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During the growth of the fetus, the intestines grow more rapidly than the abdominal cavity. For a period, a portion of the intestines of the unborn child usually lies outside the abdomen in a sac within the umbilical cord. Normally, the intestines return to the abdomen, and the defect is closed by the time of birth. Occasionally the abdominal wall does not close solidly, and umbilical hernia results. This defect is more likely to be seen in premature infants and in girls rather than boys. It usually closes by itself. Coughing, crying, and straining temporarily cause the sac to enlarge, but the hernia never bursts and digestion is not affected. If the defect in the abdominal wall has not repaired itself by the time the child is 2 years old, surgery to correct the condition (herniorrhaphy) can then be performed.
Umbilical hernia should be distinguished from omphalocele, in which the intestines protrude directly into the umbilical cord and are covered only by a thin membrane. Omphalocele is a surgical emergency that must be treated immediately after birth.
infanticideForensic medicine The active or semi-passive killing of a viable conceptus > 20 gestational wks, which breathes spontaneously. See Battered child syndrome, Child abuse. Cf Stillbirth.
um·bil·i·cal cord(ŭm-bil'i-kăl kōrd)
The umbilical cord is surgically severed after the birth of the child. To give the infant a better blood supply, the cord should not be cut or tied until the umbilical vessels have ceased pulsating. However, in preterm infants, the cord should be clamped and cut before pulsation ceases to avoid maternal-newborn transfusion and reduce the risk of hypovolemia, polycythemia, and hyperbilirubinemia.
The stump of the severed cord atrophies and leaves a depression on the abdomen of the child (the navel, umbilicus, or belly button).