Piccardi L, Verde P, Bianchini F, Morgagni F, Guariglia C, Strollo F. Mental rotation task in a pilot during and after pregnancy. Aviat Space Environ Med 2013; 84:1092–4. Introduction: Discordant findings have been reported about the change in pregnant women’s cognitive test performance. Visuo-spatial abilities, which are crucial in terrestrial/flight navigation, could be influenced by hormonal variations. Case report: A 32-yr-old Italian Air Force pilot underwent a 2-D Mental Rotation Task (MRT) and hormonal assessment in the second trimester of pregnancy and 1 yr after delivery. Her performance was compared with that of two nonpregnant groups of women: one with flying experience and the other without. Estradiol and progesterone were significantly higher in pregnancy compared with postpartum, while testosterone was almost unchanged. During pregnancy, we observed a significant difference in the subject’s response time compared with pilots (she was slower) and nonpilots (she was faster). One year after delivery, her performance was still better than the nonpilot group and was almost the same as the pilot group. Discussion: Our data are consistent with an effect of pregnancy on visuo-spatial ability that can last for some time after delivery, even with the early recovery of the hormonal levels. MRT smoothly changed in our subject, supporting previous findings that women who are experts in flight navigation are less sensitive to hormonal fluctuations. Conclusion: In this case, visuo-spatial ability requiring effortful processing underwent variations during pregnancy and postpartum. Further studies are needed in order to confirm our observations in a wider population.