What Is an Omphalocele?
A baby born with an omphalocele has an opening where the umbilical cord goes into
the belly. A membrane or thin sac that covers the internal organs bulges through the
opening.
An omphalocele (ahm-FAL-uh-seel) happens because the belly wall doesn't close as
it should.
Some omphaloceles close on their own, but many need treatment, including surgery.
Some kids born with omphaloceles have other health problems too.
What Causes Omphaloceles?
An omphalocele happens while a baby is developing in the womb. The baby's belly
muscles don't close completely to keep the internal organs inside the belly. Doctors
think this might happen because of changes in genes
or chromosomes. Or, it might be a combination of genes and things going on in the
environment.
A baby born with an omphalocele is more likely to have other problems, such as:
- extra chromosomes, like trisomy 13, trisomy 18, or trisomy 21 (Down
syndrome)
- genetic syndromes, like Beckwith-Wiedemann syndrome
- gastrointestinal problems
- cleft lip
and palate
- heart defects
How Are Omphaloceles Diagnosed?
Sometimes an omphalocele shows up on a prenatal
ultrasound or other routine
tests done during pregnancy. If doctors find out that a baby has an omphalocele
before birth, they may do more tests to see if the baby has another health problem.
Sometimes doctors don't know a baby has an omphalocele until birth.
How Are Omphaloceles Treated?
If a baby is diagnosed with an omphalocele before birth, the parents
and care team will plan to:
If a baby is diagnosed with an omphalocele at birth, the care
team will develop a plan. Treatment for an omphalocele depends on its size and whether
it has ruptured (burst open).
- A small omphalocele may not need any treatment, or a surgeon
may do a minor procedure to close it with stitches within a few days of birth. The
baby probably will spend a few days in the hospital. After that, babies with small
omphaloceles usually don't need more treatment.
- A large omphalocele (called a giant omphalocele)
usually gets treated in stages. This lets the baby's belly muscles grow and form more
fully, making surgery more successful. The stages of treatment are:
- Wrap: At birth, the omphalocele is wrapped in moist gauze until
a pediatric surgeon checks the baby. The surgeon then decides the best plan for treatment,
including how to care for the omphalocele and when to do surgery.
- "Paint and wait": Parents learn how to "paint" the omphalocele
with an antibiotic mixture. They do this over a period of months while their baby's
skin grows over the sac.
- Surgery: Usually several months after the painting process, doctors
do one or more surgeries to fix the omphalocele.
- A ruptured omphalocele needs special treatment. An omphalocele
can burst open (rupture) as the baby is being born. It needs special treatment because
the ruptured membrane can't protect the organs inside the belly. The surgeon will
replace the membrane with a patch.
Some babies with omphaloceles may need to spend extra time in the hospital if they
have trouble with breathing or feeding, or other medical problems.
The care team typically includes a pediatric surgeon, a neonatologist (a pediatrician
specializing in complex newborn care), and NICU
critical care nurses. If doctors diagnose a baby's omphalocele during pregnancy,
the care team also might include a high-risk pregnancy specialist (called a maternal-fetal
medicine specialist or perinatologist).
What Can Parents Do?
If your baby has an omphalocele, your care team will be there to guide you. Be
sure to:
- Learn all about wound care before taking your baby home from the hospital so you
can help your child heal well.
- Go to all follow-up visits with the surgeon.
- Meet with any specialists your doctor recommends (for example, a registered dietitian
or genetic counselor).
