{"id":2825,"date":"2021-04-15T12:28:02","date_gmt":"2021-04-15T12:28:02","guid":{"rendered":"https:\/\/ayurvedanetworkbhu.com\/?p=2825"},"modified":"2022-06-08T08:54:39","modified_gmt":"2022-06-08T08:54:39","slug":"2825-2","status":"publish","type":"post","link":"https:\/\/ayurvedanetworkbhu.com\/?p=2825","title":{"rendered":"Module on &#8220;Non-Invasive Management of Pregnancy Bleeding-A Successful Case Report&#8221; By- Dr. Anuradha Roy"},"content":{"rendered":"<p style=\"text-align: justify;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/oMq4yS-YYGI\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center;\"><strong>\u201c<\/strong><strong><u>Non-invasive management of pregnancy bleeding- a successful case report<\/u><\/strong><strong>\u201d<\/strong><\/p>\n<p style=\"text-align: center;\"><strong>Dr. Anuradha Roy<\/strong><\/p>\n<p style=\"text-align: center;\">Department of Prasuti Tantra, Faculty of Ayurveda, IMS; BHU, Varanasi.<\/p>\n<p style=\"text-align: justify;\"><u>Introduction:<\/u> Pregnancy bleeding is an alarming sign which should be taken care of so as to rule out the cause of such bleeding. The pregnancy may remain viable (threatened abortion) in spite of bleeding or it may be a feature of non-viability (missed abortion\/blighted ovum). The pregnancy may also be partly (inevitable\/incomplete abortion) or completely expelled (complete abortion).<\/p>\n<p style=\"text-align: justify;\">Abortion is quite a common counting about 15% of confirmed pregnancy. It causes a significant psychological and physical trauma. Thus counseling and psychological support is very important key point in the management of abortion.<\/p>\n<p style=\"text-align: justify;\">Spontaneous abortion is often very complex and obscure in its etiological factors. Causes of abortion are usually divided into- ovular or fetal, maternal environment, paternal factor, unknown.<\/p>\n<p style=\"text-align: justify;\"><u>Patient Profile: <\/u><\/p>\n<p style=\"text-align: justify;\">A 28 years old hindu female, second gravida with LMP on 26\/08\/2020 with a complaint of amenorrhoea of 3 months 08 days with vaginal bleeding (1pad\/day) since 15 days off and on associated with general debility came to the OPD of Sir Sunderlal Hospital, Banaras Hindu University for proper management.\u00a0She is a resident of Lanka, Varanasi city, married for 8 years. She had a FTND female of 7yrs.<\/p>\n<p style=\"text-align: justify;\"><u>Case history:<\/u><\/p>\n<ul style=\"text-align: justify;\">\n<li>On General Examination her BP measured in OPD was 100\/70 mmHg (in sitting position)<\/li>\n<li>Routine investigations like CBC revealed Hb-10.6 gm\/dl with normal platelet count.<\/li>\n<li>Urine routine and microscopy examination reveals the presence of pus cells-2-3 \/hpf and epithelial cells 3-5 cells\/hpf.<\/li>\n<li>Per abdomen examination does not reveal any other evidence.<\/li>\n<li>Per vaginal examination was withheld to avoid undue handling of uterus considering the bleeding situation as USG is easily available.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><u>Management:<\/u><\/p>\n<ul style=\"text-align: justify;\">\n<li>The patient was counseled and advised to have complete bed rest with head in low position.<\/li>\n<li>Light diet.<\/li>\n<li>Supportive management as per ANC protocol given with Phala Ghrita 5 gms twice daily with lukewarm milk.<\/li>\n<li>Local application- <em>Gairika churna<\/em> 5gms with <em>Shatadhauta ghrita<\/em> 15-20 gms in the form of lepa application twice- thrice a day.