Maternal and fetal outcome in oligohydramnios diagnosed at or after 34 weeks of gestational age: a case-control study

Syeda Nazhath Fathima; Geeta Choudhari; Purshottam B. Jaju

doi:10.18203/2320-1770.ijrcog20261274

Authors

Syeda Nazhath Fathima Department of Obstetrics and Gynaecology, Al-Ameen Medical College and Hospital, Vijayapura, Karnataka, India
Geeta Choudhari Department of Obstetrics and Gynaecology, Al-Ameen Medical College and Hospital, Vijayapura, Karnataka, India
Purshottam B. Jaju Department of Obstetrics and Gynaecology, Al-Ameen Medical College and Hospital, Vijayapura, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20261274

Keywords:

NICU admission, Caesarean section, Uteroplacental insufficiency, Nonreactive non-stress test, Oligohydramnios, Pregnancy-induced hypertension

Abstract

Background: Oligohydramnios, a deficiency in amniotic fluid volume diagnosed at or after 34 weeks of gestation, is a common obstetric dilemma. While historically linked to adverse outcomes, optimal management remains controversial particularly in isolated cases, balancing the risks of prematurity against intrauterine compromise. Aim was to compare the maternal and fetal outcomes in pregnancy with oligohydramnios diagnosed at or after 34 weeks of gestation with those of normal amniotic fluid index (AFI).

Methods: A prospective case-control study was conducted in the Department of Obstetrics and Gynaecology at Al-Ameen Medical College and Hospital, Vijayapura, from February 2024 to January 2026. A total of 102 pregnant women were included, with 51 cases of oligohydramnios and 51 matched controls with normal AFI. All participants underwent detailed clinical evaluation, ultrasonography including AFI, Doppler and fetal biometry, and non-stress tests (NST).

Results: Baseline characteristics were comparable between groups, but hypertensive disorders were significantly higher in the oligohydramnios group (37.3% vs. 9.8%). Non-reactive NST patterns, abnormal fetal heart rate patterns, labour induction (60.8% vs. 17.6%), and caesarean section rates (58.8% vs. 17.6%) were more frequent among cases. Neonates in the oligohydramnios group had lower mean birth weight (2670 g vs. 2850 g) and higher NICU admissions (43.1% vs. 13.7%)

Conclusions: Oligohydramnios in late pregnancy may indicate placental pathology and is linked to increased maternal and perinatal complications, requiring careful evaluation, close fetal surveillance, and individualized multidisciplinary management rather than purely conservative care

References

Figueroa L, McClure EM, Swanson J, Robert N, Ana LG, Janet LM, et al. Oligohydramnios: a prospective study of fetal, neonatal and maternal outcomes in low-middle income countries. Reprod Health. 2020;17(1):19.

Bynarowicz T, Jenkins SM, Shanks AL. Oligohydramnios. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025.

Nicolini U, Fisk NM, Rodeck CH, Talbert DG, Wigglesworth JS. Low amniotic pressure in oligohydramnios is the cause of pulmonary hypoplasia. Am J Obstet Gynecol. 1989;161(4):1098-101.

Lyndon M, Hill MD. Oligohydramnios: Sonographic diagnosis and clinical implications. Clin Obstet Gynecol. 1997;40(2):314-27.

Bansal D, Deodhar P. A clinical study of maternal and perinatal outcome in oligohydramnios. J Res Med Dent Sci. 2015;3(4):312-6.

Peleg D, Kennedy CM, Hunter SK. Intrauterine growth restriction: identification and management. Am Fam Physician. 1998;58(2):453-60.

Leeman L, Almond D. Isolated oligohydramnios at term: is induction indicated? J Fam Pract. 2005;54(1):25-32.

Voxman EG, Susan T, Wing DA. Low amniotic fluid index as a predictor of adverse perinatal outcome. J Perinatol. 2002;22(4):282-5.

Locatelli A, Vergani P, Toso L, Verderio M, Pezzullo JC, Ghidini A. Perinatal outcome associated with oligohydramnios in uncomplicated term pregnancies. Arch Gynecol Obstet. 2004;269(2):130-3.

Trudell A, Ott W, Morris B. 689: Isolated oligohydramnios after 34 weeks: obstetric and neonatal outcomes. Am J Obstet Gynecol. 2011;206(1):S308.

Kreiser D, El-Sayed YY, Sorem KA, Chitkara U, Holbrook RH, Druzin ML. Decreased amniotic fluid index in low risk pregnancy. J Reprod Med. 2001;46(8):743-6.

Ghosh R, Oza H, Padhiyar B. Maternal and fetal outcome in oligohydramnios: study from a tertiary care hospital, Ahmedabad, India. Int J Reprod Contracept Obstet Gynecol. 2018;7(3):907-11.

Chiniwar MA, Menasinkai SB. Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation. Int J Reprod Contracept Obstet Gynecol. 2018;7(11):4604-9.

Saxena R, Patel B, Verma A. Oligohydramnios and its perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2020;9(12):4965-9.

Rahman M, Mina MN, Sarker T, Areen S, Ahamed TII, Chowdhury K. Outcome of pregnancies with severe oligohydramnios in the 3rd trimesters. Ann Int Med Dent Res. 2023;9:4.

Royal College of Obstetricians and Gynaecologists. The investigation and management of the small-for-gestational-age fetus. 2nd ed. London: RCOG; 2013. (Green-top Guideline No. 31). Available at: https://www.rcog.org.uk/media/t3lmjhnl/gtg_31.pdf. Accessed on 12 February 2026.

Ghimire S, Ghimire A, Chapagain S, Paudel S. Pregnancy outcome in cases of oligohydramnios after 28 weeks of gestation. Int J Adv Med Health Res. 2016;3(2):68.

Patel KJ, Bhatiya S. A prospective study of fetal outcome in a case of oligohydramnios after 34 weeks of pregnancy at tertiary care centre of South Gujarat, Surat. Int J Clin Obstet Gynaecol. 2021;5(1):156-8.