After a nine-year wait and a decade of medical hurdles, a couple in Hoskote, Bengaluru, finally welcomed their daughter at 36 weeks. But the hard-won joy of her first cries was short-lived. Beneath the surface, the newborn’s lungs harboured a life-threatening secret, instantly turning their long-awaited celebration into a desperate race for survival.
As the newborn’s respiratory distress intensified, standard non-invasive ventilation proved insufficient to stabilise her deteriorating oxygen saturation. The clinical picture was clear: the baby had reached a critical threshold, requiring immediate escalation to a Level 3 or 4 NICU.
What is PPHN?
By the time the infant reached Manipal Hospital, her oxygen saturation had plummeted to a perilous 85%—a level that signalled a body in desperate distress. The transfer itself was a high-stakes midnight mission; at 1:30 am, the baby was rushed through the city’s quiet streets in a MARS (Manipal Ambulance Response Service) unit. This specialised 'NICU on wheels,' equipped with a state-of-the-art incubator, acted as a mobile lifeline until she reached the hands of the awaiting neonatal team. There, Dr Anand Patil, Lead Consultant in Neonatology and Paediatrics, and his team stood ready to intervene in a situation that had reached its most critical hour.
Through careful monitoring, including blood gases, vital signs, urine output, and an echocardiogram, they diagnosed Persistent Pulmonary Hypertension of the Newborn (PPHN).
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The baby's lung blood vessels hadn't made the crucial transition from fetal life, where oxygen comes from the placenta, to breathing on its own, said Dr Patil. "Instead of relaxing and allowing blood to flow to the lungs for oxygenation, they remained constricted, starving the body of oxygen," he added.
What was the cause behind it?
The baby was lightly preterm at 36 weeks, its sepsis markers were elevated (indicating possible infection), and there may have been an incident or stress during the mother’s pregnancy that triggered it.
PPHN affects about 1-2 babies per 1,000 live births globally, with varying reports in India (0.4-6.8 per 1,000), often linked to maternal infections or unknown causes.
Without intervention, the condition is often fatal, and it could also lead to irreversible organ damage or worse.
The baby's lungs were immediately supported by a ventilator. The team managed the unstable blood pressure with medications and used targeted therapies to relax those stubborn pulmonary vessels. Continuous monitoring ensured every adjustment was precise, tracking the heart function via echo, adjusting oxygen levels, and watching for any signs of complications.
Offering financial assistance to the parents, the Manipal Hospital Foundation stepped in and paid for about 30% of the costs, which made things easier for them during this difficult time.
After a few days, the oxygen levels stabilised, the blood pressure normalised, and the pulmonary pressures eased. The baby was weaned off the ventilator and soon was in the arms of the parents, healthy, breathing on its own.