Omphalocele

Question 1

It is a protrusion of the abdominal contents through the abdominal wall at the point of junction of the umbilical cord and abdomen

Answer 1

Omphalocele

Question 2

What are the usual herniated organs

Answer 2

Intestines, sometimes liver and stomach

Question 3

What covers the organs

Answer 3

Transparent layer of peritoneum

Question 4

When does this condition occur

Answer 4

6-8 weeks of intrauterine life where the abdominal contents growing faster than the abdomen

Question 5

When the abdomen has enlarged sufficiently, when doe the intestines return

Answer 5

7 to 10 weeks

Question 6

Therapeutic management

Answer 6

Immediate surgery to prevent rupture
For larger omphalocele - application of silver sulfadiazine to prevent infection followed by delayed surgery

Question 7

Before surgery

Answer 7

Make sure to not rupture or dry or cracked
avoid exposure to air for rapid heat loss
Place baby in warmed incubator
Do not leave infant in radiant heat source

Question 8

Assessment

Answer 8

Elevated MSAFP examination during pregnancy
Obvious at birth
If determined in utero, cesarean may be performed

Question 9

Do’s and don’ts

Answer 9

Keep sac moist by applying sterile saline-soaked gauze or sterile plastic bowel bag until surgery
The covers must be at body temperature to prevent heat loss
NGT to prevent intestinal distention
Do not feed orally or suck on pacifier
Observe for obstruction when infant starts feeding