Safe Pregnancy And Motherhood

Saturday, February 7, 2009 17:38
Posted in category Ayurvedic Science, Health

Each Minute Of Every Day, Somewhere In The World And Most Often In A Developing Country, A Woman Dies From Complications Related To Pregnancy. For All Women Who Die, 30 To 50 Percent Of Women Suffer From Injury, Infection, Or Disease. Pregnancy-Related Complications Are Among The Leading Causes Of Death And Disability For Women Aged 15-49 In Developing Countries. At Least 40% Of All Pregnant Women Experience Some Type Of Complication During Their Pregnancies. For About 15%, This Complication Is Life-Threatening, And Requires Immediate Obstetric Care.

(A) Maternal Death During Pregnancy
(B) Treatment In Different Gestational Month
(C) General Disorder During Pregnancy And Their Management

So, Safe Motherhood Means Ensuring That All Women Receive The Care They Need To Be Safe And Healthy Throughout Pregnancy And Childbirth. It Can Be Achieved By Providing High-Quality Maternal Health Services To All Women During Pregnancy, Childbirth, And The Postpartum Period.

(A) Most Maternal Deaths Are Due To These Major Medical Causes

Severe Bleeding (Hemorrhage)

  • Infection
  • Unsafe Abortion Complications
  • Hypertensive Disorders Of Pregnancy
  • Obstructed Labor
  • Warning Signs During Pregnancy
  • Failure To Gain Weight (At Least 6 Kilograms Should Be Gained During Pregnancy)
  • Anemia, Paleness Inside The Eyelids (Healthy Eyelids Are Red Or Pink)
  • Unusual Swelling Of Legs Arms Or Face
  • Movement Of Fetus Being Very Little Or Not At All

So, A Pregnant Woman Needs To Be Checked At A Clinic Or Health Facility At Least Four Times During Every Pregnancy. It Is Also Important To Seek The Advice Of A Skilled Birth Attendant (Such As A Doctor, Nurse Or Midwife) About Where The Baby Should Be Born. A Woman Should Also Be Properly Educated So That She Can Take Care Of Herself And Her Baby.

But Still, A Pregnant Woman Is Susceptible To All Those Possible Diseases Which A Normal Human Being Can Encounter, Hence If There Is Any Disorder During Pregnancy, The Situation Can Be Best Managed Under The Guidance Of Good Physician.

Considering The Above Fact, In Ayurveda Also, Kasyapa Has Given Two Full Chapters On This. Harita Has Enlisted Emaciation, Nausea, Vomiting, Edema, Fever, Anorexia, Diarrhea & Discoloration Etc. According To Susruta, Pregnant Woman Are Prone To Facial Paralysis. Similarly Charaka And Vagbhata Have Also Suggested That The Pressure Caused By Growing Fetus Increases In Case Of Piles & Edema.

According To Caraka (C. 1000 B.C.), Pregnant Woman Should Be Treated With Soft, Sweet, Cold, Pleasing And Gentle Drug, Dietetics And Behavior. She Should Not Be Given Emetics And Purgatives.

Exercise And Use Of Pungent Drugs Should Be Avoided (Charaka Sutra 25/40).

According To Harita (10-12th Cent. A.D.), Unripe Fruit Of Bilva Mixed With Curd And Sugar Is Always Beneficial.

There Are Certain Diseases Whose Treatment At The Initial Stage Itself Prevents Them From Becoming Major Disorders At A Later Stage.

(B) Line Of Treatment In Different Gestational Month

During Fourth Month Of Pregnancy: In This If Women Suffers From Any Disease Of Vata, Retention Of Urine, Other Pain Etc. Then Castor Oil With Milk Should Be Given (Kasyapa Khil,10).

During Fifth Month: In This Evacuative Enema And Nutritive Enema Containing Sour, Saltiest Drug And Sweet Substance Should Be Given (Kasyapa Khil,10).

During Sixth Month: In Case Of Lymphadenitis, Furunculous, Inflammation, Abscess Harsh Or Rough Treatment I.E. Use Of Cauterization And Surgery Should Be Done (Kasyapa Khil, 10).

