E-ISSN:2456-3110

Case Report

Ayurvedic approach on Bad Obstetric History

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 8 August
Publisherwww.maharshicharaka.in

An Ayurvedic approach on Bad Obstetric History w.s.r. to Putarghani Yonivyapad: A Case Study

Kumari M1*, Panda J2, Tanwar S3
DOI: DOI:10.21760/jaims.8.8.35

1* Manisha Kumari, Post Graduate Scholar, Prasuti Tantra Evum Stree Roga, Shri Krishna Govt Ayurvedic College, Kurukshetra, Haryana, India.

2 Jitesh Kumar Panda, Professor HOD, Prasuti Tantra Evum Stree Roga, Shri Krishna Govt Ayurvedic College, Kurukshetra, Haryana, India.

3 Suniti Tanwar, Associate Professor, Prasuti Tantra Evum Stree Roga, Shri Krishna Govt Ayurvedic College, Kurukshetra, Haryana, India.

Introduction: Spontaneous pregnancy loss can be physically and emotionally taxing for couples, especially when faced with recurrent losses. Recurrent pregnancy loss (RPL), also referred to as recurrent miscarriage or habitual abortion, is historically defined as 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period. Based on the incidence of sporadic pregnancy loss, the incidence of recurrent pregnancy loss should be approximately 1 in 300 pregnancies. In Ayurveda Putraghni Yonivyapad is described where repeated abortions or the early neonatal deaths are explained which are due to Artava Dosha, Rakta Dosha, Raktastrava and Raktakshaya. When we came across with descriptions given by different Acharyas we come to know that these all points came under the Bad Obstetric History described in modern science. As we all know that Ayurveda is a science of life. Methods: In the present case study, a 34 years old women patient consulted to the OPD with the complaints of recurrent pregnancy loss in first trimester [5 Abortions]. Her hematological and sonographic reports were normal. Diagnosis was unexplained. She was supposed to be treated with Ayurvedic Shodhan and Shaman therapy. Result: Only Ayurvedic protocol were used during the course of the treatment. After this, patient conceived after 3 months of treatment, and no evidence of abortion was found. She delivered a healthy baby. Discussion: The present study shows the role of Ayurveda in bringing a positive result in the management of Putraghni Yonivayapad.

Keywords: Recurrent Abortion, Putraghni Yonivyapad, Ayurveda, Shodhan, Shaman

Corresponding Author How to Cite this Article To Browse
Manisha Kumari, Post Graduate Scholar, Prasuti Tantra Evum Stree Roga, Shri Krishna Govt Ayurvedic College, Kurukshetra, Haryana, India.
Email: 		Kumari M, Panda J, Tanwar S, An Ayurvedic approach on Bad Obstetric History w.s.r. to Putarghani Yonivyapad: A Case Study. J Ayu Int Med Sci. 2023;8(8):230-233.
Available From
https://jaims.in/jaims/article/view/2708

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-06-12 2023-06-19 2023-06-26 2023-07-07 2023-07-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 19.36

© 2023by Kumari M, Panda J, Tanwar Sand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Repeated (or Habitual) abortion refers to a history of repeated miscarriage, defined as three or more successive pregnancy losses.[1] Repeated miscarriage suggests the need for medical evaluation of a couple and ongoing care for what may be chronic problems (e.g., hormonal dysregulation, infection, etc.). The incidence of repeated miscarriage is 1% in India. The risk increases with each successive abortion reaching over 30% after 3 consecutive losses.[2] In Ayurveda infertility is defined in detail based on its causative factors, and clinical presentations. Some such contexts are Jataharini, Putraghni and Asrijayonivyapad. According to Ayurveda classics, repeated miscarriage (Putraghniyonivyapada) is an inflammatory condition spelled "early pregnancy loss".[3] It is clear that maternal genital tract infection plays an important role in sporadic spontaneous abortion.

Considering causes mentioned in the classics seems similar to modern science. Indulgence of Aharaja, Viharaja and Manasikanidana like stress-induced hormonal disturbances leads to Apanakshetradushti, Vataprakopa which causes disturbances in menstruation like painful menstruation and Garbha development. Considering Hetu, Sthana, and clinical symptoms Shodhana Chikitsa like Virechana, Basti and Uttarbasti holds promising results.[4,5] Considering the need for Shodhana in this case, firstly patient showed a history of miscarriage [repeated], which shows Vatadushti, Srotas involved are Rasavaha and Artavavaha Srotas which are Matrijaavayava. The second one is Kshetra involvement which is Apanavatakshetra. Mentioning the above symptoms is Bahudoshavastha, hence, needs Shodhana. Thorough examination, investigations, and sonological examinations were done. Shamanaushadhis like Phalaghrita and Chandraprabhavati, Grabhpalrasa have been given, and periodically follow-up were taken.

