Vol. 7, Issue 2, Part C (2025)

Background: Persistent Pulmonary Hypertension of the Newborn (PPHN) is a life-threatening condition characterized by sustained high pulmonary vascular resistance, leading to right-to-left shunting and severe hypoxemia. Early recognition and management are crucial for survival.
Objective: To evaluate the clinical profile, management strategies, and outcomes of 60 neonates diagnosed with PPHN over a two-year period.
Methods: This retrospective study included all neonates diagnosed with PPHN at Neonatal Intensive Care Unit, Northeast Medical College Hospital, Bangladesh from January 2023 to December 2024. Data on demographics, clinical features, etiology, echocardiographic findings, treatment modalities, and outcomes were collected and analyzed.
Results: Among 60 neonates with PPHN, 38 (63.3%) were male and 22 (36.7%) female, with a male-to-female ratio of 1.7:1. The mean gestational age was 38 ± 2 weeks, and mean birth weight was 2.9 ± 0.5 kg. Primary etiologies included meconium aspiration syndrome (35%), sepsis (25%), idiopathic PPHN (20%), respiratory distress syndrome (12%), and other causes (8%). All neonates presented with respiratory distress, and 85% had cyanosis; 40% had Apgar scores <7 at 5 minutes. Management included high-flow oxygen therapy (100%), pulmonary vasodilators (66.7%), antifailure therapy (83.3%), inotropic support (16.7%), PDA management (10%), correction of acid-base disturbances or hyperventilation (60%), and mechanical ventilation (16.7%). Outcomes were favorable in most cases with timely interventions.
Conclusion: PPHN predominantly affects term or near-term neonates, with meconium aspiration and sepsis being the leading causes. Prompt recognition and a structured management approach, including oxygen therapy, pulmonary vasodilators, and supportive care, are crucial in improving neonatal outcomes.