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Year : 2020  |  Volume : 9  |  Issue : 1  |  Page : 18-26

A Retrospective study on the profile of persistent pulmonary hypertension of newborn in a tertiary care unit of Eastern India

1 Department of Neonatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
2 Department of Physiology, Ananda Mohan College, University of Calcutta, Kolkata, West Bengal, India

Correspondence Address:
Dr. Somnath Pal
Assistant Professor,Department of Neonatology,Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, West Bengal; 30/1B, Old Ballygunge First Lane, P.S- Karaya, P.O- Ballygunge, Kolkata, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcn.JCN_68_19

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Context: Persistent pulmonary hypertension of newborn (PPHN) is a common neonatal morbidity. There is a scarcity of data about PPHN from developing countries and the profile of babies with PPHN is different from those reported from developed countries. Aims: The aim is to study the incidence, maternal and infant risk factors, etiologies, treatment modalities, and outcome in babies with PPHN. Setting and Design: This retrospective study was conducted in the Level III neonatal unit of a referral center of Kolkata, India. Methods: This study was conducted by retrospective review of the departmental electronic database and nursing charts of the babies admitted with the diagnosis of PPHN from January 2013 to March 2019. Statistical Analysis: Chi-square test was used for categorical variable and Student's t-test was used for continuous variables to determine statistical significance. P < 0.05 was considered statistically significant. Results: A total of 86 neonates with PPHN were identified during the period, with the incidence of 3.38/1000 live births. Meconium aspiration syndrome (MAS) and transient tachypnea of newborn (TTNB) were the most common etiologies (17.44% each), followed by pneumonia, asphyxia, and congenital diaphragmatic hernia. Overall mortality rate was 29.06%. Survival in surgical cases was poor compared to medical cases (P = 0.0002). Pulmonary hypoplasia was associated with significant mortality. On the other hand, TTNB and idiopathic variety were associated with better prognosis. Use of high-frequency oscillatory ventilation without inhaled nitric oxide (iNO), milrinone, and combined use of pulmonary vasodilators and inotropes were associatedwith increased mortality, whereas use of surfactant was associated with increased survival. Conclusion: PPHN has been associated with significant mortality. In the absence of iNO, use of other drugs has not been associated with reduction of mortality.

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