During Seventh Month: If There Is Protuberant Flesh Then Its Suppression Should Be Done With Help Of Surgery Or Cauterization (Kasyapa Khil, 10).

(C) General Disorder During Pregnancy And Their Management:

  1. Vomiting
  2. Pre- Eclamptic Toximia
  3. Eclampsia
  4. Fever
  5. Diarrhea During Pregnancy
  6. Epilpesy
  7. Jaundice
  8. Heart Pain
  9. Tuberculosis
  10. Aneamia
  11. Acute Pain In Abdomen

1. Vomiting:

The Vomiting Related To Pregnancy Is Classified As Simple Vomiting Of Pregnancy Or Milder Type
Hyperemesis Gravidarum Or Severe Type. Slight Vomiting Is Common In Early Pregnancy (About 50%). It May However, Occur At Any Time In Day, Generally Occurs In Morning. It Does Not Produce Any Impairment Of Health Or Restrict The Normal Activities Of Women And Gets Disappeared With Or Without Treatment By 12-14 Weeks Of Pregnancy.

It Could Be Managed By Avoiding Fatty And Spicy Foods. Patient Is Advised To Take Plenty Of Fluids (2.5l In 24hr.) And Fruit Juices.

Hyperemesis Gravidarum Is Serve Type Of Vomiting Of Pregnancy Which Has Got Deleterious Effect On The Health Of The Mother In Day To Day Activities. The Etiology Is Obscure But The Following Are The Known Facts:

  • It Is Mostly Limited To First Trimester.
  • It Is Most Common In First Pregnancy.
  • It Has Got A Familial History.
  • It Has More Prevalent In Hydatidiform Mole & Multiple Pregnancies.
  • It Is More Common In Vata Vaigunya, Non-Fulfillment Of Dauhrda Stage (I.E. Non Fulfillment Of Desires Substance By Women During Pregnancy)

Management:

  • To Correct The Fluids, Electrolytes And Other Metabolic Disturbance.
  • Nutritional Support With Vit.B1, B6, Vit.C And Vit.B12.
  • Nursing Care: Sympathetic But Firm Handling Of The Patient Is Essential.

Some Useful Drugs:

Paste Of Dhanyaka Mixed With Rice Water And Sugar Should Be Given (Yogratnakar, Stri Rog Chikitsa Sthan).
Flour Of Parched Barley Mixed With Decoction Of Sunthi And Bilva (Yogratnakar, Stri Rog Chikitsa Sthan).

2. Pre-Eclamptic Toxemia

It Is A Multi System Disorder Of Unknown Etiology Characterized By Development Of Hypertension To The Extent Of 140/90mm Hg Or More With Proteinuria After The 20th Week. It May Appear Even Before 20th Week As In Case Of Hydatidiform Mole And Acute Poly Hydramnios.

Demonstration Of Pitting Edema Over The Ankles After 12hr. Bed Rest, Rapid Gain In Weight Of More Than 1lb A Week Or More Than 5lb A Month Of Pregnancy May Be Earliest Evidence Of Pre-Eclampsia.

There Is Increased Association Of Pre-Eclampsia With Primigravide, Family History, Placental Abnormalities, Genetic Disorder And Thrombophilias.

Management

  • As Long As The Etiology Is Obscure The Treatment Is Mostly Empirical And Symptomatic.
  • Diet Should Contain Adequate Amount Of Protein (About 100gm). Usual Salt Intake And Fluids Is Not Restricted. Total Calorie Approximate 1600cal/day.

In Favorable Cases, There Is Fall Of Blood Pressure And Weight With Subsidence Of Edema. Urinary Output Increases With Diminishing Proteinuria, If Previously Present.

In Unfavorable Cases, The Definitive Treatment Of Pre-Eclampsia Is Termination Pregnancy Through Which Mother Could Be Saved.

