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OmphaloceleTreatments

• What are my choices during this pregnancy?
• What will happen after birth?

What are my choices during this pregnancy?

Time intervals for ultrasound studies are decided on an individual basis. Usually, repeat studies are not necessary more than once a month, unless something is changing. For small omphaloceles with no other defects, the baby can be delivered normally at term in a center with pediatric surgeons available. Babies with very small omphaloceles can be safely transported for repair elsewhere, but most will benefit by being repaired shortly after birth in the same unit.

Large and giant omphaloceles should be delivered at a high level tertiary center with pediatric surgery expertise and very good neonatology support. These babies often require prolonged respiratory support during reconstruction. Often, babies with large omphaloceles are delivered by Cesarean section. This is done to minimize the risks to the baby and the mother. You and your obstetrician will determine your delivery plans.

What will happen after birth?

Your baby should be born at a hospital with an intensive care nursery and experienced pediatric surgeons. Soon after birth, your child will have surgery to close the opening in the abdominal wall and return the organs to the abdomen. The pediatric surgeon attempts to close the hole at the time of the surgery, but sometimes this is not possible. If the omphalocele is large, a silo is placed. A silo is a covering placed over the abdominal organs on the outside of the baby. Gradually, the organs are squeezed through the silo into the opening and returned to the body. This method can take up to a week.

Extremely large omphaloceles are not surgically repaired until the baby grows. They are treated by topical placement of painless drying agents on the omphalocele membrane. Babies born with omphaloceles can stay in the hospital from one week to one month after surgery, depending on the size of the defect. The baby's ability to tolerate feedings will determine the length of stay in the hospital.   Babies are discharged from the hospital when they are taking all their feedings by mouth and gaining weight. Most babies with small to medium omphaloceles do not have any long-term problems.

After discharge from the hospital, your baby is at risk for bowel obstruction due to scar tissue or a kink in a loop of bowel.   Symptoms of bowel obstruction include: 1) bilious (green) vomiting, 2) a bloated stomach, and 3) no interest in feeding. If any of these symptoms occur, you should contact your pediatrician immediatealy.