ABSTRACT
Delayed passage of meconium may increase enterohepatic circulation of bilirubin, which
appears to be an important contributor to neonatal jaundice. To evaluate the effect
of early meconium evacuation on neonatal hyperbilirubinemia, between January 1993
and December 1993, 265 healthy neonates were studied and randomly divided into two
groups. Group 1 consisted of 130 neonates who received glycerin enema (1 mL of glycerin
mixed with 1 mL of warmed normal saline) within 30 minutes after birth and the same
procedure was repeated at 12 hours of age. Group 2 consisted of 135 neonates receiving
no glycerin enema throughout their hospital stay. Determination of total serum bilirubin
using capillary samples was performed daily for 7 days. Our data showed that 12 neonates
(15.4%) in group 1 and 18 neonates (13.3%) in group 2 had serum bilirubin level 15
mg/dL or higher and received phototherapy. We conclude that early evacuation of meconium
by using glycerin enema within 30 minutes after birth and 12 hours after birth in
order to reduce enterohepatic circulation of bilirubin has no effect on lowering peak
serum bilirubin levels or on serum bilirubin concentrations in the first 7 days of
life.
Keywords
Meconium evacuation - neonatal hyperbilirubinemia - enterohepatic circulation - phototherapy
