Radiological findings in symptomatic neonatal plethora resulting from placental transfusion

As a result of excessive placental transfusion at birth, 8 premature and 3 full-term infants presented with cardiorespiratory and neurological symptoms. Cord clamping was delayed in all infants, and blood volume studies showed polycythemia or hypervolemia. The radiological findings included pulmonary vascular congestion, hyperaeration, pleural effusion, and mild cardiomegaly. Most infants responded to conservative medical management and were asymptomatic within 24 to 72 hours. Three acutely ill infants showed great improvement after phlebotomy, providing further evidence that circulatory overload due to placental transfusion may be the etiological factor in this symptom-complex.