Current issues of diagnosis and treatment of neonatal omphalocele

Abstract

The review of topical issues of diagnostics and treatment of malformation of the anterior abdominal wall - omphalocele in newborns is presented. Currently, there are no specific, recognized criteria acceptable for the maintaining and further managing pregnancy, delivery and treatment of children with omphalocele. Prenatally, the possibility of predicting the tactics of surgical treatment and postoperative management of a newborn with omphalocele is not taken into account. In the choice of tactics of treatment of this category of patients there is a need to consider many factors, namely: the data for the antenatal diagnosis of the defect, duration of respiratory support at the stage of preparation for surgery, age at the time of surgical treatment, the size of the hernia SAC, and the size of the liver in the hernia SAC. These criteria are necessary to determine the possibility of radical surgery for the anterior abdominal wall or stage-by-stage treatment with the creation of a temporary abdominal cavity, with preliminary gradual immersion of the evented organs into the abdominal cavity under the control of the child’s hemodynamic and respiratory parameters, with the dynamic control of the occurrence and progression of pulmonary hypertension under the ultrasound control. To date, a unified approach has not been developed in the surgical treatment and postoperative care of newborns with omphalocele. The use of a variety of methods of surgical correction and their modifications reveals extensive potential for the treatment of different form of exomphalos, but leads to the fact that some of these techniques find their applications in a single universally accepted treatment of this condition. The lack of unified standards of prevention and organization of treatment approaches for newborns with various forms of omphalocele makes this problem very relevant. When preparing a literary review, such databases as PubMed, MedLine, CyberLeninka, and RSCI were used.