Homeopathy in induction of normal labor and preventing caesarean section

Homeopathy in induction of normal labor and preventing caesarean section : a case report

Dr Sapna Gupta BHMS
Reader NFSG, Department of Pathology, Nehru Homoeopathic Medical College and Hospital, Directorate of AYUSH, Govt of NCT of Delhi. India. E-mail: drsapnagupta@gmail.com

Dr Parul G Wadhwani,BHMS MD
Reader NFSG, Department of Obs and Gynae, Nehru Homoeopathic Medical College and Hospital, Directorate of AYUSH, Govt of NCT of Delhi. India. E-mail: drparulwadhwani@gmail.com

ABSTRACT: Homoeopathy has lot of medicines with respect to complaints occurring during pregnancy, labour and puerperal stage.  Patients frequently consult homeopathic physician for complaints occurring in such times as they are well aware of efficacy and no side effects of homeopathic treatment. A case of delayed engagement in a primigravida is mentioned here where Homeopathic medicine Pulsatilla brought about rapid engagement and normal labor and prevented caesarean section.

Key Words: Labor, Homeopathy, Caesarean section, engagement, Pulsatilla

Introduction: The pre-monitory stage of labor begins approximately 2 to 3 weeks prior to the onset of  labor especially in a primigravidae and few days before in multigravida. It is characterised by engagement, ripening of cervix and appearance of false pain.

Engagement occurs a few weeks prior to the onset of labor especially in primigravidae. The presenting part of the foetus sinks into the true pelvis. The fundal height decreases, thereby minimising the pressure on the diaphragm. Engagement is a favourable sign as it rules out cephalopelvic disproportion [1].

Homoeopathic literature mentions several homeopathic medicines useful in efficient management of labor cases. In the book ‘Homeopathic therapeutics’ by Samuel Lilienthal, the best remedies to facilitate labor or to remove dynamic difficulties as given are: Acon., Calc., Caul., Caust., Cham., Coff., Cimicif., Nux v., Puls., Sec., or Arn., Bell., Bor., Gels., Gossyp., Hyosc., Sep., Sulph., Veratr., Vibur. [2]

The prescription is to be based, however, on the basis of totality of symptoms and individuality of every case.

CASE REPORT
A 25 year old primigravida, consulted on 29 January 2017 for delayed engagement. In her last visit to Obstetrician on 28/1/17, the doctor told her that  there is already a delay in descent of child into the uterus and cervix was thick and not effaced, which should have taken place by this time of gestation in a primigravida and if the same does not happen within 3-4 days, Caesarean section shall be required.

Her last menstrual period was on 2/5/16 and as per ultrasound report dated 8/1/17, her expected date of delivery was 26.1.17 +_2 weeks. Her antenatal period had been uneventful except that she suffered from dry cough during her pregnancy.

Apart from above findings, she also complained of pain in vagina since last 4 days which aggravated in the evening and was worse turning in bed and first motion. It was better by continued motion and warm fomentation.  She used to go for long evening walks which relieved her pain. Also, there was pain in left leg.

PAST HISTORY:

• Recurrent boils since childhood.
• Dengue in 2012.

PERSONAL HISTORY:

DIET: Vegetarian

MENSTRUAL HISTORY: She had regular periods .

OCCUPATION: Housewife.

ADDICTION: None

FAMILY HISTORY: Mother- Diabetic

Paternal Grandparents : Diabetic

Maternal uncles: Diabetic

PHYSICAL GENERALS:

THERMAL REACTION: Hot. Prefers winters.

APPETITE: Adequate

DESIRE: Sweets (+++)

BOWELS: Regular and clear.

TONGUE: clean and moist.

MENTAL GENERALS:

MILD

GENERAL PHYSICAL EXAMINATION:

• BP: 110/70 MM Hg
• Wt: 72 kg
• Per abdomen: fetal height: 36 weeks
• FHS: regular
• Vertex: fixed

CASE ANALYSIS

Following rubrics were chosen for repertorization:

1. FEMALE GENITALIA/SEX – ATONY of uterus

2. FEMALE GENITALIA/SEX – PAIN – labor pains – suppressed and wanting

3. GENITALIA/SEX – PAIN – Vagina

4. GENERALS – EVENING

5. GENERALS – WARM – applications – amel

6. GENERALS – MOTION – continued motion – amel.

7. COUGH – PREGNANCY agg.; during

The case was repertorised using RADAR software Synthesis Repertory.   The result of repertorization was:

• Pulsatilla : 14/7
• Sepia : 12/6
• Causticum: 9/5
• China: 7/5
• Kali Carb: 7/5
• Rhus Tox: 9/4

Keeping in view, result of repertorization and the mild temperament of the patient , the remedy Pulsatilla was chosen for the case.

PRESCRIPTION
29/1/17 (1 PM): Pulsatilla 200/ three doses/ 30 minutes interval.

30/1/17: On waking in the morning, patient felt a sense of relief  on her chest, a symptom suggestive of engagement, and also felt as if the uterus has come down. BY 1 PM,  labor pains started and at 5: 30 pm , she was admitted to hospital. Obstetrician confirmed that  the cervix was dilated and effaced. At 10:30 PM, she delivered a healthy baby boy by normal labor.

DISCUSSION AND CONCLUSION
Homoeopathic medicine ‘Pulsatilla’ is a renowned medicine for management of difficulties in relation to labor. Several references can be found in homoeopathic literature regarding the same.

• Pulsatilla is a medicine for Inertia of uterus. Pains are slow, weak, ineffectual or spasmodic and irregular, exciting fainting, wants doors and windows open, fears to suffocate; chilliness and pale face; soreness of uterus and of abdominal walls; it corrects malposition of the foetus by stimulating the action of the muscular walls of the uterus. [3]

• Pulsatilla is used for Uterine inertia with want of expulsive power causing retention of the fetus. The uterine contractions are weak and feeble.[4]

In the above case, the prescription was based on the totality of the case and its individuality. Pulsatilla covered all the symptoms of the patient along with the modalities. The case re-emphasises the value of Homeopathic medicine Pulsatilla in the management of labor cases.

References :

• Dutta D C, Textbook of Obstetrics, 9th edition, edited by Hiralal Konar, Jaypee Brothers Medical Publishers(P) Ltd., pp 110.
• Lilienthal S. , Homoeopathic Therapeutics, Reprint edition, B Jain Publisher (P) ltd. pp 647
• Lilienthal S. , Homoeopathic Therapeutics, Reprint edition, B Jain Publisher (P) ltd. pp 650
• Kulkarni, Shrikant, Gynaecological and Obstetric Therapeutics, first edition, B. Jain Publishers put ltd, pp. 182