Polycythaemia

[PseudoBadger]

Hello,

This might be better in children's health, but its about my future concerns for dc2 so not sure really. Sorry for the length...

I've never found anyone whose DC has had similar, and the midwifes I've spoken to so far this pregnancy have been rather clueless about newborn health ("we deal with the mother, paeds deal with the baby" :o)

DS was born in 2011 via emcs after a very long induced (drip) labour and over 2 hours failed pushing.
He was fine when he came out but was sleepy from as soon as we got to recovery. His temperature then started to fall and he became jittery, however due to shift changes this was not immediately picked up by medics.

At about 2am (he was born just before 6pm) he was rushed away from me on the post natal ward and taken to NICU. All I was told at that stage was that he needed to be on a drip for a possible infection.

To cut a long story short he had polycythaemia which was explained to me in my post cs haze as 'sticky blood'. His blood was thinned down using a drip and he was in an incubator to raise his temperature.
Whilst he was in NICU I was also unwell and had a blood transfusion.

After he was released from NICU (3 days) he then developed jaundice (always just below the treatment line) which persisted for at least 3 weeks. He took the same amount of time to regain birthweight too and I came under an immense amount of pressure from the midwives visiting at home to sort this out.

So.... DC2 will be born via elcs in October and I guess what I'm asking is how likely is this to happen again? I can find very little information regarding causes of polycythaemia other than a link to delayed clamping - and I have no idea how long my cord was left for with DS.

Can anyone help me?

[essexgirl31]

Ds2 had this. He ended up in NICU 24 hours after birth having a similar procedure to the one your dc had. He was then in scbu for a while. He ended up with jaundice too. He lots quite a lot of birth weight.

While he was in NICU I was told it one of these things that happen and that it is rare.

When I returned to an outpatients appointment a few weeks later the awful dr there said it was caused by dehydration from ineffective breast feeding. This was not mentioned to me by any health care professional while in hospital. So who knows what caused it. Quite frankly I didn't believe that dr as she was useless and really couldn't answer my questions.

Like you the only information I really found was to do with the time the cord was clamped. I had a water birth and would have no idea how long it took to clamp the cord.

It was an incredibly frightening time as what could have happened if it hadn't been detected doesn't bear thinking about!!

I have never met another person who has had it, heard of it or new someone that had it!

Apologies for the essay!

Hope all goes well with dc2

[MarilynMoanroe]

That sounds like an ordeal! Has your ds fully recovered, in regards to the "sticky blood"?

You can also request a de brief with a midwife at the hospital who can explain the details of the delivery and details of his time in icy?

[essexgirl31]

Knew not new!

[PseudoBadger]

Essexgirl! Great (iykwim) to find someone else who has experienced this. Sounds like perhaps medics aren't too sure about what causes it either?
I have found some things about overdue babies being more likely to have it (but DS was born at 38 weeks), and extremely high BP in the mother perhaps having an impact (which did apply for me).

What really annoyed me is that I now know that jaundice is inevitable after polycythaemia as it is the natural effect of breaking down the excess red blood cells. Like you I was made to feel guilty that I had 'allowed' him to develop jaundice. There was never any cross referencing by midwives (once home) to the condition and resultant jaundice.

Perhaps we need an MN campaign to raise awareness :o

Marylin, thank you. He is completely fine (2 and a half now!) and once the jaundice went there seemed to be no impact at all.

He had a paed follow up a few weeks after but this focused on his possible retained testicle (which he never actually had!) so the polycythaemia kind of got pushed aside. Oh yes it was a fun time, as soon as he left NICU we were off for ultrasounds on his tiny groin :(

[essexgirl31]

I had forgotten about overdue babies! Ds2 was a week overdue.

It is nice to find someone else who has been through it. Ds was fine once we had been discharged apart from the jaundice too.

[talsi]

I had two children with this, both were in Icu within a few hours of being born, and no one can really say why they had it (didn't have any of the reasons said above, two v quick natural labours). Advice I would give is to ask for your baby to be checked as soon as its born - this is what I did the second time, they checked him and took him straight to nicu to start procedure and we were only in for two days. Have just had another baby and also got them to check the baby straight away, he didn't have it but they kept us in extra night to run tests twice

[onceipopicantstop]

Hi sorry to hear you had a rough time with your last pregnancy. Sorry if im repeating what you already know but polycythaemia basically means a higher percentage of red blood cells in the circulation than normal. At the lower level its not a big problem, but as the concentration increases the blood becomes thicker and the circulation can be affected. In extreme circumstances clots can form. Usually its managed with fluids to dilute the concentration, but in severe cases a transfusion may be required to reduce the risk of complications. As already mentioned jaundice is much more common because the excess cells eventually get broken down and this is the cause of jaundice. I think the cause is usually unknown, although dehydration can cause it and its more common in post dates babies. Theres a useful article on emedicine - cant do a link on this computer sorry, but if you type neonatal polycythaemia into google its the top link. I havent worked with neonates for a very long time so my knowledge is a bit rusty but hope that helps.

[PseudoBadger]

Thank you Talsi I will certainly ask for that at birth this time - hopefully they'll know what I'm on about :o

Thanks Onceipop, I think unfortunately for DS his deterioration was missed for several hours due to ward transfers, shift changes etc. Certainly there were several notes made about his falling temperature before any concerns were raised with doctors, who then noticed he was jittery. I really want to avoid it again!