Persistent Pulmonary Hypertension of the Newborn (PPHN) is a condition that affects newborns and causes them to be unable to get enough oxygen after birth. This condition is caused by closed blood vessels in the lungs that do not open fully at birth. The closed blood vessels can cause too much blood to bypass the lungs or too much pressure to build up in the blood vessels to the lungs.
The common symptoms of PPHN are:
The exact cause of this condition is unknown. Prior to birth, babies get oxygen from the mother via the placenta. During birth, when the baby takes its first breath, the pulmonary blood vessels should open allowing blood to flow through the lungs and amass oxygen so the baby can breathe. Due to poorly understood mechanisms, this process does not occur in babies with PPHN.
Babies are at risk for PPHN if they have experienced the following:
In most cases, PPHN is suspected as soon as a child cannot breathe following delivery. When this symptom has been observed during delivery, blood tests are taken to look at oxygen saturation. A pulse oximeter will also show oxygen levels in the delivery room. An echocardiogram can be used to take pictures of the heart and the blood vessels leading to it.
Treatment for PPHN requires increasing the oxygen in the blood and opening the blood vessels in the lungs. A nasal cannula can supply oxygen right after delivery. Many of these babies will need the help of a CPAP machine to breathe when they go home. Babies with serious oxygen saturation issues might need the support of a ventilator.
Babies with this condition will need to be given blood pressure medicine as well as antibiotics to help prevent lung infections. These babies can also benefit from being given sedatives to slow down their breathing rate and keep the baby calm. Surfactants can also help the lungs to work better and bring in more oxygen.
Prevention of this condition is not possible. It is still poorly understood, and the mechanisms that lead to it need to be investigated more to determine if there is anything that can be done to prevent it.