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Hyperviscosity - newborn

Definition

Hyperviscosity of the newborn is the slowing and blockage of blood flow that results when there are too many red blood cells in an infant's blood.

Alternative Names

Neonatal polycythemia

Causes, incidence, and risk factors

Hyperviscosity can occur when the percentage of red blood cells (RBCs) in the infant's blood,, called the "hematocrit," is greater than 65%. This may result from various conditions that develop before birth, such as:

  • Birth defects
  • Delay in clamping the umbilical cord
  • Diabetes in the baby's birth mother
  • Inherited diseases
  • Not enough oxygen reaching body tissues (hypoxia)
  • Twin-twin transfusion syndrome, which occurs when blood moves from one twin to the other.

The extra RBCs can block the flow of blood in the smallest blood vessels. This may lead to tissue death from lack of oxygen. This blocked blood flow can affect all organs, including the kidneys, lungs, and brain.

Symptoms

Symptoms may include:

  • Extreme sleepiness
  • Feeding problems
  • Seizures
  • Very ruddy (red) skin color

Signs and tests

There may be signs of breathing problems, kidney failure, and newborn jaundice.

If the baby has symptoms of hyperviscosity, a blood test to count the number of red blood cells will be done. This test is called a hematocrit.

Other tests may include:

  • Blood gases to check oxygen level in the blood
  • Blood sugar (glucose) to check for low blood sugar
  • Blood urea nitrogen (BUN), a substance that forms when protein breaks down
  • Creatinine, a substance produced by muscles that can build up in the blood if the kidneys aren't working properly
  • Urinalysis

Treatment

The baby will be monitored for complications of hyperviscosity. If needed, an exchange transfusion will be done to lower the amount of red blood cells that are moving through the baby's blood vessels.

Other treatment may include increasing body fluids.

Expectations (prognosis)

The outlook is good for infants with mild hyperviscosity and those who receive treatment for severe hyperviscosity.

Some children may have mild changes in neurological development. Parents who believe their child may show any signs of developmental delay should contact their health care provider.

Complications

Complications may include:

  • Death of intestinal tissue (necrotizing enterocolitis)
  • Decreased fine motor control
  • Kidney failure
  • Seizures
  • Strokes

Review Date: 6/17/2011
Reviewed By: Kimberly G Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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