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Persistent fetal circulation syndrome(ACDMPV)

MedGen UID:
45824
Concept ID:
C0031190
Disease or Syndrome
Synonyms: Familial persistent pulmonary hypertension of the newborn; Persistent fetal circulation; Persistent pulmonary hypertension of the newborn
SNOMED CT: PFC - Persistent foetal circulation (233815004); Persistent pulmonary hypertension of the newborn (233815004); PFC - Persistent fetal circulation (233815004); PPHN - Persistent pulmonary hypertension in newborn (233815004)
 
Related gene: FOXF1
 
HPO: HP:0011726
Monarch Initiative: MONDO:0022430
OMIM®: 265380; 601089

Definition

Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a disorder affecting the development of the lungs and their blood vessels. The disorder affects the millions of small air sacs (alveoli) in the lungs and the tiny blood vessels (capillaries) in the alveoli. It is through these alveolar capillaries that inhaled oxygen enters the bloodstream for distribution throughout the body and carbon dioxide leaves the bloodstream to be exhaled.

In ACD/MPV, the alveolar capillaries fail to develop normally. The number of capillaries is drastically reduced, and existing capillaries are improperly positioned within the walls of the alveoli. These abnormalities in capillary number and location impede the exchange of oxygen and carbon dioxide.

Other abnormalities of the blood vessels in the lungs also occur in ACD/MPV. The veins that carry blood from the lungs into the heart (pulmonary veins) are improperly positioned and may be abnormally bundled together with arteries that carry blood from the heart to the lungs (pulmonary arteries). The muscle tissue in the walls of the pulmonary arteries may be overgrown, resulting in thicker artery walls and a narrower channel. These changes restrict normal blood flow, which causes high blood pressure in the pulmonary arteries (pulmonary hypertension) and requires the heart to pump harder.

Most infants with ACD/MPV are born with additional abnormalities. These may include abnormal twisting (malrotation) of the large intestine or other malformations of the gastrointestinal tract. Cardiovascular and genitourinary abnormalities are also common in affected individuals.

Infants with ACD/MPV typically develop respiratory distress within a few minutes to a few hours after birth. They experience shortness of breath and cyanosis, which is a bluish appearance of the skin, mucous membranes, or the area underneath the fingernails caused by a lack of oxygen in the blood. Without lung transplantation, infants with ACD/MPV have not been known to survive past one year of age, and most affected infants live only a few weeks. [from MedlinePlus Genetics]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
Follow this link to review classifications for Persistent fetal circulation syndrome in Orphanet.

Conditions with this feature

Chromosome 6q24-q25 deletion syndrome
MedGen UID:
461565
Concept ID:
C3150215
Disease or Syndrome
6q25 microdeletion syndrome is a recently described syndrome characterized by developmental delay, facial dysmorphism and hearing loss.
Mitochondrial complex 3 deficiency, nuclear type 10
MedGen UID:
1719382
Concept ID:
C5394051
Disease or Syndrome

Recent clinical studies

Etiology

Cookson MW, Abman SH, Kinsella JP, Mandell EW
Semin Fetal Neonatal Med 2022 Aug;27(4):101367. Epub 2022 Jun 3 doi: 10.1016/j.siny.2022.101367. PMID: 35688685Free PMC Article
Mandell E, Kinsella JP, Abman SH
Pediatr Pulmonol 2021 Mar;56(3):661-669. doi: 10.1002/ppul.25073. PMID: 32930508
Raffi ER, Nonacs R, Cohen LS
Clin Perinatol 2019 Jun;46(2):215-234. Epub 2019 Mar 28 doi: 10.1016/j.clp.2019.02.004. PMID: 31010557
Pearlstein T
Best Pract Res Clin Obstet Gynaecol 2015 Jul;29(5):754-64. Epub 2015 Apr 17 doi: 10.1016/j.bpobgyn.2015.04.004. PMID: 25976080
Nair J, Lakshminrusimha S
Semin Perinatol 2014 Mar;38(2):78-91. doi: 10.1053/j.semperi.2013.11.004. PMID: 24580763Free PMC Article

Diagnosis

Eilers LF, Kyle WB, Allen HD, Qureshi AM
Pediatr Rev 2021 Nov;42(11):632-634. doi: 10.1542/pir.2020-004564. PMID: 34725225
Singh Y, Lakshminrusimha S
Clin Perinatol 2021 Aug;48(3):595-618. doi: 10.1016/j.clp.2021.05.009. PMID: 34353582Free PMC Article
Mukherjee D, Konduri GG
Compr Physiol 2021 Jun 30;11(3):2135-2190. doi: 10.1002/cphy.c200023. PMID: 34190343Free PMC Article
Raffi ER, Nonacs R, Cohen LS
Clin Perinatol 2019 Jun;46(2):215-234. Epub 2019 Mar 28 doi: 10.1016/j.clp.2019.02.004. PMID: 31010557
Pearlstein T
Best Pract Res Clin Obstet Gynaecol 2015 Jul;29(5):754-64. Epub 2015 Apr 17 doi: 10.1016/j.bpobgyn.2015.04.004. PMID: 25976080

