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
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.
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:
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
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.