{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:03:21Z","timestamp":1788264201953,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Edwards Lifesciences Foundation\u00ae"},{"name":"State Government of Minas Gerais","award":["310679\/2016\u20138"],"award-info":[{"award-number":["310679\/2016\u20138"]}]},{"name":"State Government of Minas Gerais","award":["PPM-00428-17"],"award-info":[{"award-number":["PPM-00428-17"]}]},{"name":"National Institute of Science and Technology for Health Technology Assessment","award":["465518\/2014-1"],"award-info":[{"award-number":["465518\/2014-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Impact of heart disease (HD) on pregnancy is significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to evaluate the feasibility of integrating screening echocardiography (echo) into the Brazilian prenatal primary care to assess HD prevalence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Over 13 months, 20 healthcare workers acquired simplified echo protocols, utilizing hand-held machines (GE-VSCAN), in 22 primary care centres. Consecutive pregnant women unaware of HD underwent focused echo, remotely interpreted in 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At total, 1 112 women underwent screening. Mean age was 27 \u00b1 8 years, mean gestational age 22 \u00b1 9 weeks. Major HD was found in 100 (9.0%) patients. More than mild mitral regurgitation was observed in 47 (4.2%), tricuspid regurgitation in 11 (1.0%), mild left ventricular dysfunction in 4 (0.4%), left ventricular hypertrophy in 2 (0.2%) and suspected rheumatic heart disease in 36 (3.2%): all, with mitral valve and two with aortic valve (AV) involvement. Other AV disease was 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).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmaa115","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T23:30:42Z","timestamp":1600817442000},"page":"225-230","source":"Crossref","is-referenced-by-count":14,"title":["Echocardiographic screening of pregnant women by non-physicians with remote interpretation in primary care"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5586-774X","authenticated-orcid":false,"given":"Bruno R","family":"Nascimento","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Cardiologia e Cirurgia Cardiovascular e Centro de Telessa\u00fade do Hospital das Cl\u00ednicas da UFMG, Belo Horizonte, MG, Brazil"},{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte - MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Sable","sequence":"additional","affiliation":[{"name":"Children\u2019s National Health System, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carmo P","family":"Nunes","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cardiologia e Cirurgia Cardiovascular e Centro de Telessa\u00fade do Hospital das Cl\u00ednicas da UFMG, Belo Horizonte, MG, Brazil"},{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte - MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaciane K B","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cardiologia e Cirurgia Cardiovascular e Centro de Telessa\u00fade do Hospital das Cl\u00ednicas da UFMG, Belo Horizonte, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Franco","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cardiologia e Cirurgia Cardiovascular e Centro de Telessa\u00fade do Hospital das Cl\u00ednicas da UFMG, Belo Horizonte, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia M","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cardiologia e Cirurgia Cardiovascular e Centro de Telessa\u00fade do Hospital das Cl\u00ednicas da UFMG, Belo Horizonte, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison T","family":"Reese","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana C","family":"Diamantino","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cardiologia e Cirurgia Cardiovascular e Centro de Telessa\u00fade do Hospital das Cl\u00ednicas da UFMG, Belo Horizonte, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domingos S\u00e1vio G","family":"Ferreira Filho","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte - MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederico V B","family":"Macedo","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte - MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo A M","family":"Raso","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte - MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarcha M W","family":"Paiva","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cardiologia e Cirurgia Cardiovascular e Centro de Telessa\u00fade do Hospital das Cl\u00ednicas da UFMG, Belo Horizonte, MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio L P","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cardiologia e Cirurgia Cardiovascular e Centro de Telessa\u00fade do Hospital das Cl\u00ednicas da UFMG, Belo Horizonte, MG, Brazil"},{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte - MG, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Z","family":"Beaton","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, 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