Homeopathy in Obstetric Disorders

DISORDERS DURING PREGNANCY

1. Iron deficiency anemia
2. Gestational diabetes
3. Miscarriage
4. Fetal problems
5. Hypertension during pregnancy
6. Infections
7. Hyperemesis gravidarum
8. Abnormalities of placenta and cord
9. Pre-eclampsia
10. Preterm labour
11. Depression and anxiety

SCOPE OF HOMEOPATHY

• Miscarriage (abortions)
• Fetal problems
• Infections
• Placenta previa
• Placental abruption
• Depression and anxiety

 ABORTION is the expulsion or extraction from its mother of an embryo or fetus weighing 500 gms or less when it is not capable of independent survival (WHO).

ETIOLOGY:

Genetic factors (50%)

Endocrine or metabolic factors (10-15%)

Anatomical factors (10-15%)

Infections (5%)

Immunological (5-10%)

Others

FIRST TRIMESTER: 1. genetic factors 2. endocrine disorders (lutueal phase defect, Thyroid, diabetes)     3. Immunological disorders 4. Infections 5. Unexplained

SECOND TRIMESTER: 1. anatomical abnormality a) cervical incompetence  b) Mullerian fusion defects (bicornuate uterus, bifid uterus, uterine synechiae c) maternal medical illness d) unexplained.

MECHANISM OF ABORTION

• In early weeks, death of ovum occurs first, followed by its expulsion. In later weeks, maternal environmental factors are involved leading to expulsion of the fetus which may have signs of life but is too small to survive.
• BEFORE 8 WEEKS: ovum surrounded by villi with the decidual covering, is expelled out intact. Sometimes os fails to dilate so entire mass accommodates in dilated cervical canal called cervical abortions
• 8-14 WEEKS: expulsion of fetus commonly leaving behind placenta & membranes. A part it partially separated with brisk hemorrhage or remains totally attached to uterine cavity
• BEYOND 14 WEEKS: like mini labour. Fetus followed by placenta after varying intervals.

BOH

• Bad Obstetric History (BOH) The term ‘Bad Obstetric History or BOH’ is applied to mothers in whom a previous poor pregnancy outcome is likely to have a bearing on the prognosis of her present pregnancy.
• The Habitual Abortion (HA) is defined as the emergence of a number of at least three consecutive spontaneous abortions.
• Habitual abortion affects 1-3 % of fertile couples!!

 

Case No. 1

Mrs. MRB                                                       Date: 10/7/2019

Age: 22 yrs

Address: Jalgaon

C/O: Primigravida, LMP: 30/5/2019. Preg. 5weeks 5 days.

USG: early pregnancy with gestational age 5wks, 5 days, large sub chorionic hematoma is seen sized 3.1*0.9 cms.

•      Female, reproductive system, cervix, vagina since 5 days Since 3 days

Leucorrhea – small quantity, swelling2, itching2, no burning. Bleeding , light red colored

 

ASSOCIATED COMPLAINTS

Skin since 3months Left hand thumb and lumbar region Skin of fingers Face,on and off

Fungal infection, Watery discharge blackness black spots

< brinjal Rx allopathic treatment, injections taken for it

 

• PAST HISTORY: Father – NAD, Mother – hypothyroidism.
• P/G: App- less, nausea

Thirst: thirstless

Stool- normal

Urine- clear

Sleep – sound

Dreams- 0

Desires – rice2

Aversion -0

Perspiration – anxiety after

Thermals- HOT

MENTAL GENERALS:

– Studied till 10 std, scored 86% but no further study due to religious background, parents got her married.

– Husband is a fruit seller.

– After marriage stays in joint family.

– Fear –  of everything, fear of dark, alone.

– Anxiety – future, worried about finances.

– Forgetfulness because of constant thinking.

– Extroverted And Expressive

– Irritability – when wronged, gets angry – stops talking, starts by herself after some time.

– Work speed is fast

– Fastidious wants everything neat and clean.

– Washing mania, wants cleanliness3,

– Clairoyance2

– Restlessness and hurried3

TOTALITY OF SYMPTOMS:

1. Cleanliness3, washing 3
2. Fear3, of dark, alone2,
3. Restlessness and hurried
4. Abortion in second month
5. HOT
6. Thirstlessness

Remedy differentiation:

THUJA  and MEDORRHINUM.

– Strong sycotic traits

• Symptom similarity

Final Remedy: THUJA 200

– Modality of 2^nd month

Follow up : Date: 23/7/2019, bleeding stopped completely on the next day, leucorrhea >>, itching1>, hand eruptions >, feeling fresh, app- normal, thirsty, st- normal, urine- clear, sleep –sound

Case no 2.

Mrs. PDW                                                    DATE: 29/8/2019

Age: 31 yrs

Address: JALGAON

C/0: USG shows 1-2 cms funneling, cervical length 1.6cm. G3P1L1A1. Preg. 6^th month.

Right leg thigh from 2 months.	Pain2 Sudden, now increasing , so not able to walk	< walking, wake up, standing, slight movement.	Weakness3 Swelling  all over body.
GIT since 4 months	Nausea	< fasting, coconut water, empty stomach, morning

 

Cervical funneling is a sign of cervical incompetence and represents the dilatation of the internal part of the cervical canal and reduction of the cervical length. Greater than 50% funneling before 25 weeks is associated with ~80% risk of preterm delivery.

 

P/H: 1 daughter 7yrs.

4 yrs back pregnancy aborted in 2^nd month so D&C done.

Diagnosed with secondary infertility and IVF done

F/H: father- DM- police, Mother – house wife. 2 brothers. Patient is elder.

