背景:在一些罕见的心律失常综合征中,女性患者的心律失常风险在怀孕期间增加,需要额外的控制。我们想评估怀孕期间心律失常风险的增加是否适用于患有Brugada综合征的女性及其潜在受影响的胎儿。
方法:对PubMed(MeSH搜索词“Brugada综合征,\"\"怀孕,\"\"分娩,\“\”劳动,\"\"交货,\"\"胎儿死亡,\"和\"死产\")。
结果:总体而言,共确定了6例病例报告,共6例患者.在这六名患者中(三名SCN5A变体携带者,三个未测试),两名女性(均为SCN5A身份未知),妊娠期发生严重心脏事件.第一个病人,在12岁时有心脏骤停流产史,发达的心室纤颤(VF),而另一个人在产后被诊断为Brugada综合征,因为怀孕期间夜间有呼吸。
结论:这些(有限,异质性)病例表明,患有Brugada综合征(及其可能受影响的胎儿)的女性,怀孕期间发生心律失常的总体趋势可能较低,但缺乏有关危险因素(SCN5A状态)的重要数据。怀孕期间心律失常的风险似乎在先证者和以前经历过心脏事件的人中增加。我们建议在这些女性中使用风险分层来改善患者护理,降低怀孕母亲的情绪压力和身体负担,降低医疗成本。此外,我们呼吁对所有这些女性进行SCN5A分析,以便进行风险分层,并对携带SCN5A突变的儿童进行级联筛查,特别是对专门护理.
BACKGROUND: In some rare arrhythmia syndromes, arrhythmia risk in female patients increases during pregnancy, necessitating extra controls. We wanted to evaluate if the increased risk for arrhythmia during pregnancy applies in women with Brugada syndrome and their potentially affected fetuses.
METHODS: A comprehensive literature search was performed on PubMed (MeSH search terms \"Brugada syndrome,\" \"pregnancy,\" \"parturition,\" \"labor,\" \"delivery,\" \"fetal death,\" and \"stillbirth\").
RESULTS: Overall, six case reports with a total of six patients were identified. Of these six patients (three carriers of an SCN5A variant, three not tested), two women (both with unknown SCN5A status), developed severe cardiac events during pregnancy. The first patient, with a previous history of aborted sudden cardiac arrest at the age of 12 years, developed ventricular fibrillation (VF), while the other was diagnosed with Brugada syndrome postpartum because of nocturnal agonal respiration during pregnancy.
CONCLUSIONS: These (limited, heterogenous) cases suggest that women with Brugada syndrome (and their possibly affected fetuses), might have an overall low tendency to develop arrhythmias during pregnancy, but important data on risk factors (SCN5A status) are lacking. Arrhythmia risk during pregnancy seems to increase in probands and those who have previously experienced cardiac events. We suggest the use of risk stratification in these women to improve patient care, lower the emotional stress and physical burden for the pregnant mother, and lower health costs. Furthermore, we plead for SCN5A analysis in all these women for use of risk stratification and to enable cascade screening especially for specialized care in children carrying an SCN5A mutation.