BACKGROUND: Asymmetrical intrauterine growth retardation (IUGR) represents a foetal mechanism, consequent to placental insufficiency, due to many factors: genetic, vascular, malformative. At present, no therapy is really efficient. The aim of this study was to evaluate the efficacy, in these pathological conditions, of the use of L-arginine. This amino-acid improves GH-RH incretion, with consequent increase of plasmatic GH influencing somatic growth. L-arginine moreover, is the obligatory precursor for nitric oxide (NO) enzymatic synthesis (Endothelial-derived relaxing factor). NO helps the prolapse of smooth musculature and, consequently, the improvement of placental blood circulation. METHODS: On the basis of the double activity of NO, vasodilatation and GH-RH induction, 43 pregnant women have been treated suffering from IUGR, diagnosed by ultrasonic examination an by evaluation of Doppler velocimetry values, from 30th week of gestation, administering L-arginine (Bioarginina, 6 g per os/day). Periodically, USG and Doppler velocimetry examinations were performed to evalue foetal growth and possible increase of peripheral vessels resistance. RESULTS: 32 patients improved the clinical course of pregnancy: 19 recovered the whole retardation; 9 only one week; 4 had premature delivery after 36 weeks with foetal weight coincident with gestational age. CONCLUSIONS: The positive results suggest the prosecution of clinical studies in order to attempt the achievement of an effective pharmacological treatment of IUGR.
BACKGROUND: Asymmetrical intrauterine growth retardation (IUGR) represents a foetal mechanism, consequent to placental insufficiency, due to many factors: genetic, vascular, malformative. At present, no therapy is really efficient. The aim of this study was to evaluate the efficacy, in these pathological conditions, of the use of L-arginine. This amino-acid improves GH-RH incretion, with consequent increase of plasmatic GH influencing somatic growth. L-arginine moreover, is the obligatory precursor for nitric oxide (NO) enzymatic synthesis (Endothelial-derived relaxing factor). NO helps the prolapse of smooth musculature and, consequently, the improvement of placental blood circulation. METHODS: On the basis of the double activity of NO, vasodilatation and GH-RH induction, 43 pregnant women have been treated suffering from IUGR, diagnosed by ultrasonic examination an by evaluation of Doppler velocimetry values, from 30th week of gestation, administering L-arginine (Bioarginina, 6 g per os/day). Periodically, USG and Doppler velocimetry examinations were performed to evalue foetal growth and possible increase of peripheral vessels resistance. RESULTS: 32 patients improved the clinical course of pregnancy: 19 recovered the whole retardation; 9 only one week; 4 had premature delivery after 36 weeks with foetal weight coincident with gestational age. CONCLUSIONS: The positive results suggest the prosecution of clinical studies in order to attempt the achievement of an effective pharmacological treatment of IUGR.