It is normal for any mother or father to be worried if they see some of the organs in their little one's belly protruding through the navel. In medical terms, we call this condition Omphalocele. Although this may sound a bit scary, having the right understanding about it will help you cope with it. So, let's talk about it in detail.
What is Omphalocele? Let's understand it simply.
Simply put, an omphalocele is a congenital abnormality that occurs at birth . It is a condition in which organs that should be inside the baby's abdomen, such as the intestines, protrude through the belly button. However, these protruding organs are covered by a thin, transparent membrane . This membrane is made up of the lining of the abdomen called the peritoneum.
This is something that happens while the baby is still in the womb, that is, before birth. Let's see how this happens:
- Between 6 and 10 weeks of pregnancy: During this time, as the baby's intestines grow, they may push a little toward the umbilical cord. This is normal and nothing to worry about.
- By 11 weeks: Normally, the intestines that came out like this should go back into the abdomen. But if that doesn't happen, an omphalocele condition occurs.
Importantly, more than two-thirds of babies with omphalocele have it along with other conditions. For example:
* Spinal problems
* Digestive system problems
* Heart problems
* Urinary system problems
* Limb problems
There is another name for this, which is `(exomphalos)`.
What are the main types of Omphalocele?
This condition can be both minor and major. Accordingly, there are two types:
- Small Omphalocele: Here, a small portion of the intestine protrudes from the abdomen. The size of this protrusion is usually less than 5 centimeters.
- Large Omphalocele: Here, many of the abdominal organs (such as the intestines, liver, and spleen) have protruded from the abdomen. This is larger than 5 centimeters. Doctors also call this ``giant omphaloceles``.
How common is this condition called Omphalocele?
According to statistics from countries like America, about one in every 4,200 babies may develop this condition called Omphalocele. We see similar conditions in Sri Lanka as well.
Why do babies develop omphalocele?
As we've discussed before, it's normal for the umbilical cord to push inward as the intestines develop from the sixth to the tenth week of pregnancy. By the eleventh week, they should be back inside the abdomen. When this doesn't happen properly, an omphalocele occurs.
In fact, experts still can't say for sure why some babies get this and others don't. And they don't know if there's anything you can do to prevent it during pregnancy. So don't worry about it.
What are the risk factors for developing omphalocele?
Researchers are still investigating some of the risk factors that may contribute to this. Some of the possible factors include:
- Mother's age is over 35 years.
- Drinking alcohol during pregnancy.
- Exposure to certain chemicals or toxins: For example, things like pesticides or solvents.
- Genetics: Sometimes this condition can run in families. It can also be associated with chromosomal abnormalities. Examples: `(Trisomy 13)`, `(Trisomy 18)`, and `(Trisomy 21)`, which is `(Down syndrome)`.
- Maternal health conditions: Conditions such as maternal obesity, diabetes mellitus, and high blood pressure.
- Maternal nutritional deficiencies: A decrease in the mother's nutritional needs or certain vitamins during pregnancy.
- Smoking.
- Taking certain medications: Certain medications taken during pregnancy, for example, antidepressants called SSRIs or certain fertility drugs.
These are some of the risk factors that have been identified. However, it is important to remember that not everyone who has these factors will develop this condition.
What are the possible complications of Omphalocele?
Babies born with an omphalocele often have other complications, including:
- Beckwith-Wiedemann syndrome: This is characterized by a large tongue, elevated insulin levels, and low blood sugar.
- Chromosomal abnormalities.
- Heart malformations.
- The digestive process is slow.
- Lungs not developing properly.
Doctors usually diagnose this condition during pregnancy. They will then talk to you about it and explain what treatment is needed after the baby is born. As soon as the baby is born, the medical team will take the necessary steps to protect the baby and begin treatment.
How is this condition called Omphalocele diagnosed?
Doctors often detect this during an ultrasound scan during the second and third trimesters of pregnancy. It shows the baby's organs growing outside the wall of the womb. After this is detected, your doctor will likely order a fetal echocardiogram (an ultrasound scan of the baby's heart) to check for any abnormalities.
Sometimes it may not be detected during pregnancy. If that happens, it will be detected soon after the baby is born. Then the medical team can quickly take the necessary steps to protect the baby's health.
What tests will I and my baby need to undergo?
If your doctor diagnoses your unborn baby with this condition, you may need to have several more tests during the rest of your pregnancy. For example:
- Amniocentesis: This involves taking a sample of amniotic fluid from inside your uterus and testing it for chromosomal problems.
