Polycythemia of the Newborn Workup

  • Author: Karen J Lessaris, MD; Chief Editor: Ted Rosenkrantz, MD   more...
 
Updated: Mar 27, 2012
 

Laboratory Studies

  • The central venous hematocrit (Hct) measurement is used as a surrogate for diagnosing hyperviscosity in newborns with polycythemia because it is readily available. Most clinical laboratories are not able to measure blood viscosity.
  • Other laboratory tests include measurements of the following:
    • Serum glucose and calcium levels: Measure these to determine if the patient has decreased levels that require treatment.
    • Bilirubin level: Measure this level in the infant with jaundice and polycythemia because the increased RBC mass leads to an increased load of bilirubin precursors that can result in hyperbilirubinemia.
    • Arterial blood gases (ABG): Consider measuring ABG values to assess oxygenation in the symptomatic infant with respiratory distress and cyanosis.
    • Platelet count: This count may demonstrate thrombocytopenia if thrombosis or disseminated intravascular coagulation (DIC) are present.
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Karen J Lessaris, MD  Clinical Faculty, Department of Pediatrics, Division of Neonatology, Carolinas Medical Center

Karen J Lessaris, MD is a member of the following medical societies: American Academy of Pediatrics and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Scott S MacGilvray, MD  Clinical Professor, Department of Pediatrics, Division of Neonatology, The Brody School of Medicine at East Carolina University

Scott S MacGilvray, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Brian S Carter, MD, FAAP  Professor of Pediatrics (Neonatology), Vanderbilt University School of Medicine; Director, Neonatal Follow-up Program, Monroe Carell Jr Children's Hospital at Vanderbilt

Brian S Carter, MD, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Society for Bioethics and Humanities, American Society of Law, Medicine & Ethics, National Hospice and Palliative Care Organization, Society for Pediatric Research, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Carol L Wagner, MD  Professor of Pediatrics, Medical University of South Carolina

Carol L Wagner, MD is a member of the following medical societies: American Academy of Pediatrics, American Chemical Society, American Medical Women's Association, American Public Health Association, American Society for Bone and Mineral Research, American Society for Clinical Nutrition, Massachusetts Medical Society, National Perinatal Association, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Ted Rosenkrantz, MD  Professor, Departments of Pediatrics and Obstetrics/Gynecology, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine

Ted Rosenkrantz, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Pediatric Society, Connecticut State Medical Society, Eastern Society for Pediatric Research, and Society for Pediatric Research

Disclosure: Nothing to disclose.

References

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  2. 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].

  3. Sankar MJ, Agarwal R, Deorari A, Paul VK. Management of polycythemia in neonates. Indian J Pediatr. Oct 2010;77(10):1117-21. [Medline].

  4. [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].

  5. 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].

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  9. Pappas A, Delaney-Black V. Differential diagnosis and management of polycythemia. Pediatr Clin North Am. Aug 2004;51(4):1063-86, x-xi. [Medline].

  10. Rosenkrantz TS. Polycythemia and hyperviscosity in the newborn. Semin Thromb Hemost. Oct 2003;29(5):515-27. [Medline].

  11. Schimmel MS, Bromiker R, Soll RF. Neonatal polycythemia: is partial exchange transfusion justified?. Clin Perinatol. Sep 2004;31(3):545-53, ix-x. [Medline].

  12. 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].

  13. Werner EJ. Neonatal polycythemia and hyperviscosity. Clin Perinatol. Sep 1995;22(3):693-710. [Medline].

  14. Wirth FH, Goldberg KE, Lubchenco LO. Neonatal hyperviscosity: I. Incidence. Pediatrics. Jun 1979;63(6):833-6. [Medline].

  15. 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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