Gastrointestinal congenital anomalies requiring surgery: diagnosis, counselling, and management

Abstract

Key content Congenital anomalies affect more than 2% of fetuses in the UK, with 70% noncardiac in origin. Around 10% are gastrointestinal anomalies such as abdominal wall defects and intestinal atresias. Most gastrointestinal anomalies require postnatal surgical management. Obstetricians must understand the key features of diagnosis and management of common gastrointestinal anomalies. Clinically relevant and evidence‐based information helps facilitate parental reproductive autonomy through timely and informed counselling, planning for delivery and optimising perinatal outcomes. Management of pregnancies complicated by congenital gastrointestinal anomalies requires a multidisciplinary approach with specialist input. Learning objectives To be familiar with the antenatal diagnosis of gastrointestinal anomalies, associated conditions and potential obstetric complications To understand the antenatal and postnatal management of gastrointestinal anomalies including the approach to surgery To appreciate the role of multidisciplinary counselling in fetal medicine Ethical issues Antenatal counselling in the context of diagnostic and outcome uncertainties Consideration of termination of pregnancy for fetal anomaly, including grounds for, and timing of, decision‐making