Article Open Access

Multidisciplinary Management in Late-Pregnancy Fetal Omphalocele: A Case Report of Prenatal Diagnosis and Perinatal Planning
(1) * Yusi Farida Mail (Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sriwijaya, Palembang 30126, Indonesia)
(2) Nurul Islamy Mail (Faculty of Medicine, Lampung University/ Abdul Moeloek General Hospital, Dr. Rivai Street No. 6, Tanjung Karang, Lampung, Indonesia)
*Corresponding author

Abstract


Omphalocele is a congenital anterior abdominal wall defect characterized by herniation of abdominal viscera into the base of the umbilical cord, covered by a membranous sac. The condition is associated with significant perinatal morbidity and mortality, particularly when accompanied by other congenital anomalies. Prenatal diagnosis allows comprehensive counseling and multidisciplinary planning to optimize maternal and neonatal outcomes. To describe the clinical presentation of a pregnancy complicated by fetal omphalocele and to highlight the role of multidisciplinary decision-making in determining the optimal timing and mode of delivery. A 20-year-old primigravida (G1P0A0) at 35 weeks of gestation was referred with a singleton live fetus in cephalic presentation diagnosed prenatally with omphalocele. Maternal condition was stable and no signs of labor were present. Detailed fetal evaluation and multidisciplinary consultation involving obstetrics, neonatology, pediatric surgery, and anesthesiology were conducted. A joint conference was held to determine perinatal management and delivery planning, taking into consideration gestational age, fetal condition, anticipated neonatal surgical needs, and available healthcare resources. Individualized management was established to optimize neonatal stabilization and postnatal surgical intervention. Prenatal identification of fetal omphalocele requires coordinated multidisciplinary management. Joint decision-making facilitates individualized delivery planning, improves perinatal preparedness, and may contribute to better maternal and neonatal outcomes.

Keywords


Omphalocele; Prenatal Diagnosis; Multidisciplinary Management; Perinatal Planning

   

DOI

https://doi.org/10.33122/ejeset.v7i1.1536 		      

Article metrics

Abstract views : 0 | PDF views : 0

   

Cite

How to cite item
   

Full Text

Download

References


Akinkuotu, A. C., Sheikh, F., Okitoye, O. O., et al. (2015). Giant omfalokel: Surgical management and perinatal outcomes. Journal of Surgery, 1–5.

Antara, P., & Artana, W. (2018). Insidens dan karakteristik kelainan kongenital traktus gastrointestinal pada neonatus di Rumah Sakit Umum Pusat Sanglah Denpasar tahun 2015. Medicina, 423–427.

Bastiani, M., Sartore, L., Melfi, F., et al. (2019). Prenatal diagnosis of omphalocele: Ultrasound and magnetic resonance imaging features. Journal of Pediatric Surgery, 54(4), 689–695. https://doi.org/10.1016/j.jpedsurg.2019.01.025

Bauman, B., Stephen, D., & Gerstone, H. (2016). Management of giant omfalokels: A systemic review of methods of staged surgical vs nonoperative delayed closure. Journal of Pediatric Surgery, 45–48.

Bielicki, I., Somme, S., Frongia, G., & Holland-Cunz, S. (2021). Abdominal wall defects: Current treatments. Children, 8, 170–173.

Brady, M., Lee, J., Krishnan, N., et al. (2021). The role of maternal diabetes in the development of omphalocele: A case-control study. Diabetes Research and Clinical Practice, 172, Article 108670. https://doi.org/10.1016/j.diabres.2021.108670

Cavallo, A., Raffaelli, M., Mancuso, M., et al. (2019). Omphalocele: A review of pathogenesis, diagnosis, and management. Journal of Pediatric Surgery, 54(7), 1304–1312. https://doi.org/10.1016/j.jpedsurg.2019.01.041

Chircor, L., Medhedinhi, R., & Hincu, M. (2018). Risk factor related to omfalokel and gastroschisis. Journal of Morphology and Embryology, 50(4), 645–649.

Conner, P., Vejde, J. H., & Burgos, C. M. (2018). Accuracy and impact of prenatal diagnosis in infants with omfalokel. Pediatric Surgery International, 34(6), 629–633.

Fogelstrom, A., Caldeman, C., Granstrom, A., & Burgos, C. (2021). Omphalocele: National current birth prevalence and survival. Pediatric Surgery International, 37, 1515–1520.

Hijkoop, A., Peters, N. C. J., Lechner, R. L., Van Bever, Y., Tibboel, D., Wijnen, R. M. H., Cohen-Overbeek, T. E., & IJsselstijn, H. (2019). Omfalokel: From diagnosis to growth and development at 2 years of age. Archives of Disease in Childhood – Fetal and Neonatal Edition, 104(1), 18–23.

Linnaus, M., Donato, B., Mahon, M., et al. (2016). A case traumatic rupture of giant omfalokel and liver injury. Journal of Pediatric Surgery, 14, 4–7.

Maritska, Z., & Kinanti, S. R. A. (2016). Kejadian dan distribusi kelainan kongenital pada bayi baru lahir di RS dr. Moehammad Hoesin Palembang periode Januari–November 2015. Jurnal Kedokteran Unila, 1(2), 347–350.

Nishida, H., & Tanaka, S. (2012). Prenatal diagnosis of omphalocele and its management. Pediatric Surgery International, 28(11), 1039–1044. https://doi.org/10.1007/s00383-012-3123-9

Roux, N., Jakubowicz, D., Salomon, L., Grangé, G., Giuseppi, A., Rousseau, V., Khen-Dunlop, N., & Beaudoin, S. (2018). Early surgical management for giant omfalokel: Results and prognostic factors. Journal of Pediatric Surgery, 53(10), 1908–1913.

Smith, K. L., & Smith, G. C. (2020). Ultrasonographic diagnosis of omphalocele in the second trimester: Evaluation of predictive factors. In Maternal-fetal medicine: Principles and practice (5th ed., pp. 507–515). Elsevier.

Sundgren, N. C., Kelly, F. C., Weber, E. M., Moore, M. L., Gokulakrishnan, G., Hagan, J. L., Brand, M. C., Gallegos, J. O., Levy, B. E., & Fortunov, R. M. (2017). Improving communication between obstetric and neonatology teams for high-risk deliveries: A quality improvement project. BMJ Open Quality, 6(2), 1–8.

Valdés, J., García, R., Cortés, A., et al. (2017). Congenital abdominal wall defects: Omphalocele and gastroschisis. The American Journal of Surgery, 214(1), 166–171. https://doi.org/10.1016/j.amjsurg.2017.01.048


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

 
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0