Neonatal Polycythemia (Polycythemia in Newborn)
Neonatal Polycythemia is the abnormal condition of having too many red blood cells in circulation.
- Post maturity, and low blood levels of oxygen in the fetus are the usual reasons for polycythemia in newborns. If the mother is diabetic, the infant has a higher risk of developing this condition.
- When the number of red blood cells in a given volume of blood is higher, it increases the viscosity of the blood. The thicker blood, or the hyperviscosity of the blood, slows down its flow through the smaller vessels.
- The infants with polycythemia may not exhibit any symptoms, but they may look reddish or dusky. Lethargy, poor feeding may develop due to this condition. Seizures too may occur, but it is very rare.
- A blood test to assess the red blood cell content helps in diagnosing polycythemia.
- When symptoms are absent, mild polycythemia is treated with the administration of adequate amounts of fluids.
- When symptoms are present, exchange transfusion of blood help reduce hyperviscosity, as well as the symptoms associated with polycythemia.
When the blood is too thick due to very high concentration of the RBCs, the blood flow in the capillaries becomes very slow. It may compromise the oxygen supply to the various tissues of the body. The reasons for polycythemia in infants are many. It is very common in postmature infants who are born one or two weeks after the completion of the normal gestational period. Infants born to mothers who have high blood pressure or diabetes, and those from high altitude areas also can have this condition. Smoking during pregnancy is another reason that puts the infants at high risk.
A fetus that had hypoxia or low blood levels of oxygen and which suffered intra uterine growth retardation are prone to developing neonatal polycythemia at birth. When a newborn has received large amounts of blood, either from the placenta before the umbilical cord is severed, or from its twin via twin-to twin blood transfusion, it may result in excess amount of blood in the baby.
When polycythemia is severe, the newborn may have a reddish complexion or may look dusky. Lethargy and poor feeding may be indications of neonatal polycythemia. Very rarely, seizures too occur. A test of hematocrit is often done to assess the red blood count. If the hematocrit is very high or if the symptoms are present, the infant’s blood is diluted by partial exchange transfusion. In this procedure, a small amount of the infant’s blood is drawn out with a syringe first, and then the same quantity of saline is injected back into the vein, thus bringing down the RBC concentration in the blood.
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Yasser Elnahas
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