Education: BA, now housewife.

Husband: sales tax officer in GST bhavan.

P/G: App: good, easy satiety, Thirst: normal, stool- N, Urine: clear, Sleep: Disturbed due to pain in thigh. Dreams – 0,

Desires: sweets

Aversion: bitter,

Perspiration: scanty

Thermals: ambithermal

M/G: irritable, sudden mood changes.

Fastidious, wants everything neat and clean

Fear of hospital, injections

Impatience – wants to get over with pregnancy, problem should be solved.

Anticipatory anxiety2,

Introverted / inexpressive, express her feeling sometimes.

Childhood is good

Weeping while telling her symptoms about illness.

Totality

1. Cervical os – half open
2. Weeping while talking about illness
3. Impatience
4. pain in thigh < motion.

Reference:

Female, dilatation, genitalia, , uterus, cervix, os,  half open: remedies     sepia 1, Secale cor 2

Sepia 200 single dose, with sepia 0/10, 5 drops, in half cup of water, three times a day and SL 4 pills bd after food for 15 days., with that her hormonal (allopathic) treatment is also continued.

FOLLOW UPS:

14/9/2019: palpitation & trembling of body3, thigh pain – sq, nausea>>, weakness>>, app- normal, thirst- normal, stool – N, Urine- Clear. – ct all for 15 days

30/9/2020: thigh pain – sq, nausea -0, weakness-0, palpitation & trembling of body – Sq, feeling fresh,

My thinking was everything is better but her thigh pain is –sq, so thought of giving constitutional medicine. Gave Lyco 200 single dose

16/10/2020: pain in abdomen left side, preg. 7 month started. Leucorrhea started from yesterday, palpitation & trembling is –SQ, thigh Pain –sq, p.g. good, except sleep- which is disturbed and less – so given sepia 0/10, TDS for 15 days again.

31/10/2019:leucorrhea -0, palpitation and trembling –sq, pain in abdomen-0, acidity-0. sleep improved. P.g. good,                                                               SL for 15 days

16/11/2019: palpitation-sq, sleep – less, no pain, acidity on & off, leucorrhea-0, fresh

USG: liquor is slighly less AFI-7cm, cervix is closed, placenta –               postero-lateral. – sl given for 15 days

And stopped medicine. Pt delivered healthy baby boy on 19/12/19, normal delivery, 15 days early with no need of admission in NICU

CASE NO:3

Mrs. PG                                                          Date:22/4/2019

Age: 22 yrs

Add: Bhokardan.  Dist- Jalna.

C/O: G5 P0 A4 L0 , LMP: 13/3/2019, UPT +ve but fetal pole not developed.

H/O BOH – Habitual abortions. (4 times). Inevitable abortions requiring D&C every time.

Each time, Patient complained of burning all over the body with pain in abdomen and sudden bleeding ,USG showing infant death.

1^{st –}  5 yrs back – 2nd month

2^{nd –}  4 yrs back – 2nd month

3^{rd –}  3 yrs back – 3rd month

4^{th –}  2 yrs back – 4^th month

Married since 6yrs.

LMP: 13/3/2019

Family history:

Father- T.B. Rx. Allopathic, perfume seller

Mother- NAD

4 brother & 5 sisters, patient is 3^rd sibling. 1 sister expired Due to measles.

Education 7^th std.

Husband: perfume seller working in Mumbai. Love marriage, consanguineous. H/O: consanguineous marriages in family.

PHYSICAL GENERALS:

App- good,

Thirst: Thirsty.

Stool- normal

Urine- frequent since 8 days

Sleep: sound

Dreams- 0

Desires: potato3, rice2

Aversion: peanuts, coconut, dry fruits.

Agg: coconut water – headache.

Perspiration: scanty

Thermals: Hot

MENTALS:

ANGER3, irritabilty3. with desire to kill.

Anger expressed over anyone.

Anger stops talking- once incident she stopped talking for 5 months., stops taking meal. Others must listen her.

Talk – arrogant

Contradiction intolerance of3

Extroverted and expressive.

Tension of abortions – ghar kas chalnar, husband is only bread winner in family. FIL expired 6 yrs back.

Anxiety future about.

Superstitious.

Fear of dark3, shout loud if sudden darkness. Not able to be alone in dark.

Totality

1. Fear of dark, alone.
2. Anger, desires to kill
3. Anxiety future about
4. Superstitious
5. Hot
6. Thirsty

Problems: USG was done very early with no fetal pole or cardiac activity seen in 5 weeks. Also, patient was not sure of LMP. As all we know it can take 6-8weeks for development of fetal pole, I was confused whether to wait or to start medicines. Patient has strong history of BOH, So thought of starting with constitutional medicine.

 Remedy:

Stram. 200 single dose, 0/1 5 drops in half cup of water TDS for 15 days and come with repeat USG report.

FOLLOW UPS:
6/5/2019: no complaints, in mean time spotting which was reported by patient on phone. Her irritabilty >>, anger>>, patient is happy now. P.g.good- – stram 0/1 TDS continued for 1 month.

FOLLOW UP:
5/6/2019: nausea2, occasional spotting , irritabilty >>, p. g. good                    sl  for 1 month

5/7/2019: vomiting since 2 days with nausea due to some food changes. Irritabilty>>, acne< with black spots. – sl

6/8/2019: vomiting today1, no nausea, usg – WNL

9/9/2019: vomiting yesterday, pain in abdomen a/f outside food. Weakness1, p.g. good- sl  Asked to stop medicine now.

Patient blessed with a healthy baby boy on 21/12/2019, FTND at hometown in government hospital.