Publication:

Clinical presentation and early diagnostic features of persistent pulmonary hypertension in newborns: insights from a tertiary care hospital

Background Persistent pulmonary hypertension of the newborn (PPHN) is a severe condition with significant mortality. Data on its clinical profile and early diagnostic features from low- and middle-income countries, particularly South Asia, are scarce. This study aimed to describe the clinical presentation and early echocardiographic diagnostic features of newborns with PPHN in a tertiary care hospital in Bangladesh.

Methods This cross-sectional observational study was conducted over six months in a tertiary care hospital in Bangladesh. Data from 50 neonates with echocardiographically confirmed PPHN were retrospectively analyzed. Demographics, clinical presentation, underlying etiologies, and detailed echocardiographic findings, including associated cardiac shunts and disease severity, were recorded.

Results The majority of neonates were male (70%) and diagnosed within the first week of life (78%). The most common presenting features were tachypnea (78%) and cyanosis (72%). Echocardiography revealed that 74% of cases had an associated cardiac shunt, with an atrial septal defect being the most frequent finding (present in 42% of the total cohort). Severe PPHN was the most common classification at presentation (48%).

Conclusions PPHN in this setting presents early and is frequently associated with cardiac shunts, particularly ASDs. These findings highlight the critical role of early and comprehensive echocardiographic evaluation for accurate diagnosis and potential risk stratification in managing this vulnerable population.