Effect of L-Arginine on Intrauterine Growth Restriction Fetuses Measured by Birth weight: Randomised Controlled Trial

Abstract

Background An area of fetal medicine research interest is to determine whether the enhancement of NO productivity could boost fetal growth patterns . There are attempts to the treatment of IUGR pregnancies by L-Arginine but the results are still inadequate. Objective this study investigate the effect of L-arginine supplementation on fetal growth and pregnancy outcome. Methodology A prospective interventional randomised controlled research trial, conducted at Ain Shams University Maternity Hospital. From 2017 till 2018, 260 pregnant females as research study Categorized randomly into two equal numbered research groups, 12 cases were dropped out due to loss of contact with them. Finally249 pregnant women were diagnosed with IUGR and have been categorized into two groups according to the results:Group I:125 pregnant women with IUGR recived 3g L_arginine and 75 mg of Acetylesalicylic daily. Group II: 124 pregnant women with IUGR recived 75mg Acetylesalicylic ic acid daily only . Both research groups were followed up by daily fetal movement counting, day after day cardiotocography (CTG) ,doppler twice weekly , Pelvic sonographic assessment weekly for: Head Circumference(HC) , Abdominal circumference(AC) , Femur Length (FL), Estimated fetal weight(EFW) , Amniotic fluid index(AFI) or Mean Vertical Pocket . Results The Rate of estimated fetal weight increase, birth weight and Apgar score were statistically significantly higher among L-Arginine research group than among control group(p values<0.001). NICU admission and preterm delivery were statistically significantly less frequent among L-Arginine group than among control group(p value<0.001). Conclusions L-arginine seems to be useful management agent for improving asymmetrical mild IUGR fetuses via raising nitric oxide levels which enhances the fetomaternal circulatory functional performance