DOI: 10.26650/jchild.2026.1959609 ISSN: 1308-8491

Clinical Characteristics, Early Surgical Management, and In-Hospital Outcomes of Neonates with Omphalocele: A Single-Center Retrospective Cohort Study

Halime Sema Can Büker, Güler Azra İncebıyık, Rabia Demir, Oyhan Demirali, Gökhan Büyükkale
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Objective: Omphalocele is a rare congenital abdominal wall defect with a broad clinical spectrum, ranging from isolated small defects to complex cases associated with giant omphalocele, liver herniation, additional congenital anomalies, respiratory morbidity, and death. This study aimed to evaluate the clinical characteristics, early surgical management, and in-hospital outcomes of neonates with omphalocele treated in a tertiary neonatal intensive care unit.Material and Methods: This retrospective single-center cohort study evaluated 20 neonates diagnosed with omphalocele between 2015 and 2026; one infant was excluded because the final in-hospital outcome was unavailable at data closure. Demographic, prenatal, perinatal, respiratory, nutritional, surgical, and outcome data were reviewed from medical records. Data are presented as medians with interquartile range or number and percentage. Survivors and non-survivors were compared using appropriate non-parametric and exact tests.Results: A total of 19 neonates were included in the final analysis. Giant omphalocele was present in 10 infants (52.6%), liver herniation in 6 (31.6%), and associated congenital anomalies in 11 (57.9%). Invasive mechanical ventilation, including conventional ventilation and/or high-frequency oscillatory ventilation, was required in 15 infants (78.9%); high-frequency oscillatory ventilation was used as a rescue mode in 2 infants (10.5%), and inhaled nitric oxide in 4 (21.1%). Surgical intervention was performed in 13 infants (68.4%); 11 underwent primary repair and 2 underwent staged repair. The median day of the first surgical intervention was postnatal day 2 [IQR, 1–5]. In-hospital mortality occurred in 8 infants (42.1%). Non-survivors had significantly lower birth weight than survivors.Conclusion: In this single-center neonatal cohort, omphalocele was associated with a high burden of prematurity, associated congenital anomalies, invasive respiratory support requirement, and in-hospital mortality. Lower birth weight appeared to be an important marker of adverse outcomes. Early surgical management varied according to clinical condition and defect characteristics. These findings support antenatal diagnosis, detailed anomaly screening, appropriate genetic evaluation, and individualized multidisciplinary neonatal and surgical management.

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