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Persistent Pulmonary Hypertension of the Newborn (PPHN)

What Is PPHN?

Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening condition in which a baby's circulatory system does not function properly after the delivery. While in the womb, a baby receives its oxygen through the umbilical cord directly into the blood stream. The blood pressure in the lungs is high so the oxygen-rich blood is sent away from the lungs to other parts of the body.

Once the baby takes its first breath outside of the womb, the blood pressure in the lungs drops and the normal circulatory function of taking in air through the lungs, passing blood through the heart and pumping it through the body, should ensue. In babies with PPHN, the blood pressure remains high so the blood and oxygen are not allowed to circulate through the lungs. This causes oxygen deprivation, and if not treated, it could lead to brain damage or death.

Children who survive PPHN may have chronic lung disease, seizure disorders and/or neurological difficulties. Feeding difficulties are another major concern, and many babies will require a temporary feeding tube if they cannot eat normally to obtain the necessary nutrients for development and growth. Hearing loss is also associated with PPHN. It is recommended that parents pay attention to any signs of hearing loss or delayed speech development during a child's early years.

Signs and Symptoms of PPHN

Early detection and diagnosis of PPHN is essential to the health and survival of the baby. The common signs and symptoms of PPHN include:

  • Rapid breathing and heart rate
  • A bluish tint
  • Grunting or other signs of breathing problems
  • Respiratory distress
  • Low oxygen levels

If a baby displays any of these signs, lab tests, x-rays and ultra sounds can confirm the symptoms are related to PPHN and rule out other possibilities. Additionally, these tests can show other serious complications related to PPHN, such as bleeding in the brain, lung disease or heart problems.

Treating these symptoms involves a variety of ventilation and oxygenation methods to help reduce the blood pressure in the lungs and increase the flow of oxygen throughout the body. Some babies only need an oxygen mask, while others require more invasive methods of respiratory therapy. The most serious cases will require the baby to be hooked up to an extracorporeal membrane oxygenation machine. This machine drains blood from the baby, adds oxygen and removes carbon dioxide, and then pumps the blood back into the body. The type of treatment depends on the cause of PPHN and a baby's ability to breathe on its own.

While it may be difficult to watch your child undergo such extensive testing and treatment, it is important for your child's health and long-term prognosis.

Causes of PPHN

Persistent pulmonary hypertension of the newborn is most common in pregnancies with complications and in premature births, where the lungs are under-developed. Taking anti-depressants can also increase the likelihood of PPHN.

It is the responsibility of the attending physician to understand the risks of a baby developing PPHN, and to act appropriately to prevent it. Similarly, if a child was born with PPHN, the physician should take appropriate measures to treat it in order to prevent long-term damage. Failing to do so is cause for concern because it could result in long-term effects.

Caring for a Child With PPHN

Ultimately, the type of care a child with PPHN needs depends on the treatment and response to the treatment after birth. Some children will live normal lives with no long-term effects of the birth injury. In more serious cases, children may need special schooling, prescription medications and lifetime support if neurological functioning is inhibited.

Several possible benefits and sources of compensation are available to children with PPHN-associated disabilities. These include Medicaid and Social Security Disability benefits. Additionally, a drug manufacturer or a physician may be held liable if the PPHN resulted from dangerous medications or the failure to respond to risk factors and to take appropriate treatment measures. It may be helpful to speak to a birth injury lawyer about the possibility of a claim if you think negligence contributed to your child's disease.

The Birth Injury Team is a subsidiary of Silvers, Langsam & Weitzman, P.C., made up of experienced attorneys and medical professionals. Our lawyers have more than 100 years of combined experience handling birth injury cases. We are dedicated to helping parents understand their child's condition and guiding them through the process of securing the care and support they need. Located in Philadelphia, we serve clients across the United States.


Located in Philadelphia, Silvers, Langsam & Weitzman, P.C., home of MyPhillyLawyer, serves clients in Philadelphia County, Pennsylvania, and throughout the United States.

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