Whenever we think about newborns, the common things that come to our minds are joy, those tiny fingers grasping ours, and that calm and peaceful sleep. For some babies, their first moments can also become the toughest thing due to difficulty in breathing, and the main reason for these hectic situations is Persistent Pulmonary Hypertension of the Newborn (PPHN). It may scare you, but is there any way to prevent it? Further, this blog will break down and explore whether there are any ways to prevent it, and its signs.

What is PPHN?

PPHN is one of the complex breathing issues that arise in newborns. When babies are born, some infants cannot suddenly adapt to this environment, this is when PPHN starts affecting the babies.

When the woman is pregnant, the infant in the uterus will get oxygen from the expectant mother’s placenta or umbilical cord. Just a restricted amount of blood will get into the infant’s lungs because those blood vessels in the lungs are often closed. Blood will reach the rest of the body only after bypassing the lungs.

After the birth, your baby should start breathing, and for this, their lungs should open. Air delivers oxygen into their lungs. Further, the blood vessels will let blood travel to your infant’s lungs to get oxygen and transfer it to the rest of their body.

PPHN will occur only when the infant’s blood vessels don’t open properly, that is, there is a criteria for how much blood should reach the baby’s brain and other organs of the body as well, just like their heart, kidney, and gut, in such cases you should consider reaching out to the neonatology hospital in Coimbatore to take all the possible steps at the proper time. We can say that PPHN is one of the complex conditions that could strike newborns immediately after birth.

How common is PPHN in newborns?

Persistent Pulmonary Hypertension of the Newborn (PPHN) is a very rare but life-threatening health condition that affects about 1 to 2 newborns in 1000 live births. Usually, this occurs when a baby’s circulatory system is unable to breathe outside the womb, which causes high blood pressure in the lungs, and oxygen levels in the bloodstream are reduced.

Also, more than premature babies, full-term and babies born after the delivery date are more prone to this condition. This condition could also result in meconium aspiration, infections, and congenital heart defects. Timely diagnosis and treatment are crucial because PPHN will result in significant complications if not managed effectively. Fortunately, medical advancements have improved the outcomes.

Are there any symptoms of PPHN?

The common signs of PPHN include,

Breath-related issues like fast or slow breathing
Increased heart rate
Baby’s skin will appear blue
Hypotension
Reduced blood oxygen levels
Unusual heart sounds

What causes PPHN?

No one can predict PPHN, but several risk factors are known:

Meconium aspiration syndrome (MAS): In case the infant inhales stool-stained amniotic fluid into the lungs.
Lung underdeveloped: Notably, in conditions such as congenital diaphragmatic hernia.

Infections: At times, pneumonia or group B streptococcus causes PPHN.

Hypoxia before birth: This occurs when the baby is unable to get sufficient oxygen inside the uterus.

Medications: Before taking any medications, notably during your pregnancy, discuss with your doctor because some medications could increase the risk.

Premature birth: As mentioned above, full-term or post-term babies are prone to develop PPHN.

Also, babies who survived PPHN will tend to experience some long-term complications due to the lack of oxygen reaching their brains. Those common complications include:

Developmental delays
In rare cases, deafness can occur
Learning disabilities
Decreased ability to engage in physical activities

How to diagnose PPHN?

Doctors will employ different methods, such as laboratory or imaging tests, to diagnose PPHN, those methods include:

Pulse oximetry: Through this noninvasive method, the level of oxygen in your child’s blood will be measured.
Arterial blood gas (ABG): This method identifies how well your child’s body delivers oxygen.

Chest X-ray: This method will help in identifying whether your baby has an enlarged heart or lung disease.

Echocardiogram: As we all know, an echocardiogram is a precise ultrasound of your infant’s heart, which assists in evaluating the blood flow to their lungs and heart.

Head ultrasound: An ultrasound of your infant’s head will assist in finding bleeding in their brain.

Serum electrolyte tests: At times, healthcare providers will use serum electrolyte tests to evaluate the balance of minerals in your baby’s blood.

Lumbar puncture: This method will help in finding whether your baby has an infection or not.

How to treat PPHN?

The ultimate aim for PPHN treatment is to enhance the oxygen flow to your baby’s organs, so it can greatly assist in preventing complications. The common treatment methods for PPHN include:

Oxygen: Infants are able to get 100% supplemental oxygen with the help of a nasal cannula, nasal prongs, or a mask.
Mechanical ventilation: Healthcare providers will place a tube in your child’s windpipe, and this ventilator will greatly assist your baby in breathing.

Blood pressure support: Your baby will be given blood pressure medicine intravenously.

High-frequency oscillatory ventilation: This kind of ventilation will greatly assist in improving the oxygen level in your child’s blood.

Extracorporeal membrane oxygenation (ECMO): In case your baby is going through extreme heart or lung failure, doctors will employ an ECMO machine, which delivers oxygen to your baby’s brain and body.

