title: Effect of induction of meconium evacuation using per rectal laxatives on neonatal hyperbilirubinemia in term infants: a systematic review of randomized controlled trials.
abstract: OBJECTIVE
  To study the efficacy of early meconium evacuation using per rectal laxatives on the level of serum bilirubin and the need for phototherapy in healthy term infants.
  
  
  METHODS
  Systematic review of randomized controlled trials comparing per rectal laxatives versus no intervention was conducted using English language articles identified from the Cochrane Central Register of Controlled Trials, Medline, Ovid, and CINAHL databases and bibliographies of selected articles. Eligible studies were assessed for the risk of bias in conduct and reporting.
  
  
  RESULTS
  A total of three trials (n = 469) mostly with "unclear risk" were eligible for inclusion. Two trials used glycerin suppository whereas one used glycerin enema for meconium evacuation. Meta-analysis was not possible due to clinical heterogeneity in the choice of laxatives and frequency of intervention. In all the three studies, serum bilirubin levels at 48 h and the need for phototherapy was not significantly different between the two groups. Passage of first meconium and the transitional stools occurred significantly early in the intervention group compared to controls.
  
  
  CONCLUSIONS
  Early evacuation of meconium using per rectal laxatives does not offer any significant clinical advantage for neonatal jaundice.
authors: Department of Neonatology and Pediatrics. Joondalup Health Campus, University of Western Australia, Australia. Ravisha.srinivasjois@health.wa.gov.au
authors: Ravisha
authors: R
authors: Srinivasjois
authors: Ajay
authors: A
authors: Sharma
authors: Prakesh
authors: P
authors: Shah
authors: Maina
authors: M
authors: Kava
mesh_terms: D000285:Administration, Rectal; D004733:Enema / Q000379:methods*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000188:drug therapy* / Q000378:metabolism*; D007231:Infant, Newborn; D054368:Laxatives / Q000008:administration & dosage*; D008470:Meconium / Q000378:metabolism*; D016032:Randomized Controlled Trials as Topic
chemical_list: D054368:Laxatives