Abstract
Background
Oligohydramnios is a known obstetric complication which is associated with operative interferences and perinatal morbidity and mortality. l-arginine is a precursor of nitric oxide and may play a role in local vasodilatation. Administration of l-arginine has been suggested to improve amniotic fluid index (AFI) in oligohydramnios.
Aims and Objectives
To study the effect of l-arginine in optimizing fetal outcome in cases of oligohydramnios.
Materials and Methods
A retrospective study was conducted at Dr L H Hiranandani hospital consisting of 100 antenatal patients diagnosed with oligohydramnios [AFI < 8 cm] remote from term. Patients were evaluated for all antenatal risk factors and were started on l-arginine sachets (3 g, 3 sachets a day). The treatment was continued till an adequate improvement in liquor was noted. However, patients were considered for delivery if the liquor remained <5. Further, mean increase in AFI, intervention delivery interval, and neonatal outcome were studied.
Results
The mean gestational age at the time of recruitment was 32.3 weeks. The mean AFI noted was 5.421 cm. These patients were delivered at 35 ± 1.1 weeks, and thus, pregnancy could be prolonged by 2.4 ± 1.1 weeks. The mean AFI at the end of therapeutic intervention was 8.753, and thus, an AFI increase of 3.332 cm could be obtained. There was no significant neonatal morbidity in these patients. Significant improvement in liquor volume was obtained in these patients after intervention with l-arginine sachets.
Conclusion
l-arginine supplementation is promising in improving volume of amniotic fluid in cases of oligohydramnios and prolonging pregnancy by a mean of 2.4 weeks, allowing fetal lung maturation thus benefiting the neonatal outcome.
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The authors declare that they do not have any conflict of interest.
Ethical Approval
This study is approved by the institutional scientific and ethical committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Anita Soni is consultant Obstetrician and Gynecologist in the Department of Obstetrics and Gynaecology at Dr L H Hiranandani Hospital, at Seth G. S. Medical College and K. E. M. Hospital; Seeru Garg is junior consultant Obstetrician and Gynecologist in the Department of Obstetrics and Gynaecology at Dr L H Hiranandani Hospital; Khushboo Patel is DGO resident in the Department of Obstetrics and Gynaecology at Dr L H Hiranandani Hospital; Zarna Patel is DNB resident in the Department of Obstetrics and Gynaecology at Dr L H Hiranandani Hospital.
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Soni, A., Garg, S., Patel, K. et al. Role of l-Arginine in Oligohydramnios. J Obstet Gynecol India 66 (Suppl 1), 279–283 (2016). https://doi.org/10.1007/s13224-016-0853-7
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DOI: https://doi.org/10.1007/s13224-016-0853-7