When a baby is born, their entry into the world is a delicate physiological shift that requires every system in the body to work in unison. But in some cases, things go awry during that transition, like when the lungs fail to adapt to life outside the womb. Persistent Pulmonary Hypertension of the Newborn (PPHN) is a serious and potentially life-threatening condition in which a newborn’s circulatory system fails to adjust after birth, preventing oxygen from reaching the body as it should. While PPHN can develop for a variety of reasons, in many cases, it is entirely preventable and is the direct result of negligent care during and after labor and delivery. If your baby was diagnosed with PPHN, and you suspect that it was the result of improper care, you may have grounds for pursuing a medical malpractice claim, and you should speak to a lawyer. At Arfaa Law Group, our experienced Baltimore birth injury attorneys proudly advocate for families whose newborns have suffered birth injuries due to medical negligence, and if we represent you, we will zealously pursue the results you deserve.
Persistent Pulmonary Hypertension of the Newborn (PPHN) occurs when a baby’s circulation continues to bypass the lungs after birth, mimicking the fetal circulatory pattern. In the womb, this bypass is normal; the fetus receives oxygen through the placenta. After birth, however, the lungs must take over the role of oxygen exchange, and the bypass pathways, specifically, the ductus arteriosus and foramen ovale, should close. In babies with PPHN, these pathways remain open, resulting in high pressure in the pulmonary arteries and severely reduced oxygenation of the blood.
PPHN can develop in otherwise healthy newborns, particularly if there were complications during labor and delivery such as meconium aspiration, birth asphyxia, infection, or respiratory distress. It is also associated with the use of certain medications during pregnancy, including NSAIDs and some antidepressants, which may contribute to the underdevelopment of the fetal lungs or impaired vascular regulation. Regardless of the cause, PPHN is a medical emergency. If left untreated or not addressed in a timely and appropriate manner, it can lead to organ damage, brain injury from hypoxia, long-term respiratory issues, and even death.
In Maryland hospitals, early recognition of PPHN requires attention to signs such as cyanosis, rapid breathing, low oxygen saturation, and abnormal heart sounds. Diagnosis may involve echocardiograms, chest X-rays, and blood gas testing. Treatments may include oxygen therapy, mechanical ventilation, nitric oxide, and extracorporeal membrane oxygenation (ECMO) in severe cases. When providers fail to identify PPHN early or mismanage its progression, the results can be catastrophic. Infants who survive may face lifelong disabilities, including developmental delays, cognitive impairment, or cerebral palsy due to prolonged oxygen deprivation.
Birth injuries often cause not only physical injuries but also significant emotional trauma and financial losses. As such, many families dealing with the consequences of birth injuries will pursue claims against the parties responsible for their damages.
To prevail on a medical malpractice claim for injuries arising from PPHN, a plaintiff usually must demonstrate the defendant’s negligence. In Maryland, this means establishing four essential elements: duty, breach, causation, and damages. Healthcare providers, including obstetricians, neonatologists, and labor and delivery nurses, owe a duty of care to both the mother and child during the perinatal period. This includes monitoring fetal heart tracings for signs of distress, recognizing risk factors such as maternal medication use or gestational complications, and preparing appropriately for high-risk deliveries. A breach of this duty may involve failure to identify fetal hypoxia, delay in responding to meconium-stained amniotic fluid, improper use of labor-inducing drugs, or delays in transferring the newborn to a NICU with advanced respiratory support capabilities.
Causation in PPHN cases can be particularly nuanced. Plaintiffs must demonstrate that the child’s injuries would have been avoided or substantially lessened had the providers acted within the standard of care. Expert testimony is crucial to this analysis. In a PPHN case, this expert may assess whether earlier intervention, closer monitoring, or different treatment modalities would have led to a better outcome. They may also evaluate whether the provider’s decisions during labor, such as the timing of a cesarean delivery or the administration of medications, contributed to the development or worsening of PPHN.
Damages in birth injury cases involving PPHN can be substantial. Parents may be entitled to compensation for their child’s ongoing medical expenses, therapies, special education needs, and loss of earning potential. Non-economic damages, such as emotional distress, pain and suffering, and diminished quality of life, are also available.
PPHN is a complex condition, but with proper medical care, it is often manageable, and sometimes avoidable. When hospitals and healthcare providers fail to monitor, diagnose, or treat this condition appropriately, the results can place an overwhelming burden on families. If your child was diagnosed with PPHN and experienced serious complications that you believe resulted from medical negligence, you may be entitled to compensation, and you should speak to an attorney. At Arfaa Law Group, our skilled Baltimore birth injury attorneys have extensive experience litigating complex birth injury cases, and if we represent you, we will advocate aggressively on your behalf. Our office is located in Baltimore, and we proudly represent clients throughout the state of Maryland. To schedule a free and confidential consultation, call us at 410-889-1850 or contact us online today.