Dr. Suprabha K 1 Dept. of S.R.P.T Dr. Mamatha K. V. Professor … k.pdf · 2019-05-09 · Anaemia Maternal & perinatal morbidity &mortality Adverse affect on health, nutrition deprivation

Dr. Suprabha K

1st Year, PhD Scholar

I.P.G.T.& R.A.

Dept. of S.R.P.T

Dr. Mamatha K. V.

Professor

S.D.M.C.A. Udupi

Dept. of S.R.P.T

Under the Guidance of

Dr. L.P.Dei

Prefessor & H.O.D

I.P.G.T.& R.A.

Dept. of S.R.P.T

Purpose of the study:

Anaemia

Maternal & perinatal morbidity

&mortality

Adverse affect on health, nutrition deprivation & discomfort of

pregnancy

Hormonal,

physiological,

physical

changes during

pregnancy

Closely

spaced

pregnancies,

teenage

mothers

Malnutrition

Rasa Kshaya

Bala Varna

Hani, Nitya

klanta Adhika

Shrama

*Prevalence & consequences of anaemia in pregnancy, K. Kalaivani,Department of Reproductive Biomedicine, National

Institute of Health & Family Welfare, New Delhi, India ,Received April 24, 2009

The way body is nourished during

pregnancy, will affect maternal as well as the

fetal health.

Maternal well being is equally important as

that of the fetal well being.

Nutrition is the major intrauterine

environmental factor that alters expression of

the fetal genome

.

.

. Creates a healthy intrauterine environment

.

Rasayana therapy introduces a new concept of

nutrition

Ayurveda emphasizes the importance of Madhura

drugs endowed with Rasayana properties in

Garbhini Paricharya.

Rasayana can reach to each and every cell, even up to

the level of DNA. Hence, every primitive cell of the

fetus can definitely be influenced positively.

.

1

2

3

4

Shreyasi

praja

Rasa Samvahana

Apyayana of Rasa

Dhatu

Prashasta

Dhatu Nirmana

Rasayana makes the mother and her tissues healthy which

creates a favorable environment in-utero for the fetus to

survive and to get the best out of it.

Ayushya

Tarpana

Jivana Balya

Brumhana

Ojas Virya

Bala Varna

Medha Arogya

Aim and Objective:

•To evaluate the Rasayana effect of

Madhurausdha Siddha Avaleha in

the 6th & 7th month of pregnancy

• To assess the influence of the trial drug on maternal immune system.

Materials and methods :

SO

UR

CE

OF

DA

TA

Pregnant women in their 20-24 weeks of pregnancy were selected from I.P.D and O.P.D. of S. D. M.Ayurveda Hospital, Udupi.

CO

LL

EC

TIO

N O

F D

AT

A

A special proforma was prepared. Parameters of signs, symptoms and investigations were scored on basis of standard method and was analyzed statistically.

ST

UD

Y D

ES

IGN Randomized

comparative clinical study with pre-test and post-test design having 2 groups of 15 subjects each.

Grouping and Posology :

Group Drug Form Dose Duration Route Anupana

Group

A

(n=15)

Madhura

Aushadha

Siddha

Avaleha

Avaleha 12gms,

bd in

empty

stomach

2 months Orally Milk

Group

B

(n=15)

Shelcal

Heamup

Gems

Tablet 500mg

200mg

2 months Orally Water

Dietary instructions were given to both the groups.

DRUGS Rasa Guna Virya Vipaka D Karma

Mudgaparni M LR S M T Rasayana,Jivaniya,Prajasthapana, Balaprada, Śothahara

Mashaparni MT LS S M VP Rasayana, Jivaniya,Prajasthapana, Balya, Pushtikaraka, Shothaghna,

Bala M LS S M VP Rasayana, Prajasthapana, Brumhana, Balya, Ojo Vardhaka,

Gokshura M GS S M VP Rasayana, Garbhasthapana, Agnidipaka, Shothaghna

Draksha M GS S M VP Brumhana, Prajasthapana, Balaprada, Anulomana, Hṛdhya

Kharjura M GS S M VP Hṛdhya, Balya, Brumhana, Tarpaka,, Rucya, Dipana, Pacana,

Shatavari MT GS S M VP Rasayana, Stanyajanana, BalyaMedhya, Garbhapoṣaka, Shothaghni, Puṣṭidayaka

Ashvagandha KTKa LS U K VK Rasayana, Balya, Brumhana, Shophahara, Prajasthapana

Jivanti M LS S M VP Rasayana, Balya, Jivaniya, Stanya, Anulomana

Vaṃshalocana Mka LR S M KP Balya, Brumhana, Shothaghna

• Primi and multi gravida

• 20-24 weeks of pregnancy

• 20 – 35 years

• Hb >8 Gm %

Inclusion criteria

• IUGR, placental abnormality, eclampsia, hydraminos, multiple pregnancy, DM etc.

• HTN, HIV, CVD, hepatitis B etc.

