Therapeutic amnioinfusion in oligohydramnios during pregnancy (excluding labor)

Mahvish Qazi, Najmus Saqib, Abida Ahmad, Imran Wagay


Background: Oligohydramnios is a serious complication of pregnancy that is associated with a poor perinatal outcome and complicates 1-5% of pregnancies. The purpose of this study was to evaluate the role of antepartum transabdominal amnioinfusion on amniotic fluid volume/latency period in pregnancies with oligohydramnios.

Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Sher-i-Kashmir Institute of Medical Sciences Soura Srinagar. In this study, a total of 54 pregnant women with ultrasonographically diagnosed oligohydramnios i.e. AFI < 5 cm and gestational age of >24 weeks were taken for therapeutic amnioinfusion and its effects on amniotic fluid volume were studied. Statistical Software SPSS (Version 20.0) and Microsoft excel were used to carry out the statistical analysis of data. P-value less than 0.05 was considered statistically significant.

Results: Mean age of patients in our study was 27.5±3.19 years and gestational age group of 28-34 weeks. The mean AFI pre and post amnioinfusion was found to be 3.3 cm and 8.8 cm respectively. The difference was found to be statistically significant with a p value of <0.001. There was increase in the latency period in the studied patients with a mean latency period of 42.8±14.94 days. Mean number of transabdominal amnioinfusions in our study was 1.48±0.64. In our study, majority of patients i.e. 33 (61.1%) delivered at 38-40 weeks with a mean age at delivery 37.4±1.92 weeks. In our study, maximum number of patients i.e. 32 (59.3%) were delivered by full term normal delivery and only 15 (27.8%) required caesarean section. 78% of newborns weighed >2.5kg. The mean weight of newborn was 2.9±0.59 kgs. The incidence of newborn admissions to NICU was 20.4%. Number of neonatal deaths in our study was 5.6%. There was reduction of neonatal admission to NICU and neonatal deaths after transabdominal amnioinfusion.

Conclusions: Antepartum transabdominal amnioinfusion is a useful procedure to reduce complications resulting from decreased intra-amniotic volume. It significantly raises the amniotic fluid especially useful in preterm pregnancies, where the procedure allows for a better perinatal outcome by significantly prolonging the duration of pregnancy, increasing birth weight, preventing fetal distress and thereby reducing operative intervention. Optimizing the selection of patients who are good candidates for the procedure is a prerequisite.


Amnioinfusion, Oligohydramnios, Pregnancy

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Chemberlan MB, Manning FA, Morreson L. Ultrasound evaluation of amniotic fluid II. The relationship of increased amniotic fluid volume to perinatal outcome. Am J Obstet Gynecol. 1984;150: 250-4.

Taylor MF, Fisk NM. Hydramnios and oligohydramnios. In James DK, Steer PJ, Weiner CP, Gonik B, editors. High risk pregnancy, 3rd edition. Philadelphia: WB Saunder publications. 2006;278-85.

Moore TR, Cayle JE. The amniotic fluid index in normal human pregnancy. Am J Obstet Gynecol. 1990;162:1168-73.

Chamberlain PF, Manning FA, Morrison I. Ultrasound evaluation of amniotic fluid volume. Am J Obstet Gynecol. 1984;150:245-9.

Manning FA, Harman CR, Morrison I, Menticoglou SM, Lange IR, Johnson JM. Fetal assessment based on fetal biophysical profile scoring IV. An analysis of perinatal morbidity and mortality. Am J Obstet Gynecol. 1990;162(3):703-9.

Phelan JP, Smith CV, Small M. Amniotic fluid volume assessment with the 4 quadrant technique at 36-42 week gestation. J Reprod Med. 1987;32:540-2.

Vergani P, Ceruti P, Strobelt N, Locatelli A, D'Oria P, Mariani S. Transabdominal amnioinfusion in oligohydramnios at term before induction of labor with intact membranes: a randomized clinical trial. Am-J-Obstet-Gynecol. 1996;175(2):465-70.

Turhan NO, Atacan N. Antepartum prophylactic transabdominal amnioinfusion in preterm pregnancies complicated by oligohydramnios. Internat J Gynecol Obstetr. 2002;76(1):15-21.

Gowri R, Soundaraghavan S. Evaluation of transabdominal amnio-infusion in the antepartum management of oligohydramnios, complicating preterm pregnancies. J Obstetr Gynaecol India. 2004; 54(5):460-3.

Singla A, Yadav P, Vaid NB, Suneja A, Mohammad Faridi MA. Transabdominal amnioinfusion in preterm premature rupture of membranes. Internat J Gynecol Obstet. 2010;108:199-202.

Ogunyemia D, Thompson W. A case controlled study of serial transabdominal amnioinfusions in the management of second trimester oligohydramnios due to premature rupture of membranes. European J Obstetr Gynecol Reproduct Biol. 2002;102:167-72.

Kim GJ, Kim SY and Son MS. Pregnancy outcome following amnioinfusion in oligohydramnios. Ultrasound Obstet Gynecol. 2001;18(Suppl.1):32-61.

Jung SH, Han JY, Choi EH, Sung SJ, Jo JH, An HG, et al. Fetal outcome following transabdominal amnioinfusion in various causes of oligohydramnios. Korean J Obstet Gynecol. 2001;44(1):80-4.

Butt FT, Ahmed BS. The role of antepartum transabdominal amnioinfusion in the management of oligohydramnios in pregnancy. J Matern Fetal Neonatal Med. 2011;24(3):453-7.

Locatelli A, Vergani P, Di Pirro G, Doria V, Biffi A, Ghidini A. Role of amnioinfusion in the management of premature rupture of the membranes at < 26 weeks' gestation. Am J Obstet Gynecol. 2000;183(4):878-82.

Vergani P, Ceruti P, Strobelt N, Locatelli A, D'Oria P, Mariani S. Transabdominal amnioinfusion in oligohydramnios at term before induction of labor with intact membranes: a randomized clinical trial. Am J Obstet Gynecol. 1996;175(2):465-70.

Chhabra S, Dargan R, Nasare M. Antepartum transabdominal amnioinfusion. International J Gynecol Obstetr. 2007;97:95-9.

Mandelbrot L, Verspyck E, Dommergues M, Breast G. Transabdominal amnioinfusion for the management of non-laboring post-dates with severe oligohydramnios. Fetal Diagn Ther. 1993;8:412-7.

Santis MD, Scavo M, Noia G, Masini L, Piersigilli F, Romagnoli C, Carusa A. Transabdominal amnioinfusion treatment of severe oligo- hydramnios in preterm premature rupture of membranes at <26 gestational weeks. Fetal Diagn Ther. 2003;18:412-7.

Gramellini DD, Piantelli GG, Chiaie LLD, Rutolo SS and Vadora EE. Amnioinfusion in the management of oligohydramnios. J Perinat Med. 1998;26(4):293-301.