There is no treatment that is required prenatally unless there is a rupture of the exomphalos within the mother.
An intact exomphalos can be delivered safely vaginally and C-sections are also acceptable if obstetrical reasons require it.
There appears to be no advantage for delivery by C-section unless it is for a giant exomphalos that contains most of the liver.
In this case vaginal delivery may result in dystocia (inability of the baby to exit the pelvis during birth) and liver damage.
Immediately after birth a nasogastric tube is required to decompress the intestines and an endotracheal intubation is needed to support respiration.
The exomphalos sac is kept warm and covered with a moist saline gauze and plastic transparent bowel bag to prevent fluid loss.
The neonate also requires fluid, vitamin K and antibiotic administration intravenously.
  After management strategies are applied, a baby with an intact sac is medically stable and does not require urgent surgery.
This time is used to assess the newborn to rule out associated anomalies prior to surgical closure of the defect.
Studies show there is no significant difference in survival between immediate or delayed closure.

Surgery can be performed directly for small omphaloceles, which will require a short stay in the nursery department, or in a staged manner for large omphaloceles, which will require several weeks stay.
Staged closure requires a temporary artificial holding sac (a silo) to be placed over the abdominal organs and sutured to the abdominal wall.
This can be made of non-adhesive dressing.
The silo is gradually reduced in size at least once daily until all of the viscera have been returned to the abdominal cavity.
This is repeated for several days to a week until surgical closure of the fascia/skin can be done.
Closure may require a patch that can be rigid or non-rigid and made of natural biomaterials such as a bovine pericardium or artificial materials.
The skin is then closed over the patch and it is re-vascularised by the body's liver blood vessels post-surgery.
The staged surgery is required, as rushed reduction of the exomphalos compromises venous return and ventilation, as it raises intra-abdominal pressure.
In some cases, stretching of the abdominal wall to accommodate intestinal contents may be required.

Non-operative therapy uses escharotic ointments.
This is used for infants with large omphaloceles that have been born prematurely with respiratory insufficiency and associated chromosomal defects, as they would not be able to tolerate surgery.
The ointment causes the sac to granulate and epithelialize, which leaves a residual large ventral hernia, which can be repaired later with surgery when the baby is more stable.
After surgery, for larger omphaloceles, mechanical ventilation and parenteral nutrition is needed to manage the baby.
There is no treatment that is required prenatally unless there is a rupture of the exomphalos within the mother. An intact exomphalos can be delivered safely vaginally and C-sections are also acceptable if obstetrical reasons require it. There appears to be no advantage for delivery by C-section unless it is for a giant exomphalos that contains most of the liver. In this case vaginal delivery may result in dystocia (inability of the baby to exit the pelvis during birth) and liver damage. Immediately after birth a nasogastric tube is required to decompress the intestines and an endotracheal intubation is needed to support respiration. The exomphalos sac is kept warm and covered with a moist saline gauze and plastic transparent bowel bag to prevent fluid loss. The neonate also requires fluid, vitamin K and antibiotic administration intravenously.   After management strategies are applied, a baby with an intact sac is medically stable and does not require urgent surgery. This time is used to assess the newborn to rule out associated anomalies prior to surgical closure of the defect. Studies show there is no significant difference in survival between immediate or delayed closure.
Surgery can be performed directly for small omphaloceles, which will require a short stay in the nursery department, or in a staged manner for large omphaloceles, which will require several weeks stay. Staged closure requires a temporary artificial holding sac (a silo) to be placed over the abdominal organs and sutured to the abdominal wall. This can be made of non-adhesive dressing. The silo is gradually reduced in size at least once daily until all of the viscera have been returned to the abdominal cavity. This is repeated for several days to a week until surgical closure of the fascia/skin can be done. Closure may require a patch that can be rigid or non-rigid and made of natural biomaterials such as a bovine pericardium or artificial materials. The skin is then closed over the patch and it is re-vascularised by the body's liver blood vessels post-surgery. The staged surgery is required, as rushed reduction of the exomphalos compromises venous return and ventilation, as it raises intra-abdominal pressure. In some cases, stretching of the abdominal wall to accommodate intestinal contents may be required.
Non-operative therapy uses escharotic ointments. This is used for infants with large omphaloceles that have been born prematurely with respiratory insufficiency and associated chromosomal defects, as they would not be able to tolerate surgery. The ointment causes the sac to granulate and epithelialize, which leaves a residual large ventral hernia, which can be repaired later with surgery when the baby is more stable. After surgery, for larger omphaloceles, mechanical ventilation and parenteral nutrition is needed to manage the baby.
Omphalocele