Are there any ways to prevent PPHN?

You need to understand that PPHN is not always preventable, but reducing the risk factors will greatly help in preventing newborn breathing problems. Appropriate prenatal care, managing maternal health conditions, avoiding smoking and few medications during pregnancy, and promptly treating infections will lower the chances of risk. Simply, timely diagnosis of fetal distress and careful delivery practices also play a key role in prevention.

When can I discharge my baby from the intensive care unit?

When the infant’s oxygen saturation levels remain normal, healthcare professionals will suggest reducing the dosage of medicines, but medications will be continued until it is turned off altogether. Further, the amount of oxygen used will be reduced by the medical team, and also the level of breathing work done by the ventilator will be reduced. At this point, healthcare providers will reduce the medicine that keeps the baby still and sleepy, so eventually those infants will be more awake and aware of their surroundings.

Also, doctors will slowly reduce the medicines that are given to raise the blood pressure, and will consider stopping other medicines if a full course has been given. Further, nurses will try to feed using the tubes, passed into one of the baby’s nostrils and down the throat to the stomach, they practice this to start the milk feeds.

Once the baby starts breathing by itself, only with a limited amount of assistance from a breathing machine, doctors will consider taking the infant off the breathing machine completely. After this, babies will be ready to go back to their local hospital. At this stage, not much medication will be given, and they will continue to give just the oxygen treatment until it is no longer needed, and they will also start practicing feeding before they are discharged home.

How soon will PPHN recover?

Most of the PPHN cases will get resolved within a week or two, also some will take a longer time, like a few months, for complete recovery. It greatly depends on the severity of the condition and how fast the PPHN newborn treatment in Coimbatore has been started.

Simply, with proper medical care like oxygen therapy, appropriate medications, and at times mechanical ventilation, babies will show visible improvements within a few days. As mentioned above, full recovery will take time, anywhere from several days to a few weeks. In case the infant’s condition is very severe, longer hospital stays are required. Consider going for regular follow-ups to look for long-term effects. Simply, when diagnosed early, babies can recover from PPHN.

How will PPHN impact your child’s health?

Typically, lungs will find it harder to exchange oxygen and carbon dioxide when there are any issues with the blood flow to the infant’s lungs. Notably, infants with PPHN will have less amount of blood oxygen levels. This causes serious health problems because all of our body parts require a regular supply of oxygen-rich blood. When a sufficient amount of oxygen is not delivered to your baby’s organs, it will be damaged.

Things about PPHN that you need to know:

Babies will be affected by PPHN when there are no changes in the baby’s circulation, like in the uterus. In such cases, more blood will flow through the baby’s lungs.
1 baby in every 500 to 700 live births gets affected by PPHN. This condition will mostly affect the full-term babies or babies born after their expected delivery date. Also, this condition is more common among babies born with critical labor.
A dedicated test should be taken to diagnose PPHN, these tests include chest X-ray, monitoring oxygen levels, and blood tests.
In case your baby fails to get sufficient oxygen, they may tend to face long-term health issues.

Bonus tips that help you when you visit the healthcare provider:

Know why you are visiting the hospital and what you actually want.
Know about the diagnosis, medications, treatments, or tests that are taken during the hospital visit.
Be aware of what treatments are given for your newborn and how they will help them to recover.
Also, check with the team if there are any alternatives to treat your child.
Know why the team suggests that method and what the result could mean.
If your healthcare provider asks you to come for a regular health checkups, mark the following date to visit the hospital. Meanwhile, make sure you are following all the instructions given by the medical professionals.

What is the survival rate of PPHN?

We can say that the survival rate of babies with persistent pulmonary hypertension of the newborn has greatly improved with modern treatment methods, ranging from 80% to 90%. Also, the outcomes will vary based on the severity of the condition, underlying causes, and how fast the treatment is started once diagnosed with the condition. Also, with prenatal care of healthy lungs, infants can live a healthy life for an extended period.

When should I take my child to the hospital for PPHN treatment?

Take your baby for regular screenings so your healthcare provider can check them frequently and find any abnormalities in their condition. While you can consider getting medical help, if your baby:

Develops a fever
Isn’t feeding well
Making grunting or wheezing sounds
Start turning blue or grayish in color

Final thoughts:

In conclusion, we can say that knowing that your tiny wonder is affected by PPHN may bring a roller coaster of emotions to you. It’s quite normal to feel sad, confused, angry, or scared. Also, you need to understand that there are no possible ways to prevent PPHN, notably when it is caused due to structural or genetic causes. With appropriate prenatal care, being aware of the medications used, and timely postnatal interventions, the chances of complications can be reduced significantly.

If you are planning for or are pregnant, consider choosing an experienced obstetrician and a pediatric care team will make a world of difference. Simply, timely planning, education, and being ready can pave the way for a smoother and healthier start for your little one.