Persistent Pulmonary Hypertension of the Newborn (PPHN)

Persistent pulmonary hypertension of the newborn (PPH) is a condition that affects the blood flow to an infant’s lungs at delivery. When an infant is born, the blood pressure in the lungs should drop and the circulation changes in order for the baby to breathe alone. However, PPHN causes an infant to revert back to fetal circulation, in which blood flow bypasses the lungs, preventing the baby from breathing.

According to the Children’s Hospital of Philadelphia, at least one out of every 500 to 700 infants will develop PPHN.

Can PPHN Be Prevented?

Doctors now believe that a child has an increased risk in PPH if the mother increases the selective serotonin reuptake inhibitors (SSRIs) during the last trimester of pregnancy. Sometimes an indication of SSRIs could be maternal depression.

What are the Symptoms of PPHN?

The symptoms of PPHN may differ according to each infant. While one baby may exhibit all of the typical symptoms, another may only exhibit a few. The most common symptoms associated with PPHN include:

  • Blue-tint to the skin
  • The infant may appear ill shortly after birth
  • Rapid heartbeat and rapid breathing
  • Oxygen levels that stay low after the infant receives 100% oxygen

How Can PPHN Be Treated?

The most important thing is that the medical staff members get your child breathing again. Even if an infant is breathing in 100% pure oxygen, PPHN still results in poor blood oxygen levels.

Methods of treatment may include include:

  • Continuous monitoring of oxygenation and blood pressure
  • Maintaining a normal blood pressure
  • Correction of glucose and electrolyte abnormalities
  •  Nutritional support
  • Minimal handling of the newborn, and
  • Minimal use of invasive procedures.

Once these methods have been executed, the baby may require other therapeutic methods such as:, assisted ventilation, nitric oxide, high frequency oscillatory ventilation, inotropic support, surfactant administration, high-frequency ventilation, ECMO, endotracheal intubation, correction of acidosis and alkalosis, hearing evaluation, and a postdischarge neurologic evaluation by a neurologist or developmental pediatrician.

What is the Risk of PPHN?

PPHN keeps your baby from breathing normally. This is extremely dangerous to your baby’s health because the longer an infant is deprived of oxygen, the more hypoxic the baby’s blood becomes. This kind of oxygen deprivation can cause the baby’s brain to react adversely, causing long-term cognitive problems such as a learning disability, autism, and/or ADHD.

Infant death can also occur in severe cases of PPHN, although with immediate medical intervention, the chances of mortality are lowered significantly.