Case Study

Age -34 yrs female
Occupation - Housewife
Socio-economic Status - Middle

Chief complaint - Came to OPD with complaint of unable to convince along with stress and fear of previous 5 abortions.

History of present illness - A 34-year female patient, came in OPD with complaints of recurrent abortion losses in first trimester [5 Abortions]. Her hematological and sonographic reports were normal. Patient was managed conservatively.

Past History

N/K/C/O - Diabetes /Hypothyroidism/ HTN
PCOD/ no specific history of pelvic infections; no h/o D&C
Familial history - not specific

Menstrual history

Menstrual cycle - regular, lasts for 4 days, pain in lower abdomen on first 2 days of menstruation.
Interval - 30-32 days
Blood flow - normal in first 2 days

Clinical findings

Built - normal
Height - 5.2ft
Weight - 60kg
Gait - normal
Blood pressure - 120/70 mmHg
Pulse - 68/min
Temp - 98.3°F

Systemic examination

Cardiovascular - normal rhythm, no added sounds
Respiratory - normal vesicular breathing sounds
Central nervous system - normal.
Urogenital system - healthy cervix with no discharges, and tenderness.
Per vaginal - normal size, bilateral free fornix

Ashtavidha Pareeksha

Nadi - VK
Jihva - Sama
Mala - twice in a day
Mutra - Samyak
Shabda - Samyak
Sparsh - AnushnsheetaDrika - Samyak
Aakrti - Madhyam

Dasavidha Pareeksha

Prakrti - VK
Sara- Maansasaar
Samhanan - Madhyam
Pramaan - Madhyam
Satmya - Sarva Rasa
Satva - Madhyam
Aahar Shakti - Madhyam


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Vyayaam Shakti - Madhyam
Vaya - Yuva
Desha - Aanupa

Investigations

All hematological and sonographical investigations were normal.

Treatment Protocol

  1. Shodana Karma
Deepan Pachana Chitrakadivati - 1tds x 5 days [before meal]Avipattikar Churna -1/2 tsp-tds x 5days [before meal]
Snehpana Phalaghrita x 5 days
  1. Shaman Aushada
Phalaghrita Pana10ml with 200ml milk (empty stomach)
Chandraprabha Vati2 bd (for one cycle)
Grabhpalrasa1 tds (For 3 cycle)
Dashmoola Kwatha15ml bd after meal (for 3 cycles)
Ajmodaadi Churna5gm with warm water (HS)

Shodana Karma

1st Virechana Plan

Deepana Pachana for 5 days
Chitrakadi Vati - 1tds
Avipattikar Churna - ½ tsp tds
Snehapana with Phalaghrita for 5 days (till Samyak Lakshana of Snehapana achieved)
2 days Sarvanga Abhyanga and Swedana done.
Virechana with Trivrut Avaleha with warm water was done under observation.
Total Vega - 17-18 Noted.
Madhyam Suddhi Lakshana observed.
After that Samsarjana Karma followed for 5 days.

Shamana Aushada prescribed for 15 days

Phalaghrita Pana - 10ml followed by 200ml Godugda [early morning]
Chandraprabha Vati - 2bd
Garbhapala Rasa - 1 tds
Dashmoola Kwatha - 15ml with equal amount of water
Ajamodaadi Churna - 5gm HS

Result

After three sitting of Uttarbasti for three consecutive cycles, along with Shaman Aushadi, she reported with amenorrhea and found urine pregnancy test positive. Confirmed the pregnancy by USG, as single live intrauterine fetus. Patient regular came for ANC Checkup. She delivered a healthy baby.

Discussion

Becoming mother is the most cherished dream of all women. Ritu, Kshetra, Ambu and Beeja are the four essential factor for fertility.[6] Defect in any of these result in miscarriages (infertility). Vata is prime cause of Abortion. In Putraghni Yonivyapada (Repeated Abortion) Kshetra and Ambu plays major role. Repeated Abortion take place due to Ruksha Ahara and Vihara thus lead to Vataprakop which in turns causes Shonita and Artava Dushti result in Garbha Vinasha (Foetal loss).[7,8] Thus, the medicine used in this study have Garbhasthapaka Gana.

Mode of action

Acharya Kashyapa has mentioned that Virechana is the best line of management in Beeja and Artavadushti. After proper administration of Virechana, only these results are going to be achieved.[9] Virechana Karma has a direct effect on Agnisthana (hampered Agni is one of the initiating factors information of vitiated Raja).