Therapy

Osman A, Halling C, Crume M, Al Tabosh H, Odackal N, Ball MK
J Perinatol 2023 Oct;43(10):1211-1221. Epub 2023 Aug 5 doi: 10.1038/s41372-023-01708-2. PMID: 37543651
Sankaran D, Lakshminrusimha S
Semin Fetal Neonatal Med 2022 Aug;27(4):101381. Epub 2022 Aug 7 doi: 10.1016/j.siny.2022.101381. PMID: 35963740
Singh Y, Lakshminrusimha S
Clin Perinatol 2021 Aug;48(3):595-618. doi: 10.1016/j.clp.2021.05.009. PMID: 34353582Free PMC Article
Raffi ER, Nonacs R, Cohen LS
Clin Perinatol 2019 Jun;46(2):215-234. Epub 2019 Mar 28 doi: 10.1016/j.clp.2019.02.004. PMID: 31010557
Nair J, Lakshminrusimha S
Semin Perinatol 2014 Mar;38(2):78-91. doi: 10.1053/j.semperi.2013.11.004. PMID: 24580763Free PMC Article

Prognosis

Danhaive O, Galambos C, Lakshminrusimha S, Abman SH
Clin Perinatol 2024 Mar;51(1):217-235. Epub 2023 Dec 28 doi: 10.1016/j.clp.2023.12.001. PMID: 38325943
van Laere D, van Overmeire B, Gupta S, El-Khuffash A, Savoia M, McNamara PJ, Schwarz CE, de Boode WP; European Special Interest Group ‘Neonatologist Performed Echocardiography’ (NPE)
Pediatr Res 2018 Jul;84(Suppl 1):46-56. doi: 10.1038/s41390-018-0077-x. PMID: 30072803Free PMC Article
Lai MY, Chu SM, Lakshminrusimha S, Lin HC
Pediatr Neonatol 2018 Feb;59(1):15-23. Epub 2017 Aug 10 doi: 10.1016/j.pedneo.2016.09.011. PMID: 28923474
Babooa N, Shi WJ, Chen C
World J Pediatr 2017 Dec;13(6):517-527. Epub 2017 Oct 20 doi: 10.1007/s12519-017-0056-z. PMID: 29058246
Keller RL
Clin Perinatol 2016 Mar;43(1):187-202. doi: 10.1016/j.clp.2015.11.013. PMID: 26876130

Clinical prediction guides

Butt MU, Jabri A, Hamade H, Abdouh AA, Mhanna M, Haddadin F, Nasser F, Hammad N, Jazar DA, Toumar AJ, Siraj A, Balakumaran K, Ilbawi M
Curr Probl Cardiol 2023 Aug;48(8):101181. Epub 2022 Mar 24 doi: 10.1016/j.cpcardiol.2022.101181. PMID: 35341801
Conrad C, Newberry D
Adv Neonatal Care 2019 Jun;19(3):179-187. doi: 10.1097/ANC.0000000000000590. PMID: 30720481
Aschner JL, Gien J, Ambalavanan N, Kinsella JP, Konduri GG, Lakshminrusimha S, Saugstad OD, Steinhorn RH
J Perinatol 2016 Jun;36 Suppl 2:S32-6. doi: 10.1038/jp.2016.47. PMID: 27225964
Harris E, Schulzke SM, Patole SK
Paediatr Drugs 2010 Oct 1;12(5):301-11. doi: 10.2165/11532600-000000000-00000. PMID: 20799759
Drummond WH
Adv Pediatr 1983;30:61-91. PMID: 6424420

Recent systematic reviews

Masarwa R, Bar-Oz B, Gorelik E, Reif S, Perlman A, Matok I
Am J Obstet Gynecol 2019 Jan;220(1):57.e1-57.e13. Epub 2018 Aug 28 doi: 10.1016/j.ajog.2018.08.030. PMID: 30170040
't Jong GW, Einarson T, Koren G, Einarson A
Reprod Toxicol 2012 Nov;34(3):293-7. Epub 2012 May 5 doi: 10.1016/j.reprotox.2012.04.015. PMID: 22564982
Bassler D, Kreutzer K, McNamara P, Kirpalani H
Cochrane Database Syst Rev 2010 Nov 10;2010(11):CD007802. doi: 10.1002/14651858.CD007802.pub2. PMID: 21069698Free PMC Article
Harris E, Schulzke SM, Patole SK
Paediatr Drugs 2010 Oct 1;12(5):301-11. doi: 10.2165/11532600-000000000-00000. PMID: 20799759
Ho JJ, Rasa G
Cochrane Database Syst Rev 2007 Jul 18;2007(3):CD005588. doi: 10.1002/14651858.CD005588.pub2. PMID: 17636807Free PMC Article

Supplemental Content

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    Clinical resources

    Practice guidelines

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      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • ACMG ACT, 2013
      American College of Medical Genetics and Genomics, Newborn Screening ACT Sheet, Hypoxemia, Critical Congenital Heart Disease, 2013

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