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><u>Result:<\/u><\/p>\n<ul style=\"text-align: justify;\">\n<li>Bleeding per vaginum was relieved completely in one week period. By the end of one week patient has reported no bleeding per vaginum.<\/li>\n<li>Anointing lepa prepared with <em>Shatadhauta ghrita<\/em> and <em>Gairika<\/em> below the navel region is an effective non-invasive management in early pregnancy bleeding (<em>Garbha- srava)<\/em>.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><u>Discussion of the case with probable mode of action:<\/u><\/p>\n<p style=\"text-align: justify;\"><em>Gairika<\/em> (Red ochre) which is having\u00a0 <em>vishada<\/em> (clear), <em>snigdha<\/em>(unctous), <em>kashaya<\/em> (astringent), <em>madhura<\/em> (sweet) and <em>hima<\/em> (cold) properties (A.S.Su.12\/20), <em>sheeta virya <\/em>and<em> madhura vipaka which is classified under Shonitasthapana gana <\/em>(Ca.Su.4\/46) can act as <em>Raktastambhaka<\/em> (hemostatic) drug. According to Ashtanga Hridaya, <em>Gairika<\/em> comes under <em>kashaya<\/em> <em>skanda<\/em>. (A.H.10\/32). It is one of the safest naturally occurring mineral mostly known for its <em>Pittashamaka<\/em> and <em>Raktastambhaka <\/em>properties (Su.Ci.5\/8).<\/p>\n<p style=\"text-align: justify;\"><em>Shatadhouta ghrita <\/em>is prepared by washing ghee for 100 times in cold water(Su.U.39\/283,Dalhana). It is of light consistency and cooling\u00a0 quality and homogeneous, smooth, non-oily product, which is easier to apply, thus improving the patient compliance as a base for topical application can also act as a <em>Raktastambhaka <\/em>drug. It was found that <em>Shatadhouta ghrita <\/em>exhibits a much less degree of unsaturation and better consistency and hence suitable for topical application. <em>Shatadhouta ghrita <\/em>after preparation becomes very <em>sheeta<\/em> (cold), <em>sukshma <\/em>(minute particles) and <em>mrudu <\/em>(soft) all these properties can cause <em>sthambhana karma <\/em>(Ca.Su.22\/17)<em>.<\/em><\/p>\n<p style=\"text-align: justify;\">In <em>Shatadhouta ghrita, <\/em>due to the continuous washing and pressure applied during rubbing, particle size of fat granules get reduced makes the product non sticky, homogeneous, with a large surface area, which make it easy to apply on skin and may result in increased rate of absorption through skin. Washing results in the formation of a homogeneous mass of oil in water emulsion with better consistency and viscosity which helps in its topical application.<\/p>\n<p style=\"text-align: justify;\">When a <em>Lepa<\/em> is applied over the surface of skin opposite to the direction of hairs on it, through a proper base the active principles of the ingredients of <em>Lepa <\/em>are released into that base. After that this combination enters the <em>Romakupa <\/em>and further gets absorbed through the<em> swedavahi srotas <\/em>and<em> siramukh <\/em>(Su.Su.18\/4)<em>. <\/em>Then it reaches the desired site and pacifies the provoked <em>dosha.<\/em> Here the <em>Lepa<\/em> prepared with <em>Shatadhouta ghrita <\/em>and <em>Gairika <\/em>causes<em> Raktastambhana <\/em>by the <em>stambhana<\/em> action of both the drugs in the <em>artavavaha srotas. Shatadhouta ghrita <\/em>can act both as base and a <em>sthambana dravya.<\/em><\/p>\n<p style=\"text-align: justify;\"><u>Conclusion:<\/u><\/p>\n<p style=\"text-align: justify;\">In conclusion we can state that Ayurvedic medicine acts wonderfully in the management of early pregnancy bleeding. Moreover this combination of <em>Shatadhouta ghrita<\/em> and <em>Gairika <\/em>is a successful non- invasive method which not only is<em> Shonitasthapana <\/em>(haemostatics) also act as a <em>Garbhasthana <\/em>(fetus promoting) drug.