Detection of extracardiac abnormalities by early comprehensive abdominal ultrasound screening in neonates with congenital heart disease

Congenital heart disease (CHD) is frequently associated with extracardiac abnormalities that can significantly affect prognosis and management. Although abdominal ultrasound is a readily available and noninvasive tool, detailed observational studies on comprehensive screening for neonates with CHD remain lacking. We aimed to evaluate the prevalence of significant abdominal abnormalities detected during early comprehensive ultrasound screening in neonates with CHD. This single-center, retrospective case series included neonates admitted to a tertiary neonatal intensive care unit (NICU) between April 2021 and May 2024 who underwent screening within 14 days of birth. We compared the proportion of neonates with significant abnormalities and the number of abnormalities per patient between those with and without chromosomal abnormalities or malformation syndromes. Among 59 neonates, significant abnormalities were identified in 29 (49.2%). The most common were hydronephrosis (13.6%), hepatomegaly (10.2%), and intestinal malrotation (8.5%). The proportion of significant abnormalities did not differ significantly between the groups with and without chromosomal abnormalities or malformation syndromes (66.7% vs. 39.5%, P  = 0.06). However, the number of abnormalities per patient was significantly higher in the former group (1.38 vs. 0.61, P  = 0.03). Conclusion : Early comprehensive abdominal ultrasound screening in hospitalized neonates with CHD revealed significant abnormalities in 49.2% of cases. This screening may improve systemic management of patients with CHD, including perioperative care, and facilitate individualized treatment of CHD‒with or without chromosomal or malformation syndromes‒by enhancing phenotype characterization.