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Persistent Pulmonary Hypertension PPHN

When a newborn has breathing problems, it can be devastating for parents. After the difficulties of transitioning from getting oxygen from the mother to breathing air for the first time, some children continue to struggle. It may take months for the baby’s lungs to recover, putting them at risk of other health conditions. 

What causes some children to develop breathing problems after birth? Some birth injuries are caused by failures of the doctors or healthcare providers to give proper care during pregnancy and delivery. When a doctor makes a mistake that puts the infant at risk of injury, the doctor should be held accountable. A birth injury medical malpractice lawsuit can help provide for the injured child and improve medical care for others in the future. 

What is Persistent Pulmonary Hypertension (PPHN)?

Persistent pulmonary hypertension (PPHN) is a breathing condition in newborns that may cause the child to not get enough oxygen. “Pulmonary” refers to the lungs and “hypertension” is the term for high blood pressure. 

In a child with PPHN, the blood vessels may not fully open to allow enough blood to flow to carry oxygen throughout the body. The narrowed blood vessels cause higher than normal blood pressure. The high pressure may also not be able to circulate the blood to pick up oxygen and exhale carbon dioxide. 

The effects of PPHN would be similar to someone being in a room with low levels of oxygen. Lack of oxygen is known as “hypoxia.” Hypoxia is dangerous for anyone but can be more of a problem with babies who need oxygen for their brains and organs to develop. Hypoxia is a primary cause of infant mortality and greatly increases the risk of brain injury. About a quarter of babies who suffer hypoxia will have permanent neurological problems. 

Oxygen Deprivation in Newborns

When the baby is in the womb, during delivery, and in the early days of life are some of the most sensitive times for babies. Any oxygen deprivation can cause serious injury or be fatal. Damage to the brain can begin within minutes of reduced oxygen supply. Brain cells and tissue can begin to die within minutes. The extent of damage to the brain depends on the extent and length of oxygen deprivation. 

Causes of Neonatal Persistent Pulmonary Hypertension 

Parents may be totally unaware of any problem with their newborn until doctors tell them the child is having difficulties getting enough oxygen. Unlike some other complications, PPHN usually happens in full-term babies or babies born at 34 weeks or later. 

The exact causes of PPHN are unknown but there are a number of other conditions that increase the risk of developing persistent pulmonary hypertension. Risk factors that can increase the likelihood of developing PPHN in infants include: 

Signs of Persistent Pulmonary Hypertension and Treatment

Signs and symptoms of PPHN may appear immediately after the child is delivered. The signs may appear similar to other oxygen deprivation indicators, like bluish color of the skin, or cyanosis. The hands and feet of the baby may be cool to the touch. 

The primary indicator of PPHN may be breathing problems. Breathing problems in an infant can include: 

  • Rapid breaths
  • Slow breathing
  • Flaring nostrils
  • Retractions (chest appears to sink with each breath)
  • Grunting (grunting sound on exhaling)
  • Irregular breathing

Other indicators include low blood oxygen levels, and low blood pressure. The doctor can diagnose possible persistent pulmonary hypertension in a neonate through:

  • Echocardiogram
  • Chest x-ray
  • Cranial ultrasonography
  • Brain CT-scan or MRI
  • Pulse oximeter readings
  • Blood tests 

Treatment for PPHN (and other oxygen deprivation problems) generally begins with the use of supplemental oxygen. This can include supplemental oxygen through a mask, nasal catheter, CPAP, or ventilator. Maintaining a safe blood pressure level can be treated through the use of medication. Other medication can help open up the blood vessels in the lungs, to increase oxygen flow. 

Recovery from PPHN

With immediate and proper treatment, the baby may be able to recover from PPHN. However, it may take weeks or months before the baby’s circulatory and pulmonary systems recover to the point where they can safely breathe unassisted. While the child is suffering from breathing problems, they may be at increased risk for other complications, including illness from infection. 

After a child has recovered from PPHN, the child should still be monitored for their developmental milestones. If the child has developmental delays, it could indicate the child suffered oxygen deprivation that caused brain injury. Developmental milestones can be measured in the first few months but it may take years before parents understand the extent of their child’s developmental impairment. 

Is PPHN Caused by Medical Errors?

A child could be at greater risk for developing PPHN if the doctors failed to properly monitor the mother and fetus, and failed to properly treat the child after delivery. Monitoring the mother and fetus can help prevent a number of birth complications. Proper monitoring can also prepare the medical staff for possible health conditions or complications. When a doctor fails to provide the standard level of care, the doctor may be responsible for the child’s birth injuries. 

According to researchers, one cause of idiopathic PPHN is exposure to non-steroidal anti-inflammatory drugs (NSAIDs) during the third trimester. Idiopathic PPHN involves normal function of the lungs and remodeled pulmonary vasculature. If a doctor’s treatment of the pregnant mother with NSAIDs during the third trimester led to PPHN, the doctor may have contributed to the birth injury. 

Exposure to other medications, infection, pneumonia, meconium aspiration, and respiratory distress can also increase the risks of PPHN. If a hospital, medical professional, or doctor did not properly care for the mother and child during the pregnancy, delivery, and during neonatal care, these medical mistakes could be responsible for the damage done by PPHN. If you have any questions about whether PPHN was caused by medical errors, talk to an experienced birth injury lawyer. 

Infant Breathing Problems Caused by Malpractice

If your child suffered a birth injury, the hospital responsible for causing the damage should have to pay the costs of medical care. Talk to an experienced medical malpractice attorney about holding the doctors and hospitals accountable for their negligence. Do not hesitate to contact Gilman & Bedigian today for a free consultation. 

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