Intravenous Amino Acids in Third Trimester Isolated Oligohydramnios

Abstract

Objective:  To determine the efficacy of maternal administration of intravenous amino acid solution  in improving amniotic fluid volume in cases of isolated oligohydramnios and to observe its impact on mode of delivery and neonatal outcome.

Study Design:  A prospective case series.

Place and Duration of Study:  Lady Willingdon Hos-pital, Lahore from Jun, 2008 to May, 2010.

Methodology:  Forty two women with singleton preg-nancy, well established gestational age and clinically and sonographically proven isolated oligohydramnios in the third trimester before 36 weeks were adminis-tered amino acid solution intravenously after exclud-ing cases of premature rupture of membranes, conge-nital anomaly of fetus, maternal pulmonary, cardio-vascular and hypertensive disorders, and severe pla-cental insufficiency (raised S/D ratio). Pre-infusion and post-infusion Amniotic fluid Index (AFI) was measured and repeated weekly. Women were followed till delivery.

Results:  According to repeated measurement analysis of variance, mean pre-infusion AFI was 4.7 cm, mean one week post-infusion AFI was 5.8 cm, mean two week post-infusion AFI was 6.2 cm and mean three week AFI was 6.3 cm (p-value 0.029, significant). Ce-sarean section became a predominant mode of delivery in this group without a firm evidence of associated fetal compromise.

Conclusion:  Amino acid infusion is an effective the-rapy for raising AFI in isolated oligohydramnios in this case series. Liberal use of cesarean section in this selected group should be carefully re-evaluated.

Key words:  Oligohydramnios, amino acid infusion, amniotic fluid index, cesarean section rate.