Clinical Cases

Pregnancy with Enteric Fever and Jaundice

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Written by Vinit Monga

Dr.Vinit Monga presents a case of pregnancy with enteric fever and jaundice.

 

  1. Kaur 26 yrs, psychiatrist at New-Delhi consulted on 20-12-2006 with the following information and complaints:
  2. Pregnancy of seven months duration.
  3. Pyrexia since beginning of pregnancy. High fever reaching up to 102f. During fever – red cheeks. Dryness of mouth with thirst for large quantities during fever. Food tastes bitter during fever.
  4. Hyper emesis gravidavum since beginning of pregnancy. Nausea looking at food. Because of fever and nausea taking no extra diet except fiber diet. Nausea with vomiting of food. Offensive vomiting. Nausea while eating, after eating amel.
  5. Cough with retching and gagging since beginning of pregnancy. Nausea after cough.
  6. Constipation since beginning of pregnancy (Homeopathy for Early signs of pregnancy). Urging for stool after eating. Every time she eats, she must evacuate.

Sleep:                    Insomnia during fever. If occurred, sleepless after waking.

Dreams:                Not Particular.

Appetite:              Less. Nausea looking at food.

Thirst:                  Dryness of mouth with thirst. Thirst for large quantity.

Perspiration:                  NAD.

Stool:                   Offensive, semisolid sometime watery.

Urine:                   Yellowish, Offensive.

Desire:                  Salty, Spicy Things.

Aversion:             Milk

Tongue:                Bitter taste. Every food she eats tastes bitter.

Thermal:               Sensitive to both hot and cold.

Treatment History:        Took a/t earlier.

Mental Symptoms:

  1. Ambitious
  2. Bold
  3. Conscientious
  4. Loquacity
  5. Fastidious
  6. Fast Speed

Repertorization: – 20-12-2006

On 20-12-2006 Phosphorous 200 one dose was prescribed followed by placebo tds. After this prescription nausea gets slightly better. Fever morning and evening high, low grade afternoon. Stool habit gets slightly better.

On 06-01-2007 patient’s improved symptoms start relapsing. Phosphorus 1M one dose was given followed by placebo tds. After raising potency a few symptoms such as nausea, stool habit improved slightly.

On 09-01-2007 advised for routine blood tests along with Serum Billirubin and Widal test as nausea and vomiting during last trimester force me to think she may be jaundiced (Homeopathy for Neonatal Jaundice).

Reports of 09-01-2007 confirmed my thoughts. Her serum billirubin was raised along with Widal titer positive for TO 1:160 & TH 1:320. Her hemoglobin was 8.8 gm%.

Situation was:

  1. Seven Months of Pregnancy was completed.
  2. Two Months remained.
  3. Well being of mother as well as fetus.
  4. Dietary Restrictions.
  5. Growth of fetus without solid diet.
  6. Protection of fetus from complications of enteric fever and jaundice.
  7. Prevention of HEMORRHAGE which is main risk factor for PREGNANCY WITH ENTERIC FEVER & JAUNDICE

Task was difficult but not impossible for a follower of Hahnemannian method.  First of all I must understand the cause of Jaundice. Abdomen examination reveals the cause of jaundice. Tendency of growth of fetus was towards right side which was probably pressing the gall bladder and obstructing the flow of bile. So the jaundice in this case was Obstructive jaundice. During pregnancy obstructive jaundice sometimes presents with violent itching during last trimester, sometime with nausea, vomiting, malaise and fever. In the above case the latter condition was present.

Case again repertorized considering obstructive jaundice.

Repatriation: – 11-01-2007

On 11-01-2007 SULPHUR 200 prescribed in Bd doses. Potency 200 was decided because of threat of hemorrhage (Syphilitic Miasm). Prescription was given in Bd doses because of MAINTAINING CAUSE. Here in this case maintaining cause of obstructive jaundice was enlarged uterus in which fetus was lying.

With Sulphur 200*Bd her nausea, vomiting, cough, fever, stool habit, taste, thirst, appetite, sleep gets better. Fever off and on occurring 99f to 100f.  I tried once by giving placebo, instead of Sulphur 200 Bd dose. That day when I prescribed placebo her nausea, vomiting and cough relapsed.  Fever increased up to 102f. So it was safe for both (mother as well as for coming baby) to prescribe Sulphur 200 in Bd doses and patient advised to lie on left side.