<\/p>\n<ul style=\"text-align: justify;\">\n<li>In <em>Shatadhouta ghrita, <\/em>due to the continuous washing and pressure applied during rubbing, particle size of fat granules get reduced makes the product non sticky, homogeneous, with a large surface area, which make it easy to apply on skin and may result in increased rate of absorption through skin.<\/li>\n<li>In <em>Shatadhouta ghrita, <\/em>due to the continuous washing and pressure applied during rubbing, particle size of fat granules get reduced makes the product non sticky, homogeneous, with a large surface area, which make it easy to apply on skin and may result in increased rate of absorption through skin.<\/li>\n<li>In <em>Shatadhouta ghrita, <\/em>due to the continuous washing and pressure applied during rubbing, particle size of fat granules get reduced makes the product non sticky, homogeneous, with a large surface area, which make it easy to apply on skin and may result in increased rate of absorption through skin.<\/li>\n<\/ul>\n<p><strong>MCQs <\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"638\">1.\u00a0\u00a0\u00a0 The period of viability is considered to be<\/p>\n<p>A.\u00a0 24 weeks<\/p>\n<p>B.\u00a0 28 weeks<\/p>\n<p>C.\u00a0 30 weeks<\/p>\n<p>D.\u00a0 18 weeks<\/p>\n<p><strong><u>\u00a0<\/u><\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"638\">2.\u00a0\u00a0\u00a0 Pregnancy may continue with which of the following pregnancy-<\/p>\n<p>A.\u00a0 Missed abortion<\/p>\n<p>B.\u00a0 Inevitable abortion<\/p>\n<p>C.\u00a0 Threatened abortion<\/p>\n<p>D.\u00a0 Incomplete abortion<\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<tr>\n<td width=\"638\">3.\u00a0\u00a0\u00a0 Legal abortion is a type of which abortion-<\/p>\n<p>A.\u00a0 Spontaneous abortion<\/p>\n<p>B.\u00a0 Induced abortion<\/p>\n<p>C.\u00a0 Recurrent abortion<\/p>\n<p>D.\u00a0 Septic abortion<\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<tr>\n<td width=\"638\">4.\u00a0\u00a0\u00a0 Which of the following has majority cause of abortion<\/p>\n<p>A.\u00a0 Ovular or fetal<\/p>\n<p>B.\u00a0 Maternal environment<\/p>\n<p>C.\u00a0 Paternal factor<\/p>\n<p>D.\u00a0 Unknown<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<tr>\n<td width=\"638\">5.\u00a0\u00a0\u00a0 Deficiency of which factor is responsible for abortion<\/p>\n<p>A.\u00a0 Vit-C<\/p>\n<p>B.\u00a0 Vit-A<\/p>\n<p>C.\u00a0 Vit-B12<\/p>\n<p>D.\u00a0 Folic acid<\/td>\n<\/tr>\n<tr>\n<td width=\"638\">6.\u00a0\u00a0\u00a0 What may be the cause of abortion<\/p>\n<p>A.\u00a0 Diarrhoea<\/p>\n<p>B.\u00a0 Dysentery<\/p>\n<p>C.\u00a0 Hyperpyrexia<\/p>\n<p>D.\u00a0 Hyperemesis<\/td>\n<\/tr>\n<tr>\n<td width=\"638\">7.\u00a0\u00a0\u00a0 Major cause of first trimester abortion<\/p>\n<p>A.\u00a0 Cervical incompetence<\/p>\n<p>B.\u00a0 Defective germ plasm<\/p>\n<p>C.\u00a0 Trauma<\/p>\n<p>D.\u00a0 Environmental<\/td>\n<\/tr>\n<tr>\n<td width=\"638\">8.\u00a0\u00a0\u00a0 Major cause of mid trimester abortion<\/p>\n<p>A.\u00a0 Cervical incompetence<\/p>\n<p>B.\u00a0 Defective germ plasm<\/p>\n<p>C.\u00a0 Trauma<\/p>\n<p>D.\u00a0 Environmental<\/td>\n<\/tr>\n<tr>\n<td width=\"638\">9.\u00a0\u00a0\u00a0 Which local application is discussed in the present case<\/p>\n<p>A.\u00a0 \u00a0Lepa<\/p>\n<p>B.\u00a0 Pana<\/p>\n<p>C.\u00a0 Basti<\/p>\n<p>D.\u00a0 Nasya<\/td>\n<\/tr>\n<tr>\n<td width=\"638\">10.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <em>Shatadhauta ghrita <\/em>is prepared by washing \u2026.times with water.<\/p>\n<p>A.\u00a0 01<\/p>\n<p>B.\u00a0 20<\/p>\n<p>C.