ABSTRACT
In our community, majority of deliveries are at home and most have no intra-uterine fetal monitoring. Many congenital anomalies, including omphaloceles, are diagnosed after birth. Almost all such cases are transported to health facilities, wrapped in dirty clothing, and are heavily contaminated with established sepsis. Even in tertiary centers like ours, resuscitative and ventilatory facilities have several limitations. Under these circumstances, we have devised a line of management on conservative lines and in stages, for contaminated omphalocele major. This seems to offer the best chance of survival to the infants. The present report is of three children presented at the Children's Hospital PIMS, Islamabad. Their mode and state of presentation and method of management are discussed, which highlights several important features of this condition in our set-up. A review of literature is also presented