Reports of 25-01-2007

Hemoglobin =      11.0 gm%, earlier 8.8 gm % . Bleeding Time= 3’50”

Clotting Time= 4’10”

HbsAg = negative

Serum Billirubin= 9.0 mgm/dl

S.G.P.T. = 1180 I.U/L

Prothrombin Time Index (P.T.I.) = 77.7% (50-67%NORMAL RANGE)

Reports on 31-01-2007

Hemoglobin = 11.2%

Total platelets count = 228000 per cmm.

Serum Billirubin = 8.24 mgm/dl

S.G.O.T. = 128 I.U. /L

S.G.P.T. = 170 I.U/L

Widal test was still positive under titre TO 1:120 & TH 1:240

Prothrombin Time Index (P.T.I.) = 62% (WNL)

In spite of above report her symptoms of nausea, vomiting, fever, cough, appetite, thirst, taste, sleep, stool habit were better. Constant gynecological check-ups continued by a famous Gynecologist. She was continuously threatening her and insisting she take allopathic treatment in spite of patient’s will. Patient was totally satisfied with homoeopathic treatment and was committed to homoeopathy. As I mentioned at the beginning of this case, the patient is a psychiatrist at New-Delhi and knew the good and bad aspects of allopathic treatment.

Ultrasonography Report (Fetal Doppler study) done on date 05-02-2007 on completion of eight month pregnancy to see the fetal well being. Gynecologist was in agreement about the mal-development or developmental error of fetus due to jaundice and enteric fever, but USG SHOWS NORMAL DOPPLER STUDY

Sulphur 200*Bd was continuous.

On 07-02-04 patient reported that some colored fluid was discharging per vagina. Advised for check it and it was found to be amniotic fluid was running and bag was ruptured, meaning it’s time to deliver the baby which was waiting since eight months and seven days to see the beautiful outside world.

Prothrombin Time Index (PTI) was done and that was 60%. Gynecologist refused to deliver the baby for threat of excessive bleeding. Situation was:

  1. Bag of fluid was ruptured.
  2. Gynecologist refused to deliver for threat of excessive hemorrhage.
  3. OS was dilating two fingers and labor pains were continuous.
  4. All the family members were helplessly watching us.

Prothrombin Time index after giving Sulphur 200,1dose checked, three hours after remedy. PTI comes to 80%  CT,BT was also within normal limit and we again requested Gynecologist – now PTI is as she wanted but Gynecologist said you save mother’s life, forgot the baby. Baby will not deliver alive. Gynecologist referred her for higher medical institution. But condition of patient did not allow us to shift patient to another medical institution.

Reports of dated 07-02-2007

PTI = 80%

CT = 3’25”

BT= 2’50”

SERUM BILIRUBIN= 6.60 mgm/dl

S.G.P.T. = 41 I.U/dl

Another Gynecologist from the city was consulted and she agreed to delivery of child. She advised to arrange two units fresh blood and advised her to lie on left side to reduce excessive fetal distress. Two units of fresh blood were arranged. Dilatation was still two fingered and fetal distress so C-Section was performed. No need of blood transfusion and arranged two units of blood were donated by patient’s guardian to hospital where female baby was born. (Dated 07-02-2007, evening hours)

The two months old baby is normal and free from any developmental abnormality. Mother as well as her family members are enjoying it. Dietary articles which I advised in the above case were plenty of fresh fruits such as anar, papaya, ambla, apple which help to maintain her hemoglobin level above 10 gm%. I never prescribed tonics or so called power gaining syrups. I always stressed natural dietary articles to fulfill the deficiencies. Normalize the body’s defects and the body will accept nutrients from natural dietary articles.

After the delivery of baby, maintaining cause gradually removed and also serum billirubin level. On dated 11-02-07, four days after delivery, serum billirubin level was 1.8 mg%.  Sulphur here does a great job.

Thanks to Dr. C.F.S.Hahnemann and to those who make their marvelous contributions for the development of this great art of healing.

About the author

Vinit Monga

Dr. Vinit Monga received his diploma in Homeopathic Medicine and Surgery (D.H.M.S.) and for the last ten years has been practicing in Sirsa, Haryana, India, at his clinic, with his wife, Dr. Priti Monga. They treat all manner of diseases including cancer, Aids and heart disease. Dr. Monga also holds a certificate in food and nutrition and counsels patients in lifestyle changes.
http://www.mongahomoeopathic.com

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