यथा दोषं विशोधयेत्।..... अग्निः प्रजाश्च.....॥
विरेचन.....बीजं भवति कार्मुकम्....गर्भाशयासृजी॥
विरेक.....॥ (का.सं.सि. 2/5-7,13)

It pacifies the vitiated Kapha and Vatadosha and removes only Vaikarika Pitta only & thus does Raktashodhana. It does the quality of Srotovishodhana, so it will help in eliminating the disease from its root (Rasavaha and Raktavaha Srotas) rather than temporary relief from Artava Vikaras (menstrual disorders).

Phalaghrita helps the women to achieve the conception and cures the females genital tract disorder.[10] It is Vatahara, Balya, Deepan, Pachana, Vataanulomna and Shothahara.

Krimighna, Bruhaniya, Garbhada and Rasayana thus helps in nourishment of reproductive organs and baby later. It helps in proper development of endometrium and follicles, so result in healthy progeny.

Chandraprabha Vati has properties like Vata-Pitta- Kaphahar, Balya, Vrushya and Rasayana. It helps in correcting an anovulatory cycle.


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Garbhapala Rasa gives sustaining effect by preventing foetal loss. It also helps in disorders during pregnancy such as Shiroshula (headache), Chhardi (vomiting), Atisara (diarrhoea) and Unmada (hysteria), Eclampsia etc.

Dashmool Kwatha - Collective properties of Dashmool Kwath are Katu Rasa, Katuvipaka, Laghu- Ruksha Guna and Ushna Veerya. By virtue of this properties Dashmoola act as Aamapachana and remove the Avarana of Kaphadi Doshas. As Dashmool is Ushnaveerya and other properties associating to that are acting on Vata Dosha also. It has potent anti-inflammatory and uterine tonic action.

Conclusion

Ayurvedic medicine, an ancient holistic healing system, has gained attention in the context of modern medicine and In Vitro Fertilization (IVF). While Ayurveda offers a unique approach to health and wellness, its role in conjunction with modern medicine and IVF is a subject of debate. The incidence of repeated abortions is increased due to modern stressful lifestyle & food habits. While treating the patients of bad obstetric history one should go thoroughly examination of patient followed by the proper line of treatment only then we will get the fruitful outcome. When we came across the causes of bad obstetric history, we come to know that the integrative approach is helpful rather the individual Ayurvedic or modern approach in treatment. Here in present case study of repeated abortions is treated by Ayurvedic treatment only.

References

1. Ford, Holly B; Schust, Danny J (2009). "Recurrent Pregnancy Loss: Etiology, Diagnosis, and Therapy". Reviews in Obstetrics and Gynecology. 2 (2): 76–83. ISSN 1941-2797. PMC 2709325. PMID 19609401.

2. Dutta D.C., Textbook of Gynecology, 5th edn., Jaypee Brothers Medical publishers (P) Ltd., New Delhi, 2013, p. 222 -247.

3. Acharya Charka. Charak Samhita (ChikitshaSthan) by Acharya Vidyadhar Shukla and Prof.Ravi Dutt Tripathi foreword by Acharya Priyvrata Sharma, Chaukambha Sanskrit Pratishthan, Delhi ch,chi,30/28.

4. Bhramanand Tripathi, Charak Samhita Vol.II, Edition 2011, Varanasi; Chaukhamba Surbharati Prakashan, 2011, Adhyay 30/28-29, Page no. 1019.

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6. Sushruta. Sushruta Samhita, Vol.1 sharir sthana,2/35 Mudhagarbhanidana Adhyaya,8/3 edited by Kaviraj Kunjalal, Published By Author, Culcutta 1911.

7. Vagbhata, Ashtanga Sangraha, with Sasilekha Sanskrit Commentary by In-du,Edited by Dr. Shivprasad Sharma, Chaukhamba Sanskrit Series Publication, Varanasi, 2008; 38(37): 965

8. Vagbhata, Astanga Hrudaya, Sarvanga Sundara Commentary of Arunadatta andAyurveda Rasayana Commentary of Hemadri, Edited by; Pandit Hari Sadasiva Sastri Paradakara Bhisagacharya, Chaukhambha Surabharati Prakashan, Varanasi, Reprint-2010; 33(34): 956

9. Vriddhajivaka, Kashyapa Samhita, Siddhisthana, Trilkshanaiyaadhyaya, Choukhambha Sanskrit Series, 7th edition 2000.

10. Kaviraj Atreya Gupta, Vagbhatvirachit Ashtang Sangrah Hindi Vayakhya Edited by Pandit. Shri Nandkishor Sharama Reprinted in 1993, Varanasi; Krishnadas Academy 1993, Page no. 340.


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