Symptomatic Neonatal Plethora

Abstract

Blood volume and clinical data are reported on 8 premature and 3 full-term infants who presented with symptoms apparently due to polycythemia or hypervolemia. These cases termed ‘symptomatic neonatal plethora’ were caused by large placental transfusions associated with delayed clamping of the umbilical cord. Tachypnea, mild cyanosis, plethoric skin color, and neurological depression persisted on average for 30 h after birth. Chest X-rays showed mild cardiomegaly, pulmonary congestion and edema, and pleural effusions. Although the course was in general benign, phlebotomy was considered to be indicated in three infants to treat progressive clinical deterioration. The symptomatology and blood volume on these infants were compared with infants in an ongoing study with controlled time of cord clamping. Neonatal plethora must be considered as one cause of Ê»transient tachypnea of the newborn’.

Effects of umbilical cord milking compared to differed cord clamping in term infants, a randomized controlled trial

“…Other risks of DCC are transient tachypnea 10 , symptomatic polycythaemia 11 , increased blood viscosity 12 and hyperbilirubinaemia 13 of the term infant. However no clinically significant adverse effects consequent to these changes have been demonstrated by well-designed studies.…”

Polycythemia of the Preterm and Full-Term Newborn Infant: Relationship between Hematocrit and Gestational Age, Total Blood Solutes, Reticulocyte Count, and Blood pH

“…We noted no neonatal polycythemia in the appropriate for gestational age preterm group. It appears that preterm infants do not rapidly extravasate sufficient plasma out of their circulation to produce significantly elevated Hct values [16].…”

“…Later in the neonatal life, a venous Hct equal or higher than 65% is considered as neonatal polycythemia. Polycythemia and secondary hyperviscosity have been associ ated with various life-threatening conditions, including cardiopulmonary [6][7][8], renal [9], neurologic [10][11][12], and other associated dis turbances [13][14][15], However, little is reported about neonatal polycythemia in the preterm infant [16,17], We conducted this study in order to establish whether or not a relation ship exists between umbilical cord venous Hct at birth and the value 2 h later in both preterm and full-term newborn infants. We also attempted to determine whether there is a relationship between both Hcts and gesta tional age, reticulocyte count, total blood sol utes, and blood pH at birth.…”

Early Cord Clamping Protects At-Risk Neonates from Polycythemia

“…First, the authors' review of the literature is incomplete. There is only one actual report of a study relating cord clamping and symptomatic polycythemia [2] from 1977. We have found that the older study lacks the methodological rigor expected today and was not a randomized controlled trial (RCT).…”