Major structural abnormalities affect 2–3% of pregnancies, but they represent a much higher proportion of perinatal mortality. Detection of many congenital anomalies has increased due to improved antenatal ultrasound diagnosis. This enables fetal medicine specialists to look for other associated structural anomalies, test for chromosomal or genetic abnormalities, offer fetal therapy in selected cases, and predict long-term outcome. In conjunction with other specialists, this facilitates improved parental counselling and permits parents to make choices regarding continuation of pregnancy and allows preparation for the complex postnatal course. This contribution discusses four relatively common congenital abnormalities (talipes, exomphalos, gastroschisis, congenital diaphragmatic hernia) which require ongoing care in the antenatal setting and on the labour ward by obstetricians.
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