Routine Antenatal Echocardiography in High-Prevalence Areas of Rheumatic Heart Disease: A WHO-Guideline Systematic...

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Public Health

Background:

• Rheumatic Heart Disease (RHD) is a leading cause of valvular heart disease globally.
• Undiagnosed RHD poses risks during pregnancy, impacting maternal and fetal health.
• Echocardiography shows promise for RHD screening in pregnant populations.

Approach:

• A systematic review and meta-analysis of observational studies was conducted.
• Searches of MEDLINE and Embase identified relevant literature up to April 2023.
• Two reviewers independently assessed study eligibility in a double-blind manner.

Key Points:

• Ten observational studies, including five using portable echocardiography, analyzed data from 23,166 women.
• RHD prevalence varied significantly (0.4–6.6%), with high heterogeneity (>90%).
• Other cardiac abnormalities were detected in <1–2% of cases, with very low certainty of evidence.

Conclusions:

• Antenatal echocardiography may identify RHD and other cardiac conditions in asymptomatic pregnant women in high-prevalence regions.
• This screening could potentially reduce disease progression and adverse outcomes.
• Low evidence certainty and lack of comparative studies highlight the need for more research.