Evaluation of using agar combined with phototherapy in management of neonatal unconjugated hyperbilirubinemia

Abstract

Background:Neonatal hyperbilirubinemia is a common problem in neonates.Phototherapy is an efficient way to decrease the accumulation of bilirubin, although it involves hospitalization, and can force the baby to stop eating due to the breast separation. In certain cases of infant jaundice, the hepatic circulation of bilirubin plays a major role Objectives: The purpose of the study was todetermine the value of oral agar ingestion combined with phototherapy in management of neonatal unconjugated hyperbilirubinemia and to compare it with the use of phototherapy alone in the management. Patients and methods: This was a randomized controlled study conducted at Neonatal intensive care units in Qena university hospital and Qena general hospital. They were divided into: Case group (neonates received oral agar with phototherapy).Control group (neonates received phototherapy alone). The duration of this study was 6 months. Results: The study included 517 neonates,314 neonates (60.74%) treated withphototherapy alone and 203 neonates (39.26%) treated withphototherapy combined with agar .There was a significant decrease in total serum bilirubin (TSB) in both subgroups, but the decrease was more significant in term male babies andin group that received agar with phototherapy than the group received phototherapy alone. Conclusion: Our results show that the administration of oral agar in full-term neonates was safe to decrease total serum bilirubin (TSB) concentrations and to shorten the length of phototherapy in hyperbilirubinemic neonates. As a supplementary treatment for neonates with hyperbilirubinemia, our results indicated that agar may benefit in minimizing the length of hospitalization.

Keywords

• phototherapy; neonatal; jaundice; hyperbilirubinemia; agar; kernicterus