Caracteristics, Diagnosis, Management and Output of Persistent Pulmonary Hypertension of the Newborn at Dr. Soetomo Hospital

Abstract

Background Persistent pulmonary hypertension of the new-born (PPHN) is a failure of lung circulation in new-born. However the data related the characteristics of clinical profile, diagnostic, management and the outcome was still limited.Objective To investigated the characteristics, diagnostics, management and outcome from PPHN.Methods Retrospective observational study. Neonates with PPHN from January 2015 to December 2019 were identified from medical record. After the data was excluded, the characteristics, diagnostic, management and the outcome was collected. The statistical analysis to known the frequency and the chi-square test used to analyse the association between the treatment and the outcomes (P < 0.05).Results 37 medical records enrolled the study, with the characteristics; 62.2% babies was boy, 70.3% with term infant, 70.3% with normal birth weight, 24.3% with maternal history of eclampsia. 62.2% babies born by C-section, 21.9% with history of asphyxia and MAS. 78.4% with differences between pre-and post-ductal saturation. From echocardiography result, 13.5% diagnosed as mild PPHN, 54.1% as moderate PPHN and 32.4% severe PPHN. From the management consisted of 5.4% with O 2 nasal, 32.4% O 2 CPAP and 62.2% O 2 ventilator, 24.3% with sildenafil, 5.4% with combination sildenafil and illoprost, 5.4% with combination sildenafil, illoprost, and surfactant, 2.7% with combination sildenafil, illoprost, surfactant, and inotropic, 24.3% with combination sildenafil, illoprost, and inotropic, and 37.8% with combination sildenafil and inotropic. The outcomes was obtained 35.1% babies was died and 64.9% babies was cured, with oxygenation supplementation had significantly affecting the outcomes (P=0.02) ConclusionThe characteristics of PPHN was dominated by baby boy, term infant and good birth weight, history of asphyxia and MAS, maternal history of eclampsia, C-section delivery and the differences between pre-and post-ductal saturation. The diagnosis commonly with moderate PPHN. The management with O 2 ventilator and combination sildenafil-inotropic. The outcome mostly the babies was cured.