Early meconium evacuation: effect on neonatal hyperbilirubinemia.

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.