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Am J Perinatol 2011; 28(9): 677-682
DOI: 10.1055/s-0031-1280595
© Thieme Medical Publishers

Restrictive Management of Neonatal Polycythemia

Iris Morag1 , Tzipora Strauss2 , Daniel Lubin1 , Irit Schushan-Eisen2 , Gili Kenet3 , Jacob Kuint2
  • 1Department of Neonatology, Mayanei HaYeshua Medical Center, Bnei Brak, Israel
  • 2Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
  • 3The Thrombosis Unit, National Hemophilia Center and Institute of Thrombosis and Hemostasis, Chaim Sheba Medical Center, Tel Hashomer, Israel
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Publication History

Publication Date:
10 June 2011 (online)

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ABSTRACT

Partial exchange transfusion (PET) is traditionally suggested as treatment for neonates diagnosed with polycythemia. Nevertheless, justification of this treatment is controversial. We evaluated the risk for short-term complications associated with a restrictive treatment protocol for neonatal polycythemia. A retrospective cross-sectional analytical study was conducted. Three treatment groups were defined and managed according to their degree of polycythemia, defined by capillary tube filled with venous blood and manually centrifuged hematocrit: group 1, hematocrit 65 to 69% and no special treatment was recommended; group 2, hematocrit 70 to 75% and intravenous fluids were given and feedings were withheld until hematocrit decreased to <70%; and group 3, hematocrit ≥76% or symptomatic neonates and PET was recommended. During the study period, 190 neonates were diagnosed with polycythemia. The overall rate of short-term complications was 15% (28 neonates). Seizures, proven necrotizing enterocolitis, or thrombosis did not occur in any participating neonates. PET was performed in 31 (16%) neonates. The groups did not differ in their rate of early neonatal morbidities or length of hospitalization. Restrictive treatment for neonatal asymptomatic polycythemia is not associated with an increased risk of short-term complications.

KEYWORDS

Polycythemia - neonate - treatment

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Iris MoragM.D. 

Department of Neonatology, Mayanei HaYeshua Medical Center

Harav Povarski Street 17, Bnei Brak, Israel

Email: irismorag@gmail.com