PREGNANCY-BIRTH Messages for August, 2000: Re: PPHN & RH disease link?

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Re: PPHN & RH disease link?

From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Thu, 10 Aug 2000 09:50:24 -0500 (CDT)

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At Thu, 10 Aug 2000, Amanda wrote: >
>Hi all,
>
>I just had a baby via unscheduled c-section at 37w5d on Aug 4. He is
>doing much better now, but at the beginning, we didn't know if he would
>make it. He was diagnosed with Persistent Pulmonary Hypertension, and
>put on the ECMO heart/lung bypass machine for 3 days. He also received
>2 exchange transfusions. His indirect billirubin levels are low enough
>that they don't have him on the lights, but his direct billi levels are
>still a bit high and they have him on Phenobarbitol (not sure if that's
>the correct spelling) to help his liver process the billirubin.
>
>I was diagnosed Rh sensitized to both C & D antibodies during pregnancy.
>My OB and I were a little surprised to find out he is having such
>problems with the anemia, since his last amnio showed the Delta OD
>levels to be in Zone 1 on June 30th. Ultrasound showed no effects of
>anemia.
>
>Can the PPHN be linked to the Rh problem, or is it more likely a
>seperate issue altogether. My husband read that instances where there
>is a low oxygen level in the blood already (as was the case with my
>son), then the arteries in the lungs won't open up after childbirth.
>
>Thanks for your help!
>
>--
>Amanda
>

Amanda, Your observation is certainly astute, unfortunately there is little known about the cause of PPHN. There could be a relationship with the degree of fetal anemia in your baby, however PPHN is not a universally observed complication of anemic babies seem following Rh sensitization. The question that comes to mind when reading your history is why did you have your last amnio in June and not deliver until August? What about the fetal surveillance relative to the antibodies in July? That's quite a while to wait before either doing another amnio or delivering... Lynn

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana

**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.

**Thank you for your understanding ;-)

Next message: Lynn D. Montgomery, MD: "Re: Weight gain in pregnancy"
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