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Polycythemia is defined by venous hemoglobin concentration > 220 g/l or by hematocrit value > 0.65 during the first week of life. It correlates clinically with hyperviscosity syndrome.

The common causes:

  • chronic intrauterine hypoxia
  • twin-twin transfusion syndrome in monochorionic-diamniotic twins (recipient twin)
  • excessive placental transfusion


Clinical signs

Laboratory findings

  • venous hemoglobin concentration > 220 g/l or hematocrit value > 0.65 during the first week of life



  • treatment for individual symptoms
  • parenteral fluids (hypoglycemia, jaundice)
  • careful enteral nutrition (variable perfusion of gastrointestinal tract)


  • partial exchange transfusion => reduce hematocrit < 0.60


① Sarkar S, Rosenkrantz TS. Neonatal polycythemia and hyperviscosity. Semin Fetal Neonatal Med. 2008;13(4):248-255. doi:10.1016/j.siny.2008.02.003

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