Question
A fetus has been delivered with a massive umbilical hernia. What are the causes, and what precautions should be taken when expecting the next child?
Answer
An umbilical hernia, also known as an embryonic umbilical hernia, is a congenital abdominal wall defect. This condition occurs when a part of the intestine protrudes through an abdominal wall defect at the umbilicus at birth, being covered only by a thin, transparent film of amniotic and peritoneal membranes. This is due to developmental abnormalities in the umbilical and abdominal wall tissues during fetal development, with abdominal organs herniating into the periumbilical membrane, forming an umbilical hernia. This condition is associated with chromosomal abnormalities, and approximately 30% to 50% of affected children may have other congenital malformations, including malrotation of the intestines, ear diverticula, intestinal atresia, and intestinal stenosis. For mothers preparing to have another child, it is recommended to undergo a comprehensive pre-pregnancy and prenatal health check-up, including chromosomal abnormality screening and genetic counseling. Pregnant women should follow a balanced diet, consume adequate folic acid and various vitamins to reduce the risk of neural tube defects and other malformations. Additionally, avoiding exposure to harmful substances such as alcohol, tobacco, and certain medications is an important preventive measure. Regular prenatal check-ups are also essential to detect any abnormalities early and provide appropriate treatment.