PPHN Persistent Pulmonary Hypertension of the Newborn

PPHNJust because it is a natural process does not mean that giving birth is a perfect one. All kinds of things can unfortunately go wrong during delivery. Although it definitely is not fun to think about, it is important that you understand the various risks posed during pregnancy. One such threat comes from persistent pulmonary hypertension of the newborn (PPHN).

What Is PPHN?

PPHN is a condition that affects the blood flow of your infant’s lungs during the delivery process. When a baby is being born, the blood pressure in their lungs is supposed to drop while the circulation changes so that the baby can breathe alone. However, when PPHN occurs, the baby returns to fetal circulation, which sees blood flow bypassing the lungs. As a result, the baby cannot breathe. As scary as this may appear, it is actually relatively common. According to the Children’s Hospital of Philadelphia, one out of every 500 to 700 babes will be born with PPHN.

Warning Signs

There is only one real sign that doctors think represents an indication that PPHN will occur: if there is an increase in the selective serotonin reuptake inhibitors (SSRIs) in the mother during her last trimester. Maternal depression may be a sign of this.

Symptoms of PPHN

PPHN can display a number of different symptoms, depending on the child. One baby could exhibit all of them while another only shows a few. However, the most common PPHN symptoms to be aware of are:
  • A blue tint to their skin
  • Looking ill immediately after birth
  • Rapid heartbeat and breathing
  • Low oxygen levels even after the baby is given 100% oxygen
Simply put, the real danger that comes from PPHN is that your child is not breathing normally. When this occurs at birth, it makes your child’s blood more and more hypoxic. Oxygen deprivation is never good for someone’s blood, but is especially dangerous in babies. If a newborn’s brain was to have an adverse reaction, long-term cognitive problems could arise. This may include ADHD and other learning disabilities. However, it could also result in something as serious as autism. In the most severe of cases, PPHN can actually cause infant death. Fortunately, if medical intervention happens immediately, the chances of infant mortality drop significantly.

Treating PPHN

The good news is that this affliction can be treated. Obviously, the most important thing the medical staff can do after noticing PPHN in your baby is getting them to breathe as soon as possible. Just because an infant is breathing does not mean their blood oxygen levels are ideal, which can cause all kinds of problems. For this reason, time is of the essence. Methods for treating PPHN include:
  • Continuously monitoring blood pressure and oxygenation levels
  • Nutritional support
  • Keeping handling of the newborn to a minimum
  • Correcting abnormalities in glucose and electrolytes
  • Maintaining normal blood pressure
  • Minimal invasive procedures
Even if the above treatments are administered, the baby may still need extra help recovering. Other therapeutic methods that are common for getting a newborn past PPHN include:
  • Assisted ventilation
  • High-frequency oscillatory ventilation
  • Nitric oxide
  • Surfactant administration
  • Inotropic support
  • High-frequency ventilation
  • Endotracheal intubation
  • Hearing evaluations
  • ECMO
  • Alkalosis and acidosis corrections
Following their discharge, a doctor may recommend that your baby get evaluated by a neurologist or a pediatrician specializing in development. This way, you will know for sure that the illness has passed. There is no doubt that PPHN is a frightening possibility for any parent to confront. However, as long as you see an experienced doctor, the likelihood of this affliction permanently affecting your child will be greatly lowered.  
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