\u00a0 100<\/p>\n<p>D.\u00a0 1000<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>KEY to the MCQs<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"319\">1.<\/td>\n<td width=\"319\">B<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">2.<\/td>\n<td width=\"319\">C<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">3.<\/td>\n<td width=\"319\">B<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">4.<\/td>\n<td width=\"319\">A<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">5.<\/td>\n<td width=\"319\">D<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">6.<\/td>\n<td width=\"319\">C<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">7.<\/td>\n<td width=\"319\">B<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">8.<\/td>\n<td width=\"319\">A<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">9.<\/td>\n<td width=\"319\">A<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">10.<\/td>\n<td width=\"319\">C<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Supplementary Resources<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<ol>\n<li>Yadavaji Trikamaji (editor). Charaka Samhit\u0101 of Agnivesha with \u2018Ayurveda-Dipik\u0101\u2019 commentary by Chakrap\u0101nidatta, Siddhis\u0101sth\u0101na, chapter 9. Reprint edition, Varanasi: Chaukhamba Surbharati Prakashan;2000.<\/li>\n<li>Yadavaji Trikamaji &amp; Narayan Ram (editor). Sushruta Samhit\u0101 of Sushruta with \u2018Nibandhasangraha\u2019 commentary by Dalhana. Chikitsasthana, chapter 37. Reprint edition, Varanasi: Chaukhamba Surbharati Prakashan;2003.<\/li>\n<li>Shivprasad Sharma (editor). Asht\u0101nga Samgraha of Vriddha V\u0101gbhata with \u2018Shashilekh\u0101\u2019 commentary by Indu. Sutrasthana, chapter 28. 1<sup>st<\/sup> edition, Varanasi: Chowkhamba Sanskrit Series Office; 2006.<\/li>\n<li>Harishastri Paradakara (editor). Asht\u0101nga Hridayam of V\u0101gbhata with commentaries \u2018Sarv\u0101ngasundar\u0101\u2019 of Arunadatta &amp; \u2018Ayurvedaras\u0101yana\u2019 of Hem\u0101dri. Sutrasthana, chapter 19. 9<sup>th<\/sup> edition, Varanasi: Chaukhamba Orientalia; 2005.<\/li>\n<li>Pandit Sri Brahma Sankara Misra (Part II), Bhavaprakash of Sri Bhavamisra with commentaries \u2018Vidyotini\u2019, Cikitsa sthana, 11<sup>th<\/sup> edition, Varanasi, Chaukhambha Sanskrit Bhawan; 2009.<\/li>\n<li>Vaidya Jaymini Pandey (editor), Harita Samhita 1<sup>st<\/sup> edition, Varanasi, Chaukhambha Visvabharati, 2010.<\/li>\n<li>Priya Vrat Sharma (editor), Bhela Samhita, with English translation, commentary and critical notes, Dr.K.H. Krishnamurthy, Reprint 2008, Varanasi, Chaukhambha Visvabharati 2008.<\/li>\n<li>DC Dutta\u2019s Textbook of Obstetrics by Hiralal Konar, 8<sup>th<\/sup> edition, published by Jaypee The Health Sciences Publisher New Delhi, 2015.<\/li>\n<li>Self Assessment and Review Obstetrics by Sakshi Arora Hans, 12<sup>th<\/sup> edition, published by Jaypee The Health Sciences Publisher New Delhi, 2019<\/li>\n<li>Williams Obstetrics, edited by F Gary Cummingham, 24<sup>th<\/sup> edition published by MC Graw Hill Medical New York.<\/li>\n<li>Dewhurst&#8217;s Textbook of Obstetrics &amp; Gynaecology, Eighth Edition, Editor(s):\u00a0D. Keith Edmonds FRCOG, RRACOG, First published:5 January 2012 Print ISBN:9780470654576 |Online ISBN:9781119979449 |DOI:10.1002\/9781119979449<\/li>\n<li>Oxford Handbook of Obstretrics and Gynaecology by Sally Collins, Sabaratnam Arulkumaran at all.