Persistent Pulmonary Hypertension in Neonates: Insights from Echocardiography

Hassan, Besheir Abdallah; Ahmed, Hanan Samir; Elgohary, Samar Mossad Hassan; Rashad, Marwa Lotfy Mohammed

doi:10.21608/zumj.2025.370515.3890

	Persistent Pulmonary Hypertension in Neonates: Insights from Echocardiography
Zagazig University Medical Journal
Article 3, Volume 31, Issue 6, June 2025, Page 2195-2203 PDF (969.61 K)
Document Type: Review Articles
DOI: 10.21608/zumj.2025.370515.3890
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Authors
Besheir Abdallah Hassan¹; Hanan Samir Ahmed²; Samar Mossad Hassan Elgohary ³; Marwa Lotfy Mohammed Rashad¹
¹Pediatrics Department, Faculty of Medicine, Zagazig University, Egypt
²Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt
³Pediatrics Department, Zifta General Hospital, Egypt
Abstract
Background: A serious clinical issue known as persistent pulmonary hypertension of the newborn (PPHN) is typified by severe and refractory hypoxemia brought on by increased pulmonary vascular resistance, which causes deoxygenated blood to be shunted from the right to the left extrapulmonaryly. Infants with severe PPHN have a significant early death rate and are linked to a variety of cardiopulmonary diseases. Infants with PPHN who survive are more likely to experience long-term complications. The physiology of PPHN can be divided into three categories: (1) maladaptation, where pulmonary vessels have normal numbers and structures but exhibit abnormal vasoreactivity; (2) excessive muscularization, where smooth muscle cells are thicker and muscles extend farther to vessels that are typically not muscularized; and (3) underdevelopment, where pulmonary hypoplasia is linked to fewer pulmonary arteries. PPHN is diagnosed by trained neonatal intensivists using bedside structural and functional echocardiography, even though the diagnosis is initially prompted by clinical signs like respiratory or hemodynamic instability in a typical setting (like the ones listed above). Conclusion: it is beneficial to diagnose PPHN, rule out any underlying congenital cardiac defects (such transposition of the great arteries or total abnormal pulmonary venous return), and then evaluate the hemodynamic condition (hypovolemic or obstructive shock).
Keywords
Persistent pulmonary hypertension; neonates; echocardiography


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