3. Eclampsia

Pre-Eclampsia When Complicated With Convulsion And/or Coma Is Called As Eclampsia. The Causes Of Cerebral Irritation Leading To Convulsion Are Not Clear. The Irritation May Be Provoked By Anoxia (Spasm Of The Cerebral Vessels Following Hypertension), Cerebral Edema-May Contribute To Irritation, Cerebral Dysrhythmia-Increase Following Anoxia/edema.

Management

  • Patient Should Be Placed In A Railed Cot In An Isolated Room.
  • Anticonvulsant And Sedative Regime Should Be Used.

4. Fever

Fever To Pregnant Women Is Most Troublesome Disease And Fetus Also Suffers Due To Transfer Of Heat Of Fever From The Mother. If Fever Occurs Before 4th Month Then Patient Should Advised To Fast For One Day, Followed By Use Of Drinkables Free From Fat And Salt. She Should Take Only Rice Gruel Followed By Cereals With Soups. No Medicine Should Be Given. Lakhen Karma (The Measures Which Makes The Body Light) Could Be Used If It Occurs After 4th Month (Kasyapa Khil,10).

In Taruna Jwara (Recent Fever) Massage With Oil, Nasal Drops, And Sternutatory Drug Should Be Avoided As They Influence The Fetus By Making It Stiff Or Immobile (Kasyapa, Khil 10/18).

Similarly Emesis Produces Fetal Abnormalities Abortion And Other Serious Disorder (Charka, Siddhi 2/9).
General Treatment:

Decoction Of Chandan, Sariva, Lodhra And Mrdvika Mixed With Sugar Should Be Given.
Hriberadi Decoction Prescribed For Diarrhea Is Also Beneficial (Kasyapa, Khil.10).

5. Diarrhea During Pregnancy

Dietetic Abnormalities, Use Of Ripened Fruits And Polluted Water, Fear, Grief Etc. Psychological Trauma, Emaciation And Due To Doshas Or Other Body Disease Can Cause Diarrhea To Any Body. However During Pregnancy Presence Of Least Abnormalities May Produce Diarrhea.

Management

  • Digestive Drugs In Case Of Diarrhea Having Sufficient Quantity Of Mucous In Feces And Constipation Drug Incase Where Feces Not Containing Mucous Should Be Prescribed.
  • Kalyanakawaleha And Hriberadi Decoction Is Beneficial In All Types Of Diarrhea (Kasyapa, Khil.10).

6. Epilepsy

In This, Incidence Of Fetal Malformation And Still Birth Is Increased. The Malformation Includes- Cleft Lips/palate, Mental Retardation, Cardiac Abnormalities, Limb Defect. There Is Chance Of Neonatal Hemorrhage. The Risk Of Developing Epilepsy To The Offspring Of An Epileptic Mother Is Also There.

Management

  • Vit.K 10mg A Day Orally Is To Be Given In The Last Two Weeks Of Pregnancy.
  • Juice Of Lemon Mixed With Vid And Rock Salt.
  • Decoction Of Agnimantha.
  • Soups Of Meat Of Quail Mixed With Fat.

7. Jaundice

When The Serum Bilirubin Level Exceeds 2mg % (Normal Being .2-.8mg %), Visible Yellow Staining Of The Tissue Appear. Overall Incidence In India Is 1-4% Per 1000deliveries.

It May Be Due To Severe Pre-Eclampsia, Eclampsia, Acute Fatty Liver(Acute Yellow Atrophy Of The Liver), Severe Hyper Emesis Gravid Arum, Intra Hepatic Cholestasis Is The Second Most Common Cause Of Jaundice In Pregnancy, The First One Being The Viral Infection.

Management

  • Decoction Of Prisniparni, Bala, And Vasa Should Be Given (Yogratnakar, Stri Rog Chikitsa Sthan).
  • Use Of Pippali And Root Of Aukotha Mixed With Juice Of Horse Dung And Curd Of Buffalo’s Milk Is Beneficial (Kasyapa, Chikitsa. 2/6).

8. Heart Pain

In 32nd Week Of Pregnancy The Pressure On Heart Is Highest And With Time It Goes On Increasing. In Such Case Patient Need A Special Care.

