O PARADOXO DA ULTRASSONOGRAFIA DE ALTA RESOLUÇÃO NO PRÉ-NATAL: SOBREDIAGNÓSTICO, IMPLICAÇÕES BIOÉTICAS E O IMPACTO PSICOGÊNICO DOS MARCADORES ECOCARDIOGRÁFICOS MENORES ISOLADOS

• DOI: https://doi.org/10.22533/at.ed.80892826040515

• Palavras-chave: Ultrassonografia Pré-Natal; Ecocardiografia Doppler; Reações Falso-Positivos; Ansiedade; Trissomia do Cromossomo 21.

• Keywords: Ultrasonography, Prenatal; Echocardiography, Doppler; False Positive Reactions; Anxiety; Trisomy 21.

• Abstract: The technological advancement of prenatal ultrasonography has expanded the detection of minor echocardiographic markers; however, in low-risk pregnancies, these findings often constitute benign and transient anatomical variants, creating a scenario of overdiagnosis and significant maternal emotional distress. Objective: To analyze the false-positive rates associated with isolated minor cardiac markers and assess their iatrogenic and psychological repercussions in prenatal care. Methodology: This is a narrative literature review of a descriptive and conceptual nature, based on an examination of national guidelines (FEBRASGO) and consolidated global evidence indexed in the MEDLINE and SciELO databases between 2011 and 2026. Results: Isolated minor cardiac markers exhibit high false-positive rates in low pre-test risk populations, resulting in positive predictive values (PPV) below 1%. Untimely and inadequate communication of these findings triggers severe levels of gestational anxiety and perinatal stress, in addition to unnecessarily increasing the pursuit of invasive diagnostic procedures, contrary to the bioethical principle of non-maleficence. Conclusion: The indiscriminate screening of isolated minor markers without the epidemiological filter of baseline risk perpetuates imaging-related iatrogenesis. It becomes imperative to instruct screening professionals to contextualize the findings, prioritizing support, secondary non-invasive molecular screening (NIPT), or specialized fetal echocardiography before any consideration of invasive procedures.