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Persistent Pulmonary Hypertension (PPHN)

A severe neonatal condition with hypoxemia caused by failure of pulmonary vascular resistance to fall after birth.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Persistent Pulmonary Hypertension (PPHN)?

Persistent pulmonary hypertension of the newborn (PPHN) results when the expected fall in pulmonary vascular resistance does not occur after birth, leading to right-to-left shunting through the ductus arteriosus and foramen ovale. It causes severe drops in systemic arterial oxygenation.

Causes may be idiopathic or related to meconium aspiration syndrome, congenital diaphragmatic hernia, sepsis, pneumonia, congenital heart disease and hypoxic-ischemic encephalopathy. Clinically, severe hypoxemia, a pre-/post-ductal saturation gap and elevated pulmonary pressures on echocardiography are seen.

Treatment includes adequate ventilation and oxygenation, surfactant (in selected cases), inhaled nitric oxide (iNO), sildenafil, milrinone and, in severe cases, extracorporeal membrane oxygenation (ECMO). Timely access to hospital care is life-saving.

Symptoms

Progressive cyanosis after birth
Tachypnea and respiratory distress
Pre-ductal vs post-ductal oxygen difference
Low oxygen saturation (not improving with oxygen)
Pale skin and poor perfusion
Acidosis
Hypotension

Risk Factors

Meconium aspiration
Congenital diaphragmatic hernia
Sepsis and pneumonia
Hypoxic-ischemic encephalopathy
Term or post-term birth
Maternal SSRI or NSAID use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When cyanosis and hypoxemia are detected during neonatal intensive care monitoring
  • When there is a pre-ductal vs post-ductal saturation difference
  • Cyanosis unresponsive to oxygen
  • When the delivery room team monitoring outcomes is suspicious
  • For delivery planning when antenatal risk factors are identified

Treatment Methods

01
Adequate ventilation and oxygenation
02
Surfactant (per indication)
03
Inhaled nitric oxide (iNO)
04
Sildenafil or milrinone
05
Echocardiographic monitoring
06
ECMO (refractory cases)

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.