Impact of Management Strategies on the Outcome of Persistent Pulmonary Hypertension of the Newborn

Objectives: To evaluate the associated risk factors and to determine the impact of management strategies on the outcome of PPHN. Study Design: Prospective descriptive study in tertiary center included 40 neonates having PPHN. All patients received the conventional therapy for PPHN, sildenafil as adjuvant therapy was added in cases of failure. Results: The study included 23 males, 17 females with a mean gestational age 37.25 ± 2.6 weeks. Male patients had significantly higher systolic pulmonary artery pressure (SPAP) and higher mortality rate compared to females [7/23 (30.4%) versus 1/17 (5.9%), p = 0.04]. Infants of diabetic mothers had significantly higher mortality rate (p = 0.003). Components of the blood gases; PH, PCO2, HCO3 improved dramatically after completion of the different lines of treatment (p = 0.001). A statistical significant drop of SPAP after application of the different modalities of treatment (p = 0.001). Addition of sildenafil was effective in the reduction of the duration of NICU stay and SPAP below 40 mmHg and (p = 0.001, p =0.0001, respectively). The overall mortality rate was 8/40 neonates (20%), however, the mortality among the patients who received sildenafil in addition to conventional therapy was 1/14 neonates (7.14%) of those group with p = 0.001).