Ultrasound evaluation of NO-donor (L-arginine) therapy for intrauterine growth retardation
Sieroszewski, P.; Suzin, J.; Karowicz-Bilińska, A.
Ginekologia Polska 75(12): 913-918
2004
ISSN/ISBN: 0017-0011 PMID: 15751209 Document Number: 576124
There are many methods of the growth restriction therapy, but the results are still not satisfactory. Actually, we are conducting a project which main conception is based on the use of the NO donor (L-arginine) in growth retardation therapy. This amino acid is an effective NO donor and has a vasodilating effect on the vessels and anti-aggregation effect on platelets, which plays a great role in improving feto-maternal blood flow. The main aim of this paper is the ultrasound evaluation of the effectiveness of NO-donor (L-arginine) therapy for intrauterine growth retardation based on biometrical measurements (estimated fetal weight) compared with newborns weight estimation. The investigated group comprised two groups of pregnant women with ultrasonographically diagnosed intrauterine growth retardation (biometry <10th percentile for the gestation age): --78 patients were treated by L-arginine 3 g daily p.o. in 20 days period. --30 patients not treated (no agreement for therapy) as controls. Ultrasound estimation of fetal weight at the start and at the end of the treatment showed a mean value increase of 642 g (SE 90g) using Shepard method and 648g (SE 94g) using Hadlock method respectively. Comparing not treated group there was assessed a mean value increase of 395 g (SE 77 g) using Shepard method and 404g (SE 82g) using Hadlock method respectively. There is statistical significant difference comparing an estimated fetal weight in both methods: p = 0.008 for Shepard calculation and p = 0.012 for Hadlock calculation. There was analyzed newborn weight also--in a treated group mean value was at 2823 g and in not treated group mean value was at 2495 g. There was no significant difference found but a positive tendency for treated group newborns weight is visible. In the treated group number of the growth retarded newborns was at 29% and in the not treated group was at 73%. There was found a significant difference comparing both newborns groups at p < 0.05. The ultrasound evaluation of the estimated fetal weight and after-birth weight estimation of the newborns showed an increased dynamic of the fetal development in the L-arginine treated group of pregnant women comparing to the not treated group. The ultrasound evaluation of the estimated fetal weight is a good diagnostic tool for properly monitoring the effectiveness of treatment with L-arginine for growth retarded fetuses.