In this article, researchers aimed to evaluate the feasibility of integrating screening echocardiography (echo) into Brazilian prenatal primary care to assess HD prevalence.

Over 13 months, 20 healthcare workers acquired simplified echo protocols, utilizing hand-held machines (GE-VSCAN), in 22 primary care centers. Consecutive pregnant women unaware of HD underwent focused echo, remotely interpreted in the USA and Brazil. Major HD was defined as structural valve abnormalities, more than mild valve dysfunction, ventricular systolic dysfunction/hypertrophy, or other major abnormalities. Screen-positive women were referred for standard echo. In total, 1112 women underwent screening. 


Mean age was 27 (± 8) years, mean gestational age 22 (± 9) weeks, all, with mitral valve and two with aortic valve (AV) involvement. Other AV diseases were observed in 11 (10%). In 56 screen-positive women undergoing standard echo, major HD was confirmed in 45 (80.4%): RHD findings in 12 patients (all with mitral valve and two with AV disease), mitral regurgitation in 40 (14 with morphological changes, 10 suggestive of rheumatic heart disease), other AV disease in two (mild/moderate regurgitation).

Integration of echo screening into primary prenatal care is feasible in Brazil. However, the low prevalence of severe disease urges further investigations about the effectiveness of the strategy.