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Circulatory System of Infant  
AL00079-B_97870_1_ciruclatory_infant

Copyright © Nucleus Medical Media, Inc.

Definition  

Oxygen is needed in every cell of the body. It first enters the body through the lungs. The oxygen is then picked up by the blood flowing by the lungs. The blood brings oxygen to the rest of the body. In newborns with persistent pulmonary hypertension (PPHN), the blood does not flow by the lungs.

The baby's lungs are not used during pregnancy. Instead, oxygen passes from the mother to the baby through the umbilical cord, bypassing the lungs. Once the baby is born, the baby's lungs should take over. When this does not occur, oxygen bypasses the lungs and cannot move from the lungs to the rest of the body.

PPHN can be a very serious condition. It can cause both immediate and long-term health problems.

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Causes  

PPHN can be caused by a variety of factors, including:

  • An event or illness during pregnancy or childbirth, such as:
    • Meconium aspiration syndrome (the baby inhales meconium—the first stool—prior to or shortly after birth)
    • Severe pneumonia
    • Infection
    • Low blood sugar
    • Birth asphyxia (loss of oxygen to the fetus during delivery)
    • Respiratory distress syndrome —caused by lungs that have not fully developed
    • Use of nonsteroidal anti-inflammatory drugs (NSAIDs) by the mother during pregnancy
    • Late trimester maternal use of antidepressants, especially SSRIs
    • Amniotic fluid leak
    • Low amniotic fluid— oligohydramnios
    • Abnormal lung development as a result of congenital diaphragmatic hernia or Potter syndrome
  • Stress during pregnancy
  • Isolated condition with an unknown cause
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Risk Factors  

Factors that may increase your baby’s chance of PPHN include:

  • Stress to the fetus during pregnancy or delivery
  • Health conditions of the mother, including diabetes
  • Complications during birth or pregnancy
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Symptoms  

PPHN may cause

  • Rapid breathing—tachypnea
  • Rapid heart rate— tachycardia
  • Difficulty breathing—signs may include flared nostrils or grunting
  • Blue tint to the skin, even when the baby is receiving oxygen
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Diagnosis  

Your doctor will ask about your baby’s symptoms. Your pregnancy history may also be reviewed. A physical exam will be done.

Tests may include the following:

  • Blood tests
  • Chest x-rays —to help diagnose lung disease or enlarged heart
  • Echocardiogram —ultrasound of the heart to show the baby's circulating blood flow
  • Head ultrasound —to look for bleeding in the brain
  • Pulse oximetry monitoring—continuous monitoring of oxygen levels in the blood
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Treatment  

Talk with your doctor about the best treatment plan for you. Treatment for PPHN is typically administered by a doctor who specializes in newborn illness.

Treatment begins with correcting any related conditions. These conditions can include low blood sugar, low oxygen levels, low blood pressure, and low blood pH. Treatment options include: