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Polycythaemia Neonatal Management Clinical Guideline
Polycythaemia Neonatal Management Clinical Guideline
Clinical Guideline
V1.0
June 2021
Summary
Infant identified as
at risk of Capillary Hct
identified >65% and Infants at risk
polycythaemia with Capillary
one sign or Infant of
one sign or Haematocrit diabetic mother
symptom symptom identified (Hct) >70% Prolonged
delayed cord
clamping >2
mins
Twin to Twin
transfusion
Venous Full Blood Count Intrauterine
growth
sample
restriction
(IUGR)
Cord pH <7.0
Large for
gestational age
Asymptomatic Symptomatic >98th centile
Chromosomal
anomalies such
as Trisomy 21,
18 and 13
Venous Hct Venous Hct Venous Hct Venous Hct Severe
65-70% >70% 65-70% >70% Preeclampsia
2. The Guidance
Polycythaemia is defined as a venous packed cell volume/haematocrit (Hct) of
over 65%. This condition affects approximately 1-5% of newborns in the
postnatal period. Many affected infants are asymptomatic and the characteristic
clinical features and related complications are thought to occur as a result of
hyperviscosity. It is however important to note that not all polycythaemic infants
suffer from hyperviscosity. Hyperviscosity can result in serious clinical
consequences due to reduced blood flow to organs leading to poor tissue
perfusion and possible microthrombus formation.
Intrapartum Hypoxia
Maternal Preeclampsia
Cyanosis
Hypocalcaemia
2.3. Investigations
2.4. Management
ECG Monitoring
Nil by mouth until Hct < 65% then as per high risk
feeding regime
2.4.2.5. Equipment
Volumetric pump
2.4.2.6. Procedure
Necrotising enterocolitis
Infection
Urinalysis
Directorate / Department
Jenna Julian; Neonatal Nurse
responsible (author/owner):
All or part of this document can be released under the Freedom of Information
Act 2000
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3. Policy Intended
Outcomes
To improve the well-being of patients by offering the appropriate
management.
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the outcome? management
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to benefit from the Patients and their families.
policy?
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