Role of intravenous amino acid infusion in cases of oligohydramnios and its effect on amniotic fluid index and fetal weight gain

Pragya Shree, Nupur Mittal, Vaibhav Kanti, Sonia Vishwakarma


Background: Oligohydramnios in early pregnancy is attended by serious consequences to the fetus. Various conditions associated with oligohydramnios increase perinatal mortality and morbidity. Different medical and interventional methods have been tried to treat oligohydramnios. The present study was done to study the effect of intravenous amino acid infusion on amniotic fluid index (A.F.I) and fetal weight gain.

Methods: A total of 100 patients of oligohydramnios were studied. They were divided equally into study group and control group of 50 patients each by random allocation. The patients in the study group were given intravenous infusion of 200 ml of amino acid on alternate day for one week while those in the control group were not given any intervention. Both the groups were monitored for change in A.F.I and fetal weight gain by ultrasound at the end of the week.

Results: The average gain in A.F.I in the study group (2.57 ± 0.68 cm) was more than in the control group (2.13 ± 0.84 cm). The average gain in fetal weight in the study group was 150.0 grams with SD of ± 37.8 grams while in the control group it was 82.14 grams with SD of ± 67.1 grams.

Conclusions: Thus intravenous infusion of amino acids increases short term A.F.I and also improves fetal weight and thus has a beneficial effect to both mother and fetus in case of oligohydramnios in developing countries. However, larger studies with controlled trial are needed to be done.


Oligohydramnios, Intrauterine growth restriction, Amniotic fluid index

Full Text:



Cunnigham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD. Placenta and fetal membranes. In: Text book of Williams obstetrics, 21th ed. McGraw-Hill Company. 2003. Pp. 101-103.

Brace RA, Wolf EJ. Normal amniotic fluid volume changes throughout pregnancy. Am J Obstet gynecol. 1989;161:382-8.

Brace RA. Physiology of amniotic fluid volume regulation. Clin Obstetrics and Gynaecol. Lippincot-Raven publication. 1997;40(2):280-9.

Arias Fernando. Practical guide to high risk pregnancy and delivery. 2nd ed. Mosby – year Book. Inc. 1993;30-20:150-9.

Callen. Amniotic fluid: Its role in fetal health and disease. In: Textbook of ultrasonography in obstetrics and gynaecology. 14th ed. W.B. Saunders Company. 2000. Pp. 638-659.

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.

Rutherford SE, Phelan JP, Smith CV, Jacobs N. The four quadrant assessment of amniotic fluid volume: An adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987;70:353.

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

Cunningham FC, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD. Abnormalities of the fetal membranes and amniotic fluid. In: Textbook of Williams Obstetrics, 21st ed. Mc Graw Hill Compan. 2003. Pp. 821-822.

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.

Abida Ahmad J K. Intravenous aminoacid therapy in Oligohydramnios; Practitioner. 2006;13(3):140-1.

Umber A, Chohan MA . J Coll Physicians Surg Pak. 2007;17(6):336-9.

Mesaki Cetin I, Corbetta C, Piceni Sereni L , Marconi AM, Bozzetti P, Pardi G. concentration s 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;2(4):1078-83.

Chauhan SP, Hendrix NW: Intrapartum oligohydramnios does not predict adverse peripartum outcome among high risk parturient. Am J Obstet Gynecol. 1997;176(6):1130-6.

Jun Zhang, James Troendle: Isolated oligohydramnios is not associated with adverse perinatal outcome. Int J Gynaecol Obstet. 2004;3:220-5.

Everett FM, Thomas EN: Measurement of amniotic fluid volume-Accuracy of ultrasonography technique. Am J Obstet Gynecol. 1992;167:1533-7.

Casey Brian M, Donald D McIntire: Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol. 2000;182(4):909-12.

Hoskins IA, Friden FJ. Variable deceleration in reactive non stress test with decreased amniotic fluid index predicts fetal compromises. Am J Obstet Gynecol. 1991;165(4):1094-8.

Golan A, Lin G. Oligohydramnios - maternal complications and fetal outcome in 145 cases. Gynecol Obstet Invest. 1994;37(2):91-5.

Mercer Lane, L.G. Brown: A survey of pregnancies complicated by decreased amniotic fluid. Am J Obstet Gynecol. 1984;149:355-61.

Tayade S. The significance of meconium stained amniotic fluid – A cross sectional study in rural set up. I J BAR. 2012;3:12.

Lampariello C, De Blasio A, Merenda A, Graziano E, Michalopoulou A, Bruno P. Use of L-arginine in intrauterine growth retardation (IUGR): Authors' experience. Minerva Ginecol. 1997;49:577-81.

Moore TR, Longo J, Leopald GR, Casola G, Gosink BB. The reliability and predictive value of an amniotic fluid scoring system in severe second trimester oligohydramnios. Obstet Gynecol. 1989;73:739.

Goldstein RB, Filly RA. Sonographic estimation of amniotic fluid volume, subjective assessment versus pocket measurements. J ultrasound Med, 1988;7:363.

Hill LM. Oligohydramnios: Sonographic diagnosis and clinical implication. In clinical bstetrics and gynecology. Pitkin Roy M, Scot James R. Philadelphia: lippincot – Raven Publication. 1997;40(2):314-27.

Clement D, Barry MD: Acute oligohydramnios in postdate pregnancy. Am J Obstet Gynecol 1987;157:884-6.

Browen-Chatoor JS, Kulkarni SK: Amniotic fluid index in the management of postdates pregnancy. West Indian Med J. 1995;44(2):64-6.