Persistent pulmonary hypertension of the newborn (PPHN) occurs when the circulatory transition that shifts oxygen circulation from the placenta to the lungs after delivery fails, leading to a variety of health problems including oxygen loss that can lead to brain damage.
Prior to birth, babies receive oxygen through the umbilical cord and placenta, and the blood vessels that carry oxygen from the heart to the lungs are constricted. When a baby is born, lungs that were previously filled with amniotic fluid with oxygen, opening up the blood vessels and beginning the cycle of transporting oxygen throughout the body.
If the blood vessels do not open properly, blood pressure remains high.
When PPHN occurs – it happens in every two out of 1,000 births, experts say – it causes high blood pressure that diverts blood away from the arteries of the lungs, decreasing the available supply of oxygen to the body and the brain.
Symptoms of PPHN
The symptoms associated with PPHN reflect the baby’s struggle to take in oxygen as well as the lack of available oxygen.
The symptoms of PPHN include:
- Rapid, hard breathing that causes the skin between and beneath the ribs to pull in.
- The color of the baby’s lips turns blue and grows worse in the first 24 hours.
- The baby moans or grunts when breathing out.
- Hands and feet are cool to the touch.
- The baby’s coloring is pale or blotchy.
- Measured oxygen levels are low, even is oxygen is administered to the baby.
- Low blood pressure.
- Swelling of the baby’s torso.
- A heart murmur.
- Lethargy or a lack of energy.
- Loss of consciousness due to lack of oxygen.
- High levels of carbon dioxide in the blood.
- Swelling of the hands and feet.
- Signs of shock.
In order to treat symptoms, medical professionals will work to boost oxygen levels in the blood, regulate blood pressure levels and help relax the blood vessels in the lungs so they are better able to send oxygen through the body.
Oxygen therapy can include a ventilator to help the baby breathe, a high-frequency ventilation machine that delivers regular bursts of oxygen, a CPAP machine, which delivers a steady flow of oxygen or an oxygen hood, which immerses the baby in an oxygen-rich environment.
Blood pressure medications, antibiotics, sedatives to decrease the need for oxygen and surfactants to help improve oxygen update may also be administered.
Risk Factors for PPHN
Both full-term and near-term babies are at risk of developing PPHN, which most often occurs within the first 72 hours of birth.
Risk factors include:
- Meconium aspiration. When a baby’s first bowel movement occurs prior to birth, it can easily be inhaled into the lungs. Meconium is thick and sticky, and it impairs lung function.
- Babies born to mothers taking antidepressants, especially SSRIs (Selective Serotonin Reuptake Inhibitors), are six times more likely to develop PPHN, according to a 2006 study appearing in the New England Journal of Medicine. Celexa and Prozac were both particularly problematic, according to the study, but other antidepressants, including those that are not SSRIs, were also linked to PPHN. (Ref. 1)
- Pneumonia, group B strep and infections of the bloodstream can elevate the risk of PPHN.
- Gestational diabetes. Because diabetes causes issues with blood vessel strength and pliability, it could contribute to PPHN.
- Birth asphyxia. A birth injury that leads to a lack of oxygen reaching the brain can trigger PPHN. Potential injuries can be caused by placenta or umbilical cord problems or long, difficult childbirths caused because of either a baby being too large to fit easily through the birth canal or when the mother’s pelvis is too small for a baby to be successfully delivered vaginally.
- Congenital abnormalities of the heart and lungs. While rare, some babies who develop PPHN do so because of a blocked heart valve, a hole in the diaphragm, which is the muscle that helps with breathing, or lungs that are smaller than normal.
Complications of PPHN
PPHN is a dangerous, potentially life-threatening disorder that can cause heart failure, brain hemorrhage due to a lack of oxygen, seizures, kidney failure and damage to other organs of the body.
Because of the lack of oxygen reaching the body, cerebral palsy, breathing problems and loss of hearing are also possible.
Serious cases can lead to serious injury or wrongful Chicago chicago attorney can help you recover compensation for pain, suffering, and future medical bills.
If your baby was born with PPHN as a result of doctor error, including failure to stop prescribing SSRIs during pregnancy or failure to prevent an oxygen-related birth injury by scheduling a cesarean section, you should contact an experienced birth injury attorney to consider your options regarding compensation for the costs associated with your child’s care.
You could receive compensation for the medical costs you are likely to incur while caring for your child, not only during childhood, but potentially well into adulthood.
If your child was diagnosed with PPHN, contact our legal offices today. We can negotiate with insurance companies or gather enough evidence from expert witnesses to go before a jury and make your case.
Your consultation is free, and you won’t pay a fee until we win your case.
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