Persistent Fetal Circulation (PFC), also known as Persistent Pulmonary Hypertension of the Newborn (PPHN), is a life-threatening condition that occurs in newborn infants. It is characterized by the failure of the normal circulatory transition that should occur after birth, resulting in compromised blood flow to the lungs. In PFC, the fetal circulatory pathways, such as the ductus arteriosus and foramen ovale, which are essential for oxygen exchange before birth, remain open or fail to close after birth.
In a healthy newborn, these fetal circulatory pathways close to allow the lungs to function properly and oxygenate blood. However, in PFC, these pathways stay open, leading to an abnormal blood flow pattern where blood bypasses the lungs, resulting in reduced oxygen levels in the bloodstream. As a consequence, the right side of the heart has difficulty pumping blood to the lungs, leading to increased pressure in the pulmonary arteries.
Symptoms of persistent fetal circulation may include rapid breathing, difficulty in breathing, cyanosis (blueish color of the skin), low oxygen levels, and poor feeding. Diagnosis is typically made through clinical evaluation, medical history, and monitoring of vital signs.
Treatment for PFC aims to increase oxygen levels in the blood and decrease the pressure in the pulmonary arteries. This usually involves providing supplemental oxygen, using mechanical ventilation, and utilizing medications such as nitric oxide or sildenafil to open up the blood vessels. In severe cases, extracorporeal membrane oxygenation (ECMO) may be necessary to provide life support by bypassing the lungs.
Early detection and prompt treatment are crucial in managing persistent fetal circulation to prevent further complications and long-term effects.
