Fetal hiatal hernia of the esophagus, which is detected by a 4D ultrasound at 24 weeks of pregnancy, generally does not greatly affect the growth and development of the fetus and the pregnancy can be continued. Esophageal hiatal hernia is a common gastrointestinal disorder in which abdominal organs enter the thoracic cavity through an enlarged esophageal hiatus. Fetal esophageal hiatal hernia is a congenital anomaly that occurs during development and is generally not treatable with medications or physical methods. Generally speaking, there is no need to be overly anxious when the fetus is detected with esophageal hiatal hernia through 4D ultrasound during pregnancy, and the condition can be delivered normally. However, the newborn after delivery needs to be examined promptly, and the doctor will determine whether the newborn needs surgery and the timing of the surgery according to the situation. During pregnancy, you need to visit your doctor regularly for various checkups. If you find out that your baby is suffering from a congenital disease, you need to consult your doctor and listen to his/her advice before deciding whether or not to continue with the pregnancy. You should also seek immediate medical attention for any discomfort during pregnancy.