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22Obstetrics19 min read

Congenital abnormalities

1. Big picture

Congenital abnormalities are structural, chromosomal, genetic, or functional fetal disorders present before birth. In obstetrics, the examiner wants you to think like this:

Detect early → define severity → check genetics/infection/teratogen causes → counsel parents → plan pregnancy, delivery, neonatal care, or termination where appropriate.

Most mothers are asymptomatic. The abnormality is usually suspected by:

  • abnormal first-trimester screening
  • abnormal cell-free DNA screening
  • abnormal maternal serum alpha-fetoprotein
  • abnormal 18–22-week fetal anomaly scan
  • abnormal amniotic fluid volume, fetal growth, hydrops, or fetal movements

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