Exclusion criteria

Subjective

• Loss of Appetite

• Back ache

• Cramps in the leg

• Flatulence

• Constipation

• Heart Burn

• Pedal edema

• Recurrent infections

Objective

• Weight gain

• Hematological tests

• Maternal immunoglobulin study

Assessment criteria

Blood group and Rh type

Hb%

TC DC ESR

RBS

Urine routine

Routine

Serum calcium

Serum iron

Maternal IgG, IgM

Specific

Investigations:

Result and Discussion:

Parameters Within the group Between the group

Mean

BT

Mean

AT

d t P d t P DF

Loss of

Apetite

T 0.800 0.0667 0.733 4.036 0.001 0.733 4.602 <0.001 28

C 0.933 0.800 0.133 0.807 0.433

Pedal edema T 0.000 0.200 0.200 1.871 0.082 0.400 2.049 0.050 28

C 0.000 0.600 0.600 3.674 0.003

Cramps in

leg

T 0.800 0.400 0.400 3.055 0.009 0.000 0.000 1.000 28

C 0.600 0.400 0.200 1.382 0.189

Heart burn T 0.667 0.133 0.533 3.228 0.006 1.000 4.279 <0.001 28

C 0.600 1.133 0.533 2.779 0.015

Back ache T 0.667 0.400 0.267 1.169 0.262 0.467 2.214 0.035 28

C 0.333 0.867 0.533 3.228 0.006

Pulling Pain

in Legs

T 0.733 0.533 0.200 1.146 0.271 0.0667 0.287 0.776 28

C 0.600 0.600 0.000 0.000 1.000

Effect of the drug on physiological hindrances of pregnancy

Parameters Within the group Between the group

Mean

BT

Mean

AT

d t P d t P DF

Flatulence T 0.733 0.133 0.600 3.674 0.003 0.400 2.479 0.019 28

C 0.333 0.533 0.200 1.382 0.189

Constipation T 0.400 0.066 0.333 2.646 0.019 0.467 2.619 0.014 28

C 0.400 0.533 0.133 0.807 0.433

Minor

infections

T 0.933 0.267 0.667 2.870 0.012 0.200 0.887 0.382 28

C 0.400 0.467 0.066 0.564 0.582

Weight gain T 56.433 60.433 4.000 18.330 <0.001 2.433 0.630 0.534 28

C 54.967 58.000 3.033 11.262 <0.001

Effect of the drug on hematological parameters

Para

meters

Within the group

(paired ‘t’ test)

Between the group

(unpaired ‘t’ test)

Mean

BT

Mean

AT

d T P d t P DF

Serum

ferritin

TRIAL 8.977 12.667 3.690 2.870 0.012 16.821 3.005 0.006 28

CONTROL 25.003 29.488 4.485 0.659 0.520

Serum

Calcium

TRIAL 9.273 9.653 0.380 1.351 0.198

0.693 3.039 0.005 28CONTROL 9.093 8.960 0.133 0.561 0.584

0

5

10

15

20

25

30

Sr. FERRITIN TRIAL Sr. FERRITIN CONTROL Sr. CALCIUM TRIAL Sr. CALCIUM CONTROL

8.977

25.003

9.2739.093

12.667

29.488

9.6538.96

Para

meters

Within the group

(paired ‘t’ test)

Between the group

(unpaired ‘t’ test)

Mean

BT

Mean

AT

d T P d t P DF

Hb% TRIAL 10.217 9.417 0.800 4.413 <0.001

1.900 4.138 <0.001 28CONTROL 10.117 11.317 1.200 3.838 0.002

Serum

Iron

TRIAL 80.417 66.071 14.34 2.394 0.031 3.833 0.432 0.669 28

CONTROL 77.976 69.904 8.072 0.868 0.400

0

2

4

6

8

10

12

HEMOGLOBIN TRIAL

HEMOGLOBIN CONTROL

10.21710.1179.417

11.317

BT

AT

0

10

20

30

40

50

60

70

80

90

Sr IRON TRIAL

Sr IRON CONTROL

80.417 77.976

66.071 69.904

BT

AT

Para

meter

Within the group Between the group

Mean BT Mean AT d T P d t P DF

IgG TRIAL 1270.647 1272.047 1.400 0.029 0.977 250.70 2.284 0.030 28

CONTROL 1561.213 1529.413 31.80 0.369 0.718

IgM TRIAL 205.680 218.533 12.85 1.074 0.301 66.807 2.722 0.011 28

CONTROL 165.287 151.727 13.56 1.440 0.172

0

50

100

150

200

250

TRIAL CONTROL

205.68

165.287

218.533

151.727

IgM

BT

AT

0

200

400

600

800

1000

1200

1400

1600

TRIAL CONTROL

1270.647

1561.213

1272.047

1529.413

IgG

BT

AT

Effect on Maternal Immunoglobulins

Increases bioavailability of

better quality nutrients

Act through the mechanism of

specific molecular nutrition to the

target organs.

Rasayana - Prinana Tarpana

Dhatu Vivardhana

Promote Samyak Utpatti of

Rasa Dhatu in the Garbhini

Better nourishment of Aadhya Dhatu leads to

consequent nourishment of Uttarottara

Dhatus

Thus enabling both the mother and fetus to procure the best

qualities of Dhatus and there by even enhances the immunity.

Mode of Action:

Overall health

Overcome physiologicdiscomforts

Complete antenatal

care

Act at level of

Rasa

Agni

Srotas

induce Bala,

Vyadhikshamatva or

immunity

Madhura Ahara

nourishes Dhatu by

its Rasayana effect

Ojas, Tejas

&Veerya

Vardhaka

Madhura Rasa

controls Dhatu

Kshaya by Vatahara

property

Bala, Go

Ghrita, Jivaniya

Rasayana drugs

1 2 3 4

conclusion

Nourishes Rasa

Dhatu to Shukra

Dhatu even up to

Ojas

Imparts

Deerghayu, Medha

Arogya, Smriti,

Prabha, Varna,

Bala etc

Confirms the

nutritional benefits Improves maternal

immununity status

Rasayana

in

Garbhini

Incorporating Rasayana in ANC, benefits the pregnant lady + carry out all

round growth and development of fetus including the immunological

development during intra uterine period.

Rasayana in Garbhini

can work as a platform

to build up holistic

approach in this regard

and this would be a great

contribution from

fraternity of ayurveda,

to the branch of obstetrics

and thus to the mankind…