persistent fetal circulation, persistent pulmonary hypertension

Once the first breath is taken, the lungs expand, and the vessels within the lungs expand as well. This dramatically decreases the resistance to bloodflow and causes the blood pressure in the lungs to drop. This change sets in motion the normal circulatory changes whereby the baby&/39;s circulation switches over to the adult, airbreathing type. Ordinarily, the muscular walls of the arteries of the lungs (pulmonary arteries) relax and further decrease the blood pressure on the right side of the heart. If they do not - because of intrauterine factors that cause hypertrophy of the muscular walls of the pulmonary arteries - then the blood pressure in the lungs does not drop as it should and blood continues to be shunted away from the lungs and back to the body without receiving oxygen. The baby will appear cyanotic (blue) but will not pink up with the administration of 100% oxygen (the diagnostic test). Treatment of persistent fetal circulation (PFC) or persistent pulmonary hypertension is by the infusion of drugs to lower the blood pressure in the lungs. This is potentially a very dangerous condition, especially if it arises as a consequence of other lung disease such as meconium aspiration.

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