Among asymptomatic Brugada patients, arrhythmia could be provoked by physical activity, fever, or pregnancy. About obstetrical management, very few data or reports have been published since this syndrome has been diagnosed in late 1992. Case Presentation. A 20-year-old pregnant woman at 13 weeks of gestation was referred to our department because of her familial history of sudden cardiac deaths. Brothers and sisters of her mother died of Brugada syndrome in childhood or older and live components of this family were carrier of mutation in Brugada gene. Te pregnancy was uneventful. Te patient gave birth vaginally without any arrhythmia. Strictly cardiological monitoring was performed during labour, delivery, and 12 hours of the postpartum. Conclusion. Even though patient at low risk may never have arrhythmia, some conditions could represent a Brugada trigger. Te management could be very easy and uneventful. Otherwise it could be very difcult with need of ECMO or antiarrhythmics drugs or intracardiac device. Obstetrical management of Brugada pregnant women should be very strict and multidisciplinary in cooperation with cardiologist and anaesthesiologist and should provide an informed consent to the couple. 1. Background Brugada syndrome is characterized by dysfunction of heart’s normal rhythm. Tis disorder could lead to uncoordinated ventricular electrical activity (ventricular arrhythmia, syn- cope, sudden cardiac death). Symptomatic patients have typical ECG signs: ST segment elevation in right precordial without demonstrable structural heart disease [1, 2]. Brugada syndrome is an autosomal dominant disease. Te frst genic mutation was recognized in SNC5A, gene involved in functioning sodium channels [3]. Indeed only 15%–30% of Brugada families have this mutation. Further sodium/calcium channel mutations have been identifed in some genes: SNC1B, CACNA1C, CACNB2, and GDP1L [3]. Patients with Brugada syndrome have normal heart function but are at risk of cardiac arrhythmia; thus, the syndrome is one of the leading causes of death for young men in Southeast Asia [4]. Te only efective prevention of sudden death is implantable cardioverter defbrillators (ICD) [3, 4], but it is not still clear which patients should be treated. Te sex-related diference in the phenotypic expression of the Brugada syndrome is more pronounced than in any other autosomally transmitted arrhythmic syndrome. Te basis for this intriguing sex-related distinction is not fully understood. Potential explanations are gender-related intrinsic difer- ences in ionic currents and hormonal infuences. Due to this hormonal infuence, pregnancy represents a particular situa- tion in the life of women with BS. To date, data elucidating the role of hormonal changes secondary to pregnancy in the clinical outcome of this population have been missing [5]. It is possible to subdivide patients as symptomatic, asymptomatic, positive, or negative to drugs test and member of symptomatic or asymptomatic family. Te management, the risk stratifcation, and the quality of life are variable for each category. Nowadays Brugada syndrome is endemic in Southeast Asia and is increasing in Europe and in USA, but Hindawi Publishing Corporation Case Reports in Obstetrics and Gynecology Volume 2014, Article ID 531648, 3 pages http://dx.doi.org/10.1155/2014/531648