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Persistent Pulmonary Hypertension of the Newborn (PPHN)
Rapid Breathing :: Rapid Heart Rate :: Respiratory Distress
Persistent pulmonary hypertension of the newborn (PPHN) is a serious, often fatal condition that affects newborn babies. PPHN limits the amount of blood flowing to an infant's lungs and the amount of oxygen entering the bloodstream.
PPHN may result from a problem during delivery or another condition (e.g., possibly SSRI’s like Paxil) that affects the lungs or oxygen supply to the baby in the womb or during childbirth. PPHN occurs in approximately one or two in 1,000 babies, typically in term or near-term deliveries. Symptoms usually appear within 12 hours after birth.
In a developing fetus, blood is circulated through the placenta and umbilical cord. It is through the placenta, not the lungs, that carbon dioxide is removed from the blood and replaced with oxygen. The pulmonary artery then carries the oxygenated blood directly to the fetal heart.
In a baby with PPHN, however, this "switch" fails to take place. The baby breathes, but his blood does not reach the lungs for the oxygen-carbon dioxide exchange. The pressure in the lungs increases and the blood's failure to deliver needed oxygen throughout the body places a severe stress on vital organs. (See also Meconium Aspiration Syndrome.)
The first sign that an infant has PPHN may come in the form of symptoms, including:
- rapid breathing (tachypnea)
- rapid heart rate (tachycardia)
- irregular heartbeat
- respiratory distress, which may be indicated by flaring nostrils and grunting
- bluish tint to the skin (cyanosis), which may be present even if the baby is receiving
- extra oxygen to assist breathing
- lethargy
- sweating
- heart murmur-an extra or unusual sound heard when listening to the heartbeat
- low oxygen levels in the blood, even though the baby is receiving extra oxygen
- low blood pressure (hypotension)
- weak pulse
- swelling in the hands or feet
- an enlarged liver
If your child has symptoms of PPHN, you may want to test your child. During testing, you may be asked any about medications taken during pregnancy as well as any difficulties in labor and delivery. Some of the tests may include:
- chest x-ray to diagnose lung disease or an enlarged heart
- ultrasound of the head to check for bleeding in the brain
- electrocardiogram (EKG)
- heart catheterization
- arterial blood gases (ABG)
- complete blood count (CBC)
- serum electrolyte tests
- pulse oximetry to monitor the level of oxygen in the blood
- ultrasound of the heart (echocardiogram) to check the baby's blood flow
With regard to medications that may contribute to persistent pulmonary hypertension of newborn (PPHN), see the section on Paxil
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