Polycythemia of the Newborn Follow-up
- Author: Karen J Lessaris, MD; Chief Editor: Ted Rosenkrantz, MD more...
Further Inpatient Care
- Carefully monitor vital signs and bilirubin, glucose, and electrolyte levels as needed in newborns with polycythemia.
- Feedings may cautiously be introduced hours after completing the partial exchange transfusion.
Further Outpatient Care
- Perform routine newborn follow-up care.
Complications
- Apnea
- Arrhythmia
- Vasospasm
- Vessel perforation
- Air embolus
- Thrombosis
- Infarction
- Thrombocytopenia
- Hemolysis
- Electrolyte abnormalities
- Hypoglycemia
- Hypocalcemia
- Intrahepatic hematoma
- Necrotizing enterocolitis
Prognosis
- Infants are at increased risk for neurological deficits including speech abnormalities, fine-motor delays, and gross-motor delays.
- Partial exchange transfusion has not been shown to reduce these problems, and umbilical partial exchange continues to show increased risk for necrotizing enterocolitis (NEC). Recent data suggest that the cause of impaired long-term outcome is also the cause of the polycythemia; both conditions are associated with intrauterine fetal hypoxia.
Jeevasankar M, Agarwal R, Paul VK, et al. Polycythemia in the newborn. Indian J Pediatr. January 2008;75(1):68-73.
Mimouni FB, Merlob P, Dollberg S, Mandel D. Neonatal polycythaemia: critical review and a consensus statement of the Israeli Neonatology Association. Acta Paediatr. Oct 2011;100(10):1290-6. [Medline].
Sankar MJ, Agarwal R, Deorari A, Paul VK. Management of polycythemia in neonates. Indian J Pediatr. Oct 2010;77(10):1117-21. [Medline].
[Guideline] AAP. American Academy of Pediatrics Committee on Fetus and Newborn: routine evaluation of blood pressure, hematocrit, and glucose in newborns. Pediatrics. Sep 1993;92(3):474-6. [Medline].
Morag I, Strauss T, Lubin D, Schushan-Eisen I, Kenet G, Kuint J. Restrictive management of neonatal polycythemia. Am J Perinatol. Oct 2011;28(9):677-82. [Medline].
Awonusonu FO, Pauly TH, Hutchison AA. Maternal smoking and partial exchange transfusion for neonatal polycythemia. Am J Perinatol. Oct 2002;19(7):349-54. [Medline].
[Best Evidence] Dempsey EM, Barrington K. Short and long term outcomes following partial exchange transfusion in the polycythaemic newborn: a systematic review. Arch Dis Child Fetal Neonatal Ed. Jan 2006;91(1):F2-6. [Medline].
Drew JH, Guaran RL, Grauer S, Hobbs JB. Cord whole blood hyperviscosity: measurement, definition, incidence and clinical features. J Paediatr Child Health. Dec 1991;27(6):363-5. [Medline].
Pappas A, Delaney-Black V. Differential diagnosis and management of polycythemia. Pediatr Clin North Am. Aug 2004;51(4):1063-86, x-xi. [Medline].
Rosenkrantz TS. Polycythemia and hyperviscosity in the newborn. Semin Thromb Hemost. Oct 2003;29(5):515-27. [Medline].
Schimmel MS, Bromiker R, Soll RF. Neonatal polycythemia: is partial exchange transfusion justified?. Clin Perinatol. Sep 2004;31(3):545-53, ix-x. [Medline].
Shohat M, Reisner SH, Mimouni F, Merlob P. Neonatal polycythemia: II Definition related to time of sampling. Pediatrics. Jan 1984;73(1):11-3. [Medline].
Werner EJ. Neonatal polycythemia and hyperviscosity. Clin Perinatol. Sep 1995;22(3):693-710. [Medline].
Wirth FH, Goldberg KE, Lubchenco LO. Neonatal hyperviscosity: I. Incidence. Pediatrics. Jun 1979;63(6):833-6. [Medline].
Wong W, Fok TF, Lee CH, et al. Randomised controlled trial: comparison of colloid or crystalloid for partial exchange transfusion for treatment of neonatal polycythaemia. Arch Dis Child Fetal Neonatal Ed. Sep 1997;77(2):F115-8. [Medline].
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