Soreingam Kasar, Mitali Khatri, Melody Vashum


Background: Adequate amniotic fluid is essential for normal fetal growth and fetal well being. Reduced amniotic fluid
index (AFI), also called oligohydramnios, is associated with higher incidence of meconium staining, ceasarean section
due to fetal distress, abnormal fetal heart rate tracing, and result in lesser APGAR score, etc. Maternal nutrition had a
definite role in molecular mechanism that's directly effects on fetus. Thus, under nutrition of various nutrients as amino
acids, carbohydrates, essential fatty acids play a great role in the development of oligohydramnios and intrauterine
growth restriction. Globally various trails have been done to explore the possibility of increasing the liquor amount and
fetal weight by giving intravenous fluids of variety in the form of dextrose, maltose, amino acids etc. Improved maternal
nutritional status by intravenous amino acid infusion appears to improve the AFI.
Materials and method: It is a prospective longitudinal study. 65 pregnant women of any gravida and parity of different
age, with identified reduced amniotic fluid index (oligohydramnios) by ultrasonography were subjected to amino acids
intravenous infusion daily along with 10% dextrose infusion for 7 days and ultrasound was repeated after 1 week. If
required, they were called back for second round of infusion. Ultrasound was repeated to see whether it has any effect on
AFI or not.
Results: 61.5% improvement in AFI was found in first round of infusion and 69.2% improvement in after second round of
infusion. This finding was found to be statistically significant (p<0.05).
Conclusion: Improvement in maternal nutritional status by intravenous amino acid infusion appears to improve the AFI.
Further study with a bigger sample size, drawing various confounding factors and with robust studies like RCT will be


Amniotic fluid index (AFI), Oligohydramnios, Amino acids infusion

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Brace RA, Wolf EJ. Normal amniotic fluid volume changes throughout pregnancy. Am J Obstet Gynecol. 1989 Aug;161(2):382-8. PMID:2764058

Elizabeth GV, Susan T, Deborah AW. Low amniotic fluid index as a predictor of adverse perinatal outcome. Journal of Perinatology. 2002;22,282-285.

Phelan JP, Smith CV, Broussard P. The four quadrant assessment of amniotic fluid volume at 36-42 wks gestation. J Reprod Med. 1986;32:540

Moore TR, Cayle JE. The amniotic fluid index in normal human pregnancy.Am J Obstet Gynecol.1990;162:1168.

Jeng CJ, Lee JF, Wang KG. Decreased amniotic fluid index in term pregnancies – clinical significance. J Repro Med. 1992;37:789-92.

Kilpatrick SJ, Safford K, Pomeroy T, et al: Maternal hydration affects amniotic fluid index (AFI). Am J Obstet Gynecol. 1991;164:361.

Suzuki S, Mine K, Sawa R, Yoneyama Y, Araki T. 10% Maltose Infusion Therapy for Oligohydramnios. Australian and New Zealand Journal of Obstetrics and Gynaecology. 1991;39:373-5.

Ahmad A. Intravenous aminoacid therapy in Oligohydramnios. JK-Practitioner 2006;13(3):140-1.

Umber A, Chohan MA. Intravenous maternal hydration in third trimester oligohydramnios: effect on amniotic fluid volume. J Coll Physicians Surg Pak 2007 Jun;17(6):336-9.

Mesaki C I, Corbetta C, PiceniSereni L, Marconi AM, Bozzetti P, Pardi G. Concentration and fetal- maternal concentration differences of plasma amino acids in normal and intrauterine growth retarded (IUGR) pregnancies. Am J Obstet Gynecol.1996;174:1575-83.

Shivkumar PV, Tayade S, Tayade AT, Bagde ND, Bagde MN. The Role of Intravenous Hydration and Amino Infusion in Intrauterine Growth Restriction and Oligohydramnios. Int J Biol Med Res. 2011;20:1078-83.

Gupta R, Porwal SK, Swarnkar M, Gupta S. The Role of Intravenous Amino Acid Infusion in Oligohydramnios. Int J Pharm Sci Res 2015;3(10):3971-4.

Shree P, Mittal N, Kanti V, Vishwakarma S. Role of intravenous amino acid infusion in cases of oligohydramnios and its effect on amniotic fluid index and fetal weight gain. Int J Reprod Contracept ObstetGynecol 2016 Aug;5(8):2804-9.

Baxi K, Bansal S. A Prospective Study on Role of IV Amino Acid Infusion in Improving Pregnancy Outcome in Cases of Oligohydramnios. IABCR [Internet]. 29Dec.2018 [cited 29Apr.2019];4(4):35-8. Available from: https://iabcr.org/index.php/iabcr/article/view/435.

Meetanpreet, Bala R, Kamal P, Nagpal M. Optimising management of oligohydramnios. The New Indian Journal of OBGYN 2017 Apr;4(1):59-65.


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