\u00a0 3<sup>rd<\/sup> (<a href=\"http:\/\/gynecology.sbmu.ac.ir\/uploads\/4_5841359559276364169.pdf\">http:\/\/gynecology.sbmu.ac.ir\/uploads\/4_5841359559276364169.pdf<\/a>)<\/li>\n<li>Clinical Obstetrics and Gynaecology, Third Edition, Edited by Brian A Magowan Philip, Owen, Andrew Thomson. (<a href=\"https:\/\/in.pinterest.com\/pin\/649996158693954389\/\">https:\/\/in.pinterest.com\/pin\/649996158693954389\/<\/a>).<\/li>\n<li>Pezeshki, Kevin &amp; Feldman, Joseph &amp; Stein, Daniel &amp; Lobel, Susan &amp; Grazi, Richard. (2000). Bleeding and spontaneous abortion after therapy for infertility. Fertility and sterility. 74. 504-8. 10.1016\/S0015-0282(00)00707-X. (https:\/\/www.researchgate.net\/publication\/12347840_Bleeding_and_spontaneous_abortion_after_therapy_for_infertility) DOI:\u00a0<a href=\"https:\/\/www.researchgate.net\/deref\/http%3A%2F%2Fdx.doi.org%2F10.1016%2FS0015-0282(00)00707-X?_sg%5B0%5D=GC3gsPGS553grYWyywyY4Ct_v6MYDM7AzMMxuO-CZrcFYD8m27b6QSpD6fdcNhck9REa7g6BKh4LVsNLVUZyQ71zsw.swGPzHl6iFyt10Jj1g8TkE2JUUltf0OGigzF_60AdxASftckmErT-ezTM457n6YZRxhRuUhWQ3yJdjdIc5D8pQ\">1016\/S0015-0282(00)00707-X<\/a><\/li>\n<li>Khan, M E &amp; Barge, Sandhya &amp; Philip, George. (1996). Abortion in India: An overview. Social Change. 26. (<a href=\"https:\/\/www.researchgate.net\/publication\/266471725_Abortion_in_India_An_overview\">https:\/\/www.researchgate.net\/publication\/266471725_Abortion_in_India_An_overview<\/a>)<\/li>\n<li>Hern, Warren. (1995). ABORTION: Medical and Social Aspects. (<a href=\"https:\/\/www.researchgate.net\/publication\/272494843_ABORTION_Medical_and_Social_Aspects\">https:\/\/www.researchgate.net\/publication\/272494843_ABORTION_Medical_and_Social_Aspects<\/a>)<\/li>\n<li>Mavric, Bisera. (2012). Legal, Social and Psycho-Medical Effects of Abortion. Epiphany. 5. 10.21533\/epiphany.v5i1.48. DOI:\u00a0<a href=\"https:\/\/www.researchgate.net\/deref\/http%3A%2F%2Fdx.doi.org%2F10.21533%2Fepiphany.v5i1.48?_sg%5B0%5D=xhvDuPd3oYeuAlUgASJKQrLn8NiurpM9F5OGVKLSBsGh33H9SS8WEcpZddlP_2CYsBi5uoJ-0nZwrI5i5geV0td06g.3lgDP437OHclgX_I4giclfRJnyyk2_uI97zCMh5dEohs-0C3hnVjBRHo4ZO8As-ZosrszBhqTx7v7r2Ux1Lkww\">21533\/epiphany.v5i1.48<\/a> (<a href=\"https:\/\/www.researchgate.net\/publication\/301944707_Legal_Social_and_Psycho-Medical_Effects_of_Abortion\">https:\/\/www.researchgate.net\/publication\/301944707_Legal_Social_and_Psycho-Medical_Effects_of_Abortion<\/a>)<\/li>\n<li>Arulkumaran, I.M. Symonds, A. Fowlie, Oxford Handbook of Obstetrics and Gynaecology, Pub.Oxford University Press, New Delhi, 2004.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cNon-invasive management of pregnancy bleeding- a successful case report\u201d Dr. Anuradha Roy Department of Prasuti Tantra, Faculty of Ayurveda, IMS; BHU, Varanasi. Introduction: Pregnancy bleeding is an alarming sign which should be taken care of so as to rule out the cause of such bleeding. The pregnancy may remain viable (threatened abortion) in spite of [&hellip;]<\/p>\n","protected":false},"author":20,"featured_media":3522,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"video","meta":{"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[116,110,106,36],"tags":[],"class_list":["post-2825","post","type-post","status-publish","format-video","has-post-thumbnail","hentry","category-complete-module","category-dr-anuradha-roy","category-lecture-series","category-prasuti-tantra-striroga","post_format-post-format-video"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.0.1 - aioseo.com -->\n\t<meta name=\"description\" content=\"\u201cNon-invasive management of pregnancy bleeding- a successful case report\u201d Dr. Anuradha Roy Department of Prasuti Tantra, Faculty of Ayurveda, IMS; BHU, Varanasi. 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