Omphalocele or omphalocele is a birth abnormality (congenital abnormality) characterized by the exit of organs in the baby's abdominal cavity, such as the stomach, intestines, and liver, through the navel. Omphalocele can be detected since the baby is still in the womb, it can also be seen after the baby is born.
Omphalocele is a rare birth defect. Research results show that omphalocele occurs in 1 in 5,000 births.
Omphalocele is often equated with gastroschisis , although the two are different conditions. In omphalocele, the protruding organ is covered by a membrane. While in gastroschisis, the organ that comes out is not covered by a membrane.
Causes of Omphalocele
Omphalocele occurs as a result of abnormal fetal development. Normally, at 6–10 weeks of gestation, the intestines and internal organs of the fetus, such as the liver, bladder, stomach, ovaries, or testicles, protrude toward the navel.
The protruding organs will return to the abdominal cavity when the pregnancy age enters the 11th week. However, in babies with omphalocele, the intestines and organs that protruded earlier did not go back into the abdominal cavity.
It is not known exactly what causes an omphalocele. However, this condition is suspected to be related to changes (mutations), or abnormalities in genes or chromosomes.
Risk factors for omphalocele
Although the exact cause is not yet known, there are a number of factors that if done or experienced by pregnant women can increase the risk of omphalocele, namely:
- Consuming alcoholic beverages
- Has a smoking habit
- Using SSRI antidepressants ( selective serotonin-reuptake inhibitors )
- Suffering from obesity
Babies who suffer from omphalocele also often suffer from other genetic abnormalities, such as Turner syndrome, Patau syndrome ( trisomy 13 ), Edward syndrome (trisomy 18), Down syndrome (trisomy 21), Beckwith-Wiedemann syndrome, and congenital abnormalities in the spine, heart, and digestive organs.
Omphalocele is easy to recognize because the symptoms are quite clear, namely the exit of internal organs through the navel hole. The organ that comes out of the navel is covered by a protective membrane.
In mild omphalocele, the hole formed is not too big so that only one of the organs or only part of the intestine comes out. While in severe cases, the hole formed is large enough that the intestines, liver, bladder, stomach, and testicles can also come out.
When should you go to the doctor?
If you are pregnant, check the pregnancy routinely to the doctor. In addition to keeping the pregnancy healthy, pregnancy tests can detect if the fetus suffers from omphalocele.
If the fetus is known to have an omphalocele, the doctor will recommend that pregnancy tests be done more often. The purpose is to monitor the development of the fetus and to plan a delivery method that suits the condition of the pregnant mother and the fetus.
Diagnosis of Omphalocele
Omphalocele can be detected when the baby is still in the womb or after birth. In the fetus, omphalocele can be detected through pregnancy ultrasound, especially in the second and third trimester of pregnancy. When an omphalocele is detected, the doctor will perform a series of examinations on the fetus, such as:
- Fetal echocardiogram , to see the function and image of the heart in the fetus
- Genetic examination with amniocentesis , to detect genetic abnormalities
In newborns, omphalocele can be seen through physical examination. If a baby is born with an omphalocele, the doctor will also perform a supporting examination, such as an X-ray, to see the possibility of abnormalities in other organs.
Treatment of omphalocele is an operation aimed at reinserting the protruding organ into the abdominal cavity. The timing of the operation depends on the condition of the baby and the severity of the omphalocele suffered. If the omphalocele is classified as mild, the operation will be performed immediately after the baby is born.
Whereas if the omphalocele is classified as severe, the organ will be inserted into the stomach gradually. This is because the baby's abdominal cavity is still in development. While waiting for the baby's abdominal cavity to develop, the doctor will perform some of the following treatments:
- Place the baby in an incubator to keep it warm
- Installing breathing aids or ventilators
- Give fluids and food through infusion
- Installing a nasogastric tube to suck fluid and air from inside the abdominal cavity
- Apply antibiotic cream to the membrane that lines the organs outside the abdomen to prevent bacterial infection
- Envelops the protruding organ with a special protector to prevent dehydration
After the baby's abdominal cavity expands, the operation will be performed again to insert the organs that come out, then the holes where the organs come out will be closed and sewn up.
Complications of Omphalocele
Omphalocele can cause a number of complications, both before and after the baby is born. These complications include:
- Developmental delay
- Difficulty eating and breathing
- Infection due to rupture of the organ's protective membrane
- Tissue death in organs that come out of the navel due to lack of blood supply
To reduce the risk of omphalocele, pregnant women will be advised to routinely undergo pregnancy check -ups with a gynecologist, adopt a healthy lifestyle, and not consume drugs without consulting a doctor first.
Some other steps that can be taken during pregnancy are:
- Consume balanced nutritious food
- Consuming vitamins or supplements given by a doctor, including folic acid
- Do not smoke and do not consume alcoholic beverages
- Maintain an ideal weight