POCUS detected valvular and congenital heart disease as effectively as routine TTE but identified left ventricular systolic dysfunction less frequently (1.5% vs 2.8%; p<0.001).
Does POCUS detect structural heart disease as effectively as routine TTE in asymptomatic pregnant women?
POCUS is an effective alternative to routine TTE for screening valvular and congenital heart disease in asymptomatic pregnant women, though TTE is superior for detecting left ventricular systolic dysfunction.
Abstract Background The Prospective Pakistan Registry of Echocardiographic Screening in Asymptomatic Pregnant Women (PRESAP) is a registry designed for the echocardiographic screening of structural heart disease (SHD). Objectives This sub-study of the PRESAP registry aimed to compare the detection of SHD in asymptomatic pregnant women using POCUS versus routine TTE. Methods Between February 2023 and March 2024, pregnant women without known heart disease underwent either POCUS or routine TTE. The primary outcome was the detection of abnormal echocardiographic findings, including left ventricular systolic dysfunction (LVSD), valvular heart disease (VHD), and congenital heart disease (CHD). Results Among 18,401 patients, 9,681 (52.6%) underwent POCUS. The 1:1 propensity-matched cohort included 4,177 patients in each of the POCUS and TTE arms. Abnormal echocardiographic findings were detected in 4.4% (185) of the routine TTE group and 3% (124) of the POCUS group (p0.001). VHD (1.3% vs. 1.1%; p=0.416) and CHD (0.4% vs. 0.6%; p=0.093) were detected at similar rates by both methods, while LVSD was more frequently identified by routine TTE compared to POCUS (2.8% vs. 1.5%; p0.001). Conclusions POCUS is a reliable alternative to routine TTE for screening SHD in asymptomatic pregnant women, particularly in resource-limited settings. While routine TTE may offer superior detection of LVSD, POCUS is equally effective in identifying valvular and congenital heart disease.
Bhatti et al. (2025) studied this question. POCUS detected valvular and congenital heart disease as effectively as routine TTE but identified left ventricular systolic dysfunction less frequently (1.5% vs 2.8%; p<0.001).