- Blood tests: Your blood will be checked for elevated levels of a protein called alpha-fetoprotein. This protein is made in the baby's liver and then passes into your blood. If the levels are high, it means that your baby needs further testing.
- MRI (Magnetic Resonance Imaging) Scan: This test may also be done to look at the baby's heart, lungs, and other organs.
- Ultrasound scan: Ultrasound scans are performed regularly to check how the baby is developing.
After your baby is born, the doctor will carefully examine the omphalocele and order further tests if necessary.
How is Omphalocele treated?
The way this is treated depends on several factors, namely:
- Gestational age is the week of pregnancy at which the baby was born.
- The baby's overall health.
- The severity of the condition.
- The size of the omphalocele.
- Omphalocele: Whether the membrane surrounding the umbilicus has not ruptured.
How to treat a small omphalocele
For a small omphalocele, surgeons will perform surgery right after the baby is born. This surgery involves putting the protruding organs back inside the baby's abdomen and closing the hole in the abdominal wall. This can help prevent infections and tissue damage.
How to treat a giant omphalocele
If your baby has a giant omphalocele, where many of the organs have protruded, surgeons usually perform the surgery in stages. They gradually put the organs back inside the baby's abdomen over a period of days or weeks. During this time, the organs are covered with a sterile sheet to protect them from infection.
Why is this done in several stages? This is the safest method for a giant omphalocele. Because the baby's belly is not big enough to hold all the organs at once, and it has not developed properly. If the organs are put in all at once, they will not get the blood flow they need. After a while, the baby's belly will get bigger. In most cases, a second operation is performed within two weeks to normalize it.
Sometimes the surgeon may need to pull some of the skin from the abdomen to close the hole. In other cases, a skin flap may be used to close the hole. This means that skin is taken from one part of the body and transplanted to another.
Babies with an omphalocele, where the abdominal cavity has not developed properly, may have difficulty breathing . They may need to be connected to a ventilator to help them breathe until they can breathe on their own.
Will my baby eat after the surgery?
By the time your baby is ready to go home, they are usually eating well. However, if they have other complications, such as heart or lung problems, they may need a feeding tube. However, most babies do not need this help.
Are there any restrictions on activities after surgery?
Your baby can do activities that are appropriate for his age and developmental level . Doctors will advise you about this.
Can Omphalocele be prevented?
Researchers are still looking for ways to stop this condition from occurring. It's not yet clear if there's anything specific you can do to prevent it during pregnancy.
But in general, you can try these things to reduce the risk of complications during your pregnancy and for your unborn baby:
- Avoid drinking alcohol.
- Quit smoking.
- Maintain a healthy weight that suits you.
What is the outlook for babies with omphalocele?
The outlook depends on the size of the omphalocele and whether the baby has other health problems.
If the only health problem is an omphalocele, your baby will likely recover completely. However, omphalocele is often accompanied by other birth defects. These conditions can have lasting effects on the baby's health and cause complications later in life. Your doctor will discuss this with you in detail.
What is the life expectancy of a baby with omphalocele?
Overall, 95% of babies born with an omphalocele survive. However, there are several factors that affect these statistics. For example, whether the baby has other health problems and what body systems those problems affect.
Your medical team is here to help you. They are the best people to help you understand your condition.
How do you deliver a baby with an omphalocele?
It is best to deliver your baby in a hospital with the necessary specialists and equipment, and to provide prompt care. Your doctor will discuss your delivery options with you. You may need to have a C-section, especially if your baby has a giant omphalocele.
When should I call my baby's doctor after surgery?
If you experience any of these symptoms after surgery, call your doctor immediately:
- If something like pus is draining from the wound.
- Fever.
- Vomiting, especially if it is green (this may indicate a bowel obstruction).
- If the wound is red.
Can an omphalocele heal on its own?
Very rarely, very small omphaloceles may close on their own. However, most babies with this condition will need surgery.
Finally, things to remember (Take-Home Message)
It's normal to feel scared and overwhelmed when you find out your baby has a congenital condition like omphalocele. The uncertainty of what's going to happen can add to the stress of pregnancy.
But don't forget, your medical team is always with you. Don't hesitate to ask them questions and seek their support. They will explain everything to you, from what to expect when you give birth to what your baby's care plan will be afterwards. You are not alone, we are all with you.
Omphalocele , birth defects, baby's belly button protruding, navel, abdominal organs, pediatric surgery
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