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Polycythemia of the Newborn Workup

  • Author: Karen J Lessaris, MD; Chief Editor: Ted Rosenkrantz, MD  more...
Updated: Jan 02, 2016

Approach Considerations

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. Increased hematocrit is associated with decreased platelet count. [3]

Doppler ultrasonography

Middle cerebral artery peak systolic velocity may be a reliable tool for estimating hemoglobulin level in cases of twin anemia-polycythemia sequence (TAPS).[6, 7] In a study involving 20 cases of TAPS, Veujoz et al reported a relationship between the hemoglobin level and the middle cerebral artery peak systolic velocity, although there was a 71% sensitivity and 50% specificity of prenatal diagnosis correspondence with postnatal diagnosis.[7]

Contributor Information and Disclosures

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, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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, University of Missouri-Kansas City School of Medicine; Attending Physician, Division of Neonatology, Children's Mercy Hospital and Clinics; Faculty, Children's Mercy Bioethics Center

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 Pediatric Society, American Society for Bioethics and Humanities, American Society of Law, Medicine & Ethics, Society for Pediatric Research, National Hospice and Palliative Care Organization

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 Pediatric Society, Eastern Society for Pediatric Research, American Medical Association, Connecticut State Medical Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

Additional Contributors

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.

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