We May Use Powdered Pippali With Paste Of Patra, Coca And Priyangu Mixed With Juice Of Lemon Should Be Given. Also, Powdered Pippali, Priyangu, Bhadramusta, Harenu Is Beneficial (Kasyapa, Khil.10).

9. Tuberculosis

The Incidence Ranges Between 1-2% Among The Hospital Deliveries In The Tropics, Being Confined Predominantly To The Underprivileged Sectors Of Society. Incidence Of T.B. Is Also Rising World-Wide With The Rising Prevalence Of Hiv Infected Patient, Positive Family History, Alcohol Addition And Intravenous Drug Abuse Are Also Responsible For This.

Management

  • An Electuary Made With Kulirasingi, Marica, Bharngi, And Pippali Mixed With Lemon Juice Should Be Given (Kasyapa, Khil.10).
  • If It Is Associated With Trauma Then Use Of An Electuary Made With Madhuka, Sankhapuspi, Jiva, Laksa, Sugar And Honey Should Be Used (Kasyapa, Khil.10).
  • Pippalyadi Leha Is Also Useful (Kasyapa, Khil.10).

10.Anemia

It Is The Most Common Hematological Disorder That May Occur In Pregnancy. According To Standard Laid Down By Who, Anemia In Pregnancy Is Present When The Hemoglobin Concentration In The Peripheral Blood Is 11gm/100ml Or Less. During Pregnancy Plasma Volume Expand (Maximum Around 32nd Week) Resulting Hemoglobin Dilution, Which Result In Fall Of Hemoglobin Concentration.

Due To Anemia Pre-Eclampsia, Intercurrent Infection, Heart Failure At 30-32 Week Of Pregnancy And Preterm Labor May Happen.

General Treatment

  • A Realistic Balance Diet Rich In Protein And Vitamin Is Prescribed.
  • To Improve The Appetite And Facilitate Digestion, Various Appetizers Drug Could Be Given Such As Use Of Powder Of Pippali, Pippalimula, Musta, Nagara, With Milk Sweetened With Or Honey.
  • Effective Therapy To Cure Disease Contributing To The Cause Of Anemia.
  • Special Therapy:
  • The Principal Is To Raise The Hemoglobin Level As Near To Normal As Possible. Thereafter An Attempt Is Made To Restore The Iron Reserve At Least In Part If Possible, Before The Patient Goes In Labor.

11. Acute Pain In Abdomen

Some Amount Of Abdominal Pain Common During Pregnancy. Approximately 80% Of Women Who Are Pregnant, Back Pain Are Prevalent. The Etiology Of Pain Is Probably Related To A Combination Of Mechanical, Metabolic, Circulatory, And Psychosocial Contributing Factors. One-Third Of The Patients Who Experience Pain Starting During The First Trimester When Mechanical Forces Are Not A Significant Force, Highly Indicates That The Most Probably Cause Is Due To A Change In Hormonal Influence. Patients Are Instructed To Avoid Excessive Weight Gain; Exercise To Strengthen The Back Muscles, Maintain Correct Posture, And Wear Sensible Shoes (Not High Heels).

Pregnancy Is One Of The Most Beautiful Aspects Of Womanhood. Each Pregnancy, Each Child Born, Is A Special Opportunity For A Woman To Discover Within Herself Great Strength And Flexibility. She Can Discover Her Great Power Yet Her Ability To Surrender; Her Great Compassion Yet A Detachment. Most Importantly, Her Greatest Capacity To Love.

Conclusion:in Conclusion, Considering All The Disorders And Their Management Mentioned Above, It Can Be Said That If The Fetus And The Pregnant Woman Are Taken Care Of During Each Of The Nine Months, We Can Not Only Control All The Possible Disorders But Can Also Help Both Mother And Her Child To Live A Healthy And Happy Life.

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One Response to “Safe Pregnancy And Motherhood”

  1. B Thirunavukkarasu says:

    June 21st, 2012 at 7:18 pm

    Great useful info

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