Perinatal outcome in cases of severe oligohydramnios


  • Nilesh Dalal Department of Obstetrics and Gynecology, MGMMC and MYH, Indore, Madhya Pradesh, India
  • Anjali Malhotra Department of Obstetrics and Gynecology, MGMMC and MYH, Indore, Madhya Pradesh, India



Abruption, Amniotic fluid index, Color Doppler, IUGR (intrauterine growth restriction), NICU (neonatal intensive care unit), Oligohydramnios, Pregnancy induced hypertension, TSVD (term spontaneous vaginal delivery), VBAC (vaginal birth after caesarean)


Background: Oligohydramnios is defined as when on ultrasonography the single largest pocket in horizontal and vertical diameter is less than 2cm or amniotic fluid index is less than 5cm. Normal amniotic fluid index is 5-25cm. The overall incidence is 0.5 to more than 5%. However, the incidence increases in post dated pregnancies as many as 11%. It is increasing these days because of changes in lifestyle and also reduced maternal fluid intake.

Methods: A prospective randomized study was done in Dept of Obstetrics and Gynaecology, MGMMC and MYH, Indore during the period of 6 months from 1st July 2017 to 31st December 2017. It included 200 cases from all the antenatal patients attending Antenatal OPD in routine and emergency and who are admitted in MYH beyond 28 weeks of pregnancy.

Results: Most of the perinatal cases nearly 64% of babies were handover, 26% were IUDs (intra uterine devices) and rest 10% requiring neonatal care in nursery. The color Doppler changes showed normal flow in 54% in cases with 26% showing early fetal hypoxia and 14% showing uteroplacental insufficiency. Rest of the 6% cases were IUD. Incidence of IUGR was 50% in babies most commonly being constitutionally small. About 8% cases were found to be associated with abruption and 24% cases were found to be associated with pregnancy induced hypertension. Most common mode of delivery was vaginal delivery in 68% cases. However, 32% cases underwent LSCS.

Conclusions: There has been reported cases of sudden IUD in severe oligohydramnios presenting with loss of fetal movements.


Manning FA, Hill LM, Platt LD. Qualitative amniotic fluid volume determination by ultrasound: antepartum detection of intrauterine growth retardation. Am J Obstet Gynecol. 1981;139:254-8.

Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment with the four-quadrant technique at 36-42 weeks’ gestation. J Reprod Med. 1987;32(7):540-2.

Patrelli TS, Gizzo S, Cosmi E, Carpano MG, Di Gangi S, Pedrazzi G, et al. Maternal hydration therapy improves the quantity of amniotic fluid and the pregnancy outcome in third-trimester isolated oligohydramnios: a controlled randomized institutional trial. J Ultra Med. 2012;31(2):239-44.

Gupta R, Porwal SK, Swarnkar M, Gupta S. The role of intravenous amino acid infusion in oligohydramnios. Int J Pharm Sci Res. 2012;3(10):3971-4.

Nicolaides KH, Peter MT, Vyas S, Rabbinowitz R, Rosen DJ, Campbell S. Relation of rate of urine production to exygen tension in small for gestational age foetuses. Am J Obstet Gynecol. 1990;162:387-91.

Nageotte MP, Towers CV, Asat T, Freeman RK. Perinatal outcome with the modified biophysical profile. Am J Obstet Gynecol. 1994;170(6):1672-6.

Magann EF, Chauhan SP, Bofil JA, Martin Jr JN. Comaparability of the amniotic fluid index and single deepest pocket measurement in clinical practice. Aust N Z J Obstet Gynecol. 2003;43:75-7.

Malik R, Saxena A. Role of colour Doppler indices in the diagnosis of intrauterine growth retardation in high-risk pregnancies. J Obstet Gynecol India. 2013;63(1):37-44.

Jagatia K, Singh N, Patel S. Maternal and fetal outcome in oligohydramnios: A study of 100 cases. Int J Med Sci Public Health. 2013;2(3):724-8.

Casey BM, McIntire DD, Bloom SL, Lucas MJ, Santos R, Twickler DM, et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol. 2000;182:909-12.

Manning FA, Platt LD, Sipos L. Antepartum foetal evaluation: development of a biophysical profile. Am J Obst Gynecol. 1980;136(6):787-95.

Jandial C, Gupta S, Sharma S, Gupta M. Perinatal outcome after antepartum diagnosis of oligohydramnios at or beyond 34 weeks of gestation. J K Sci. 2007;9(4):213-4.

Clark SL, Sabey P, Jolley K. Nonstress testing with acoustic stimulation and amniotic fluid volume assessment: 5973 tests without unexpected fetal death. Am J Obstet Gynecol. 1989;160(3):694-7.






Original Research Articles