PERSISTENT PULMONARY HYPERTENSION
(PPHN)
CONTENTS
What is persistent pulmonary hypertension of the newborn
What causes it
What happens to my baby
What can be done
Will my baby get better
What can I do as a parent
WHAT IS PPHN
1. PPHN is a blood flow pattern through the baby’s lungs and heart seen in the fetus (before the baby is born).
2. While your baby was growing inside your womb, you did the breathing for him and your placenta carried oxygen to the fetus. Therefore, your baby did not need to use his or her lungs.
3. In the fetus, blood is shunted (sidetracked) through two channels in the heart—the ductus arteriosus and the foramen ovale—by-passing your baby's lungs.
4. However, after your baby is born, cries, and takes breaths, the pressure in the pulmonary (lung) vessels should decrease. Then blood can travel to the lungs to get oxygen.
5. When a baby has PPHN the pressure in the pulmonary (lung) vessels does not decrease, causing blood to continue being shunted away from the lungs as if the baby was still inside your womb.
6. This delivers unoxygenated blood to the baby’s body.
WHAT CAUSES IT
1. PPHN is usually seen in near-term, term, or post-term infants.
2. Several factors can cause PPHN. These may include:
a. A stressful birthing process
b. The baby may stool, gasp, and swallow meconium (the first stools). The meconium can get into the baby’s lungs and cause the baby to have difficulty breathing after birth
c. Cold stress
d. Low blood sugar
e. Low calcium
f. Thickening of the blood
g. Infection.
WHAT HAPPENS TO MY BABY
1. Symptoms are usually seen in the first 12 hours of life.
2. Your baby may begin to breathe faster (tachypnea) and your baby’s chest may suck in (retractions) because he’s having a hard time breathing.
3. You may see a bluish discoloration of the skin (cyanosis) because of decreased oxygen.
4. Your baby’s blood pressure may also be low.
5. The nurse will give him some medication to help him rest.
WHAT CAN BE DONE
1. The main goal is to get oxygenated blood to the rest of your baby’s body.
2. Your baby may be placed on a ventilator (breathing machine.)
3. Your baby may have several intravenous (IVs and umbilical catheters) lines to:
a. Give your baby fluid and nutrition
b. Give your baby medications
c. Obtain lab samples
d. Monitor his oxygen levels
e. Monitor his blood pressure.
4. The nurse will get blood samples to measure your baby’s blood gases. This will tell the doctor and nurse practitioner how well your baby is breathing and oxygenating himself.
5. Other labs the nurse may get are:
a. Electrolytes (sodium, potassium)
b. Glucose (sugar level)
c. Complete blood count (to see if the baby has an infection).
6. The nurse will take frequent vital signs: temperature, breathing rate, heart rate, and blood pressure.
a. Your baby may need to be on a special medication, called a vasopressor, to increase his blood pressure.
WILL MY BABY GET BETTER
1. PPHN is a VERY SERIOUS condition.
2. Some babies have no long-term problems; others may have some developmental problems.
3. The doctor or nurse practitioner is the best person to keep you informed about your baby’s progress. They will talk with you and answer any questions you have about your baby.
WHAT CAN I DO AS A PARENT
1. We encourage you to visit as often as you can; but you may wish to limit other visitors at this time.
2. Your baby needs to be as quiet as possible.
3. We try to decrease the amount of stimulation to and around your baby by:
a. Limiting talking to and handling of your baby
b. Being extra quiet around your baby’s bed
c. Dimming the lighting, when possible, around your baby’s bed.
4. You will be able to talk softly and touch your baby gently by holding his hand or foot.
a. We discourage stroking or rubbing of the baby, as this is very stimulating and upsetting to the baby.
5. These limitations may seem extreme but as your baby begins to improve, these limitations will be relaxed.
6. If you are unable to visit, please call and check on your baby. Love, concern, and support all play an important part in your baby’s progress.
Reviewed/Revised:
4/03, 11/05, 4/07, 12/09
PPHN 3