COMPARATIVE STUDY OF ORAL L-ARGININE THERAPY VERSUS NON-AMBULATORY TREATMENT IN PREGNANCY WITH ASYMMETRICAL FETAL GROWTH RESTRICTION

Abstract

L-arginine is a unique molecule that produces nitric oxide in body and plays a crucial role in physiological hemodynamic modification in pregnancy. A randomised comparative prospective study was carried out in a maternity hospital in Kolkata over one year. The study involved a study group of fifty antenatal mothers with asymmetrical fetal growth restriction detected ultrasonographically around 30-32 weeks of gestation and treated with 5 grams of L-arginine per day over a period of 28 days and a historical control group of fifty patients of same parameters with non- ambulatory treatment in home atmosphere. The aim of our study was to compare the fetal growth and pregnancy outcomes in pregnant mothers supplemented with L-arginine with that in the control group with non-ambulatory treatment in home atmosphere. L-arginine was found to accelerate fetal growth. Fetal growth restriction at delivery in L-arginine group was 42% compared to 46% in control group (p=0.84). Moreover, neonates of treatment group revealed higher Apgar score, lower incidence of respiratory distress syndrome (16% versus 42%, p=0.0076) and intraventricular haemorrhage (2% versus 20%, p=0.007) and lower admission to neonatal intensive care unit (10% versus 44%, p=0.000225). Caesarean section rate was higher in control group than in arginine group (80% versus 72%, p=0.48). Hence, oral treatment with L- arginine seemed promising in improving fetal outcome.