WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Dr. Harith Hameed Majeed*, Dr. Rekan Moflih Darak and Dr. Waad Idrees Abdullah

ABSTRACT

Background: Omphalocele is an anterior abdominal wall defect at the base of the umbilical cord, with herniation of the abdominal contents. The herniated organs are covered by the parietal peritoneum. After 10 weeks of gestation the amnion and Wharton jelly also cover the herniated mass. This defect needed to be closed either by a primary closure or staged closure. Objectives: To evaluate the prenatal diagnosis, post delivery management including surgical correction and prognosis in Mosul. Patients and methods: A prospective study of twenty patients with Omphalocele was conducted in pediatric surgery center at Al-Khansaa Teaching Hospital in Mosul from January 2005 to January 2008. The medical records of the patients were recorded for prenatal diagnosis, birth order, sex, weight, type of delivery, maternal age, gestational age, size of the defect, associated anomalies, treatment, and outcome. All patients had been examined to exclude associated congenital anomalies. All patients investigated for blood group, blood glucose and urea, echo-cardiography and ultra sound of abdomen done for them. Vitamin K was given to all patients as 1mg/kg in single dose. All patients had preoperative treatment with nasogastric tube for decompression of the GIT, kept in the incubator, I.V fluid given, I.V antibiotic and oxygen as needed. Results: Twenty full term patients, ten male and ten female. Diagnosis of all of patients was done clinically by inspection, while five of the patients were diagnosed prenatally by ultrasound examination (25.0%). All patients had normal birth weight. Only three of our patients had C\S delivery (15.0%) while the rest were product of normal vaginal delivery. Only one patient had rupture of the sac at presentation (5.0%). A fifteen patients treated successfully by primary closure (83.4%), three patients treated by staged closure (16.6%). two patients died preoperatively (10.0%) secondary to sepsis because of low birth weight and associated anomalies, one patient died postoperatively (5.0%) for the same reasons. Conclusion: All our patients were full term infants. No difference in male to female ratio. Omphalocele minor not interfere with birth weight. C\S have no additional benefit over normal vaginal delivery. Mortality is high in patients have major associated anomalies or big defect. The treatment is surgical include removal of the sac and primary closure or staged closure. The post operative period was smooth for 90.0% of the patients.

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