Omphalocele, a genetic abdominal wall defect, often causes great consternation in parents. Babies with omphalocele have intestines that protrude through an opening in the abdomen. Small omphalocele defects occur in one in 5,000 births, while giant omphalocele, which may also involve the liver, occurs in one in 10,000 births, Children's Hospital of Philadelphia explains. Omphalocele is often associated with other defects and can cause several problems in the newborn.
Feeding Problems
Babies with omphalocele require intravenous feeding until the bowel heals if surgery is done right after birth to repair a small omphalocele. Larger omphaloceles take up to several weeks to fit back into the abdominal cavity; during this time intravenous feeding takes the place of feedings by mouth. Once the omphalocele repair is completed, some infants have difficulty eating normally and may require tube feeding. Gastroesophageal reflux, the passage of partially digested food from the stomach into the esophagus, causing irritation to the tissue inside the esophagus, may occur after omphalocele repair, and may require tube feeding and medication, Minnesota Neonatal Physicians reports.
Genetic Anomalies
Around 30 percent of babies with omphalocele also have genetic abnormalities, such as Trisomy 13,18 or other lethal chromosomal abnormalities, according to Minnesota Neonatal Physicians. Only 1 percent of these babies survive. Approximately 35 percent have heart defects, while 50 percent have major organ defects, including heart defects, the same source states.
Lung Problems
Babies with omphalocele may develop respiratory problems necessitating mechanical ventilation after birth. Pulmonary hypoplasia, or underdeveloped lungs, frequently complicates omphalocele and may require long term ventilation. Only 50 percent of babies with pulmonary hypoplasia survive, according to Minnesota Neonatal Physicians. Even babies with normal lung function may need mechanical ventilation before surgery, and will be ventilated mechanically during surgery and for varying periods of time afterward. The pressure of the intestines against the lungs after repair can cause temporary breathing difficulties.
Infection
The intestines in omphalocele are often covered with a membrane that protects them from infection. Any break in the membrane can lead to infection. Sterile dressings and application of antibiotic ointments may protect the intestines from infection until they can be replaced in the abdominal cavity, the Encyclopedia of Surgery explains.
Obstruction
Bowel function is normal in omphalocele, but obstruction can develop after surgery from scar tissue twisting the bowel. Symptoms of bowel obstruction include vomiting greenish fluid, appetite loss and stomach distention, the University of California San Francisco states. Bowel obstruction requires immediate attention and possible surgery to prevent bowel death, or necrosis.
