By
Prof. Dr. Sagira Chimthanawala
Prof & Head,
Dept. Homoeopathic Gynecology & Obstetrics,
The National Academy of Homoeopathy, India
Shaad Homoeopathic Hospital Complex & Research
Centre,
Near Itwari Railway Station, NAGPUR 10
Ph: +919823518558, 0712-2766286
A Multi gravida (G3 P3A0 L2) female aged 28 years –
ANC 40 weeks reported at the department of Obstetrics, Shaad Homoeopathic
Hospital Nagpur on 24/3/10 at 1am with complaints of -
1] Abdominal pain every ½ to 1 hour since 2 hours
2] Headache- throbbing, severe since 15 minutes
3] Vomiting - 7-8 times, projectile consisting of
food and water.
Whilst coming to our hospital with her husband for
delivery, she had a fall from the running bike and sustained head injury. 15
minutes after the injury, she developed headache with projectile vomiting with
bradycardia. She was hospitalized.
O/E Conscious, oriented, having severe headache but
calm. Did not want to be examined
afebrile
BP- 130/80mm Hg
Pulse-regular, 52/minute, good
volume
Pallor +. No Icterus /cyanosis /clubbing
No oedema feet. No congestion of eyes.
Scalp-minor bruise on left tempero-parietal
region
Heart Sounds- pure. No gallop or
murmurs
Chest –clear
Per Abdomen- soft. Liver & Spleen –not
palpable. Uterus- 40 weeks, FHS-150/min
P/V – Cervix 7cm loose. 50% effaced.
Membranes +
CNS- Deep tendon reflexes – brisk. Planters -
flexors. Pupils-NSRL
Otherwise No neuro-deficit.
The present pregnancy was detected by urine
examination. All the 3 trimesters were uneventful. There was no history of PIH,
DM, fever, urinary tract infection or severe anemia, etc. Quickening started at
20 weeks. The baby was moving well.
The last USG dated 20/3/2010 showed single live
intrauterine foetus of 39weeks. Cardiac activity normal, Fetal Movements
present. FHS 148 beats/ min. Amniotic fluid adequate. Placenta – fundal,
anterior. No retroplacental clot. Maturity Grade III. Estimated Fetal weight
2913 grams +/- 300 grams. EDD - 28/3/2010.
Symptoms for Repertorization
Head, pain, injuries after
Head pain, vomiting with
Stomach, vomiting, sudden, projectile
Following were the drugs - Arnica, Bell, Natrum
sulph, Calc, carb, Cicuta
Rx
Arnica 0/1 x 15 minutes - 6 doses.
Patient was subjected for CT scan Head with due
precautions. CT scan – normal.
After 2hours - patient was much better, headache
reduced, no vomiting, labor pains stopped
Pulsatilla 1M 3 doses
Labor pains started with Cervical dilatation.
Patient delivered a full term healthy male weighing 2.75 Kg.
A repeat head scan done was normal. Patient was kept
for observation for 4 days. No neurological symptoms or signs noted. Child was
breast feeding well. Hence patient was discharged.
Discussion: Arnica Montana- the evergreen remedy for
ailments after traumatic injuries is usually given after labor when the parts
are sore bruised and lame. During pregnancy if the fetal movements are more and
there is vomiting, it calls for Arnica. Furthermore Arnica is indicated when the
labor pains have become weak or have stopped.
But in our case, although Arnica wonderfully
controlled the headache and the projectile vomiting, the labor pains with which
the patient had come, ceased. A dose of Pulsatilla was administered for
initiating the labor pains.
The trio of sudden onset severe headache, projectile
vomiting and bradycardia in an otherwise non hypertensive pregnant female was
thought of initially due to raised intra-cranial tension. But once the CAT Scan
was normal, we were bereft of the reason. On the opinion of the neurologist a
repeat scan after 10 hours was done. It was normal. Symptomatically the patient
under monitoring was well for more than 72 hours after labor and hence
discharged.
There was no obvious need of the other 2 closely
related drugs, Natrum Sulphuricum (violent crushing pain at the base of the
brain, mental traumatism due to head injury) and Belladonna (congestive headache
with full bounding pulse) as Arnica had proved its worth.
The twist in the case would have occurred if the
patient would have had an intra-cerebral bleed or a subdural haematoma. The
dilemma in such a case would be to tackle the mother suffering from the
intracranial injury as well as the delivery of the child. But our patient was
fairly lucky!! She had indeed tasted the boon of the Leopard’s Bane.
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