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A giant omphalocele in a preterm infant: the conservative approach
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  1. Felicia Drack1,
  2. Alexander Mack2,
  3. Walter Kistler2,
  4. Bjarte Rogdo1
  1. 1Paediatric and Neonatal Intensive Care Unit, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
  2. 2Department of Surgery, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
  1. Correspondence to Dr Bjarte Rogdo, bjarte.rogdo{at}kispisg.ch

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A routine antenatal ultrasound scan in the first trimester revealed a large omphalocele mainly occupied by liver in a female infant. Owing to preterm labour she was delivered by caesarean section at 29+4 weeks of gestation with a birth weight of 1450 g. No other malformations were present and her karyotype was normal.

The neonatal period was complicated by severe respiratory distress with pulmonary hypertension requiring prolonged high-frequency ventilation and inhaled nitric oxide. The infant developed bilateral grade 2 intraventricular haemorrhages. A haemodynamically significant ductus arteriosus was closed surgically. Owing to these complications, primary closure of the 4×4 cm large omphalocele (figure 1) was initially not feasible. Palliative care was considered, but was not …

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