An Integrated Ayurvedic and Modern Obstetric Evaluation of Oligohydramnios with Special Reference to Garbhodaka Kshaya

Background: Amniotic fluid is essential for fetal movement, pulmonary development, cushioning and umbilical-cord protection. Oligohydramnios is an ultrasound finding that may be isolated or reflect membrane rupture, fetal urinary-tract abnormality, placental dysfunction, maternal disease or medication exposure. Ayurveda describes garbhodaka as the fluid associated with the intrauterine environment; the classical description of garbhakshaya includes reduced abdominal enlargement and diminished or absent fetal movement. These concepts offer a historical framework for discussion but are not identical to modern oligohydramnios. Objective: To review the Ayurvedic concept of garbhodaka/garbhakshaya alongside modern amniotic-fluid physiology, ultrasound diagnosis, fetal growth and Doppler assessment, maternal and placental contributors, perinatal outcomes, and evidence-based management; and to outline a research framework for integrated evaluation. Methods: Narrative synthesis of accessible classical-text passages and contemporary professional guidance, including ACOG antenatal-surveillance guidance, SMFM fetal-growth-restriction recommendations and ISUOG ultrasound guidance. This is not a systematic review and no new patient data are analysed. Summary: A deepest vertical pocket (DVP/SDP) below 2 cm is a commonly preferred sonographic criterion for oligohydramnios. AFI of 5 cm or less is also used in many settings, although use of DVP can reduce unnecessary intervention without worsening outcomes. Evaluation must establish gestational age, membrane status, fetal anatomy, growth, placental function and fetal wellbeing. Management depends on gestational age, cause and surveillance findings; delivery is indicated when fetal or maternal risk outweighs prematurity. Hydration may improve fluid measurements in selected patients but is not a treatment for placental insufficiency. No Ayurvedic drug or procedure has adequate evidence to replace standard obstetric monitoring or indicated delivery.