Persistent Fetal Circulation: Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Venkateswarlu Kolichana , Neurologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Persistent Fetal Circulation, also known as Persistent Pulmonary Hypertension of the Newborn (PPHN), is a condition that affects newborn babies. It occurs when the normal circulation changes that should happen at birth do not occur, leading to increased pressure in the blood vessels of the lungs. This can result in decreased oxygen levels in the blood, putting stress on the baby's heart and potentially causing serious health complications.

What are the Types of Persistent Fetal Circulation?

Persistent Fetal Circulation may present in different ways, characterized by specific patterns of blood flow in the body.

Persistent Pulmonary Hypertension of the Newborn (PPHN): Abnormal constriction of the pulmonary blood vessels, leading to high blood pressure in the lungs after birth.
Idiopathic Neonatal Arterial Calcification (INAC): Rare condition where there is calcification (hardening) of the major systemic arteries in newborns.
Congenital Diaphragmatic Hernia (CDH): A defect in the diaphragm that allows abdominal organs to move into the chest cavity, impacting lung development and circulation.
Hypoplastic Left Heart Syndrome (HLHS): Underdevelopment of the left side of the heart, affecting blood flow to the body and lungs.
Pulmonary Atresia: A condition where the pulmonary valve doesn't form properly, leading to restricted blood flow to the lungs.

What are the Symptoms of Persistent Fetal Circulation?

Persistent Fetal Circulation typically presents with distinct signs that indicate underlying heart or lung problems in newborns.

Rapid breathing
Cyanosis (bluish skin color)
Poor feeding
Lethargy
Weak pulse
Cold extremities

What are the Causes of Persistent Fetal Circulation?

Persistent Fetal Circulation, also known as Persistent Pulmonary Hypertension of the Newborn (PPHN), is primarily caused by failure of the normal circulatory changes that occur during transition from fetal to newborn life.

Congenital heart defects
Meconium aspiration syndrome
Pneumonia
Hypoxic ischemic encephalopathy
Respiratory distress syndrome
Polycythemia
Infection
Pulmonary hypertension
Premature birth
Maternal diabetes

When to see a Doctor for Persistent Fetal Circulation?

Consult a Neurologist for a comprehensive evaluation and ongoing management. Early diagnosis and prompt treatment can improve oxygen delivery, protect vital organs, reducethe risk of brain injury, and improve the baby's chances of a full recovery.

Rapid or labored breathing soon after birth.
Bluish discoloration of the lips, tongue, or skin (cyanosis).
Low oxygen levels that do not improve with routine oxygen therapy.
Poor feeding or inability to breastfeed or bottle-feed properly.
Extreme sleepiness, lethargy, or reduced responsiveness.
Fast heart rate or signs of poor circulation.
Grunting, flaring of the nostrils, or chest retractions while breathing.
Persistent respiratory distress requiring intensive medical care.
Signs of complications such as seizures or abnormal movements that require immediate neurological evaluation.
Any newborn with suspected Persistent Fetal Circulation should receive emergency medical attention without delay to prevent life-threatening complications.

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How is Persistent Fetal Circulation Diagnosed?

Persistent fetal circulation is typically diagnosed through a combination of physical examination, imaging tests, and monitoring of oxygen levels in the blood.

Echocardiogram
Arterial blood gas test
Chest X-ray
Electrocardiogram (ECG)
Blood tests
Oxygen saturation monitoring

How is Persistent Fetal Circulation Treated?

Persistent fetal circulation is generally treated through a combination of supportive care and interventions aimed at improving oxygenation and circulation in newborns.

Oxygen Therapy: Providing supplemental oxygen to improve oxygen levels in the blood and tissues of the baby with Persistent Fetal Circulation.
Intravenous Medications: Administering medications such as prostaglandins to help keep the ductus arteriosus open and improve blood flow in the newborn.
Nitric Oxide Therapy: Using inhaled nitric oxide to relax blood vessels in the lungs and improve oxygen exchange, reducing pulmonary hypertension.
Extracorporeal Membrane Oxygenation (ECMO): A mechanical device that provides cardiac and respiratory support for babies with severe Persistent Fetal Circulation who do not respond to other treatments.
Surgery: In some cases, surgical interventions such as patent ductus arteriosus ligation or atrial septostomy may be necessary to improve blood flow and oxygenation in the newborn.

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What are the Risk Factors for Persistent Fetal Circulation?

Persistent fetal circulation risk factors include premature birth, maternal diabetes, maternal drug use, and certain congenital heart defects, which can disrupt normal blood flow in newborns.

Premature birth
Respiratory distress syndrome
Maternal diabetes
Maternal drug use
Maternal infection during pregnancy
Birth defects
Genetic factors

Frequently Asked Questions

1. What is Persistent Fetal Circulation (PFC)?

Persistent Fetal Circulation, also known as persistent pulmonary hypertension of the newborn (PPHN), is a condition where a newborn's circulation system fails to adapt to breathing outside the womb.

2. What are the symptoms of Persistent Fetal Circulation?

Symptoms of PFC include rapid breathing, low oxygen levels, rapid heart rate, and cyanosis (bluish skin color).

3. What are the risk factors for developing Persistent Fetal Circulation?

Risk factors for PFC include prematurity, maternal diabetes, meconium aspiration, and certain congenital heart defects.

4. How is Persistent Fetal Circulation diagnosed?

Diagnosis of PFC typically involves physical examination, blood tests to assess oxygen levels, echocardiogram, and sometimes imaging studies like chest x-rays.

5. What is the treatment for Persistent Fetal Circulation?

Treatment for PFC may include supplemental oxygen, mechanical ventilation, medications to relax blood vessels in the lungs, and in severe cases, extracorporeal membrane oxygenation (ECMO).