Neonatal Polycythemia: Risk Factors, Clinical Manifestation and Treatment Applied


BACKGROUND: Polycythemia is defined as a venous hematocrit above 65%.Polycythemia is sometimes associatedwith hyper viscosity of blood .The etiology of polycythemia is related either to intra-uterine hypoxiaor secondary to fetal transfusion. Increased viscosity of blood is associated with symptoms of hypoperfusion.Clinicalfeaturesrelatedtohyperviscositymayaffectallorgansystems. OBJECTIVE: To evaluate the prevalence of polycythemia among neonates who were admitted to the nursery careunit, to evaluate the difference between peripheral and central hematocrit (PCV) and to have an ideaabout the main presentation and modes of treatment of polycythemia. PATIENTS AND METHODS: A case – control study was done in the nursery care unit of AL - Kadhyimia Teaching Hospital , onehundred neonates (50 polycythemic and 50 control healthy neonates ) were taken , for each neonates ,information regarding (name ,age , sex , gestational age , mode of delivery , body weight ,length, headcircumference , clinical presentation and risk factors ) were taken, investigations includinghematocrite (PCV) , random blood sugar and total serum bilirubin were done for all neonates. RESULTS: The prevalence of neonatal polycythemia was (2.2%) , male was affected more than female with male: female ratio equal to ( 1.5:1) . The difference between peripheral and central PCV was (4 - 15%) with a mean and standard deviation of ( 7 ± 0.33%). The main signs & symptoms were jaundice (58%), lethargy (30%) , respiratory distress(26%) and hypoglycemia (26%) . Risk factors were preterm (36%) , neonates of diabetic mother(20%) , small for gestational age (18%) , twin pregnancy (12%) and down's syndrome (10%) . Partialexchange transfusion was done to 28 cases (56%). CONCLUSION: Males were affected more than females. Jaundice was the main presentation followed by lethargy,respiratory distress and hypoglycemia .Higher risk in twin pregnancy ,neonates of diabetic mother ,small for gestational age , preterm and down's syndrome while delivery by caesarian section reducethe risk of polycythemi