title: Malformations detected by abdominal ultrasound in children with congenital heart disease.
abstract: BACKGROUND
  Extracardiac malformations may be present in patients with congenital heart disease (CHD), bringing greater risk of comorbidity and mortality.
  
  
  OBJECTIVE
  Verify frequency and types of abdominal abnormalities detected in children with and without CHD through abdominal ultrasound (AUS), compare the patients in relation to their dysmorphic/cytogenetic findings and perform an estimative of the cost-effectiveness of the screening through AUS.
  
  
  METHODS
  We conducted a cross-sectional study with a control cohort. The cases consisted of patients with CHD admitted for the first time in a pediatric intensive care unit; the controls consisted of children without CHD who underwent AUS at the hospital shortly thereafter a case. All patients with CHD underwent AUS, high-resolution karyotype and fluorescence in situ hybridization (FISH) for microdeletion 22q11.2.
  
  
  RESULTS
  AUS identified clinically significant abnormalities in 12.2% of the cases and 5.2% of controls (p= 0.009), with a power of significance of 76.6%. Most malformations with clinical significance were renal anomalies (10.4% in cases and 4.9% in controls; p= 0.034). In Brazil, the cost of an AUS examination for the Unified Health System is US$ 21. Since clinically significant abnormalities were observed in one in every 8.2 CHD patients, the cost to identify an affected child was calculated as approximately US$ 176.
  
  
  CONCLUSIONS
  Patients with CHD present a significant frequency of abdominal abnormalities detected by AUS, an inexpensive and noninvasive diagnostic method with good sensitivity. The cost of screening for these defects is considerably lower than the cost to treat the complications of late diagnoses of abdominal malformations such as renal disease.
authors.affiliation: Programa de Pós-graduação em Patologia, Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brasil.
authors.forename: Rosana Cardoso Manique
authors.initials: RC
authors.lastname: Rosa
authors.forename: Rafael Fabiano Machado
authors.initials: RF
authors.lastname: Rosa
authors.forename: José Antônio Monteiro
authors.initials: JA
authors.lastname: Flores
authors.forename: Eliete
authors.initials: E
authors.lastname: Golendziner
authors.forename: Ceres Andréia Vieira de
authors.initials: CA
authors.lastname: Oliveira
authors.forename: Marileila
authors.initials: M
authors.lastname: Varella-Garcia
authors.forename: Giorgio Adriano
authors.initials: GA
authors.lastname: Paskulin
authors.forename: Paulo Ricardo Gazzola
authors.initials: PR
authors.lastname: Zen
mesh_terms: D000005:Abdomen / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D017677:Age Distribution; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004812:Epidemiologic Methods; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D008297:Male; D017678:Sex Distribution; D014463:Ultrasonography