The mother will deliver her baby in the presence of trained specialists, and in most cases will be able to see and hold the baby after delivery.
The baby will be stabilized in the intensive care unit. An intravenous line will be placed in an arm or a leg, so that fluids can be given. Because of the exposed intestines, the baby is likely to lose a lot of fluid by evaporation, and is likely to cool off more rapidly as well. He or she will therefore be placed under a warmer, and the loops of bowel will be carefully wrapped to protect them from the outside. If the baby shows signs of distress, it is possible that he or she will be intubated to aid with breathing.
Once it is clear that there are no major problems, the baby will undergo surgical repair. The type of procedure will depend on how much of the intestines and other organs are exposed, and the size of the baby. In many cases, all the intestines can safely be placed back in the abdomen (called "primary repair"), and the abdominal wall can be closed.
Often, however, too much of the intestines are out that they cannot be safely replaced all at once. In that case, we try to protect the intestines until they are ready to be put back in the abdomen. We place a "silo" (a clear plastic or silicone pouch) over the intestines, so that they are shielded from trauma, infection and dehydration. This can be done at the bedside, in the intensive care unit or in the operating room.
Once the swelling has gone down and the abdomen has become used to the presence of more bowel, the silo can be removed and the abdomen closed over the intestines. This typically takes a few days to a week.
The Fetal Treatment Program is a partnership of Hasbro Children's Hospital, Women & Infants' Hospital and The Warren Alpert Medical School of Brown University.