ISSN 0976 - 0075
Bicornuate uterus is a rare congenital anomaly associated with associated with increased adverse reproductive outcomes, such as: recurrent pregnancy loss,reterm birth in 25-50 % cases. A case study is presented in which a 29 year old married female with bicornuate uterus who had 5 abortions in 4 years was successfully treated by giving Ayurvedic treatment.
Wikipedia described bicornuate uterus commonly referred to as a "heart-shaped" uterus, is a uterus composed of two "horns" separated by a septum. A bicornuate uterus is a type of uterine malformation. A bicornuate uterus is formed during embryogensis. The fusion process of the upper part of the paraesonephric duts is altered. As a result, the lower part of the uterus is unitary while the upper part is bifurcated. A bicornuate uterus is associated with increased adverse reproductive outcomes, such as:recurrent pregnancy loss,reterm birth in 25-50 % cases, malpresentation ( breech birth or transverse presentation and with high risk of congenital deformity & malformations.
Here is a case study of Bicornuate uterus with successful outcome of pregnancy by Ayurvedic treatment.
A 29 year old female married 7 years back, having Bicornuate unicollis uterus. She had 5 abortions in 4 years. The H/o abortion was as follows: G1-10 weeks, G2-26 weeks (with Shirodkar's stitches), G3-20 weeks, G4-8 weeks, G5- 7-8 weeks. It may be noted that the period of gestation was showing declining trend from G3 to G5.
She was negative for HIV, VDRL, Rubella and Cardiolepin Antibodies. FSH, Prolactin, TSH was normal. Her Renal and Hepatic profile was normal. Her Hb was around 11g/dl.
She was treated by top most Obstetricians in Nandurbar, Dhule, Nashik, Pune and Mumbai but none of them succeeded in successful outcome of pregnancy. She approached to the Gynaecology and Obstetrics department in Sassoon Hospital of B.J. Medical College and the HOD opined that surgical management was not possible.
Lastly all renowned doctors told she may not deliver a child and advised her following options -couple may proceed for Surrogate pregnancy, or adopt a child.
There was severe mental trauma occurred to this lady due to repeated abortions.
She was referred to me in February 2014. I assured the lady and her father; of a successful outcome of pregnancy within 12-18 months of treatment explaining them that Ayurveda has lots of strength in treating such cases.
Bicornuate unicollis uterus
Samprapti:- Granthkaras mentioned that Garbhashay is the 8thAshay in females. The Moolsthan of Artavvahstrotas is Garbhashay and Artavvahdhamanyas. If there is aghat /injury by Abhyantar (Nij/doshik) or Bahya means, it causes Vandhyatva/ Infertility (Su. Sha. 9/12). Garbhashay is the organ made up of Mauans-dhatu and has Raktadhikya.Raja and Stanya are the upadhatus of Rasa. Therefore if Rasa dhatu is vitiated the vikruti occurs in Raja (Garbhashay) and Stanya. Further Garbhashay belongs to Apankshetra. Therefore in the present case chikitsa was given by considering Vat and Kapha doshas.
She was asked not to take any chance of conception till treatment is completed. Kapha is the Mala of Rasa-dhatu and Vaman is the best treatment to pacify Kapha. Therefore Sadhhovaman was given (for instant shodhan of doshas) followed by Sansarjankram for 3 days and Ras-Raktapachak and Anulomak chikitsa was given. It consisted Sitopaladi choorna+ Avipatikat choorna 1TSF BD before meal along with warm water, Kumari Aasav 3 TSF BD along with Sarswat arishta (to reduce anxiety and depression) 3 TSF BD with warm water after meals for 7 months. She was given Phat-ghrit 1TSF (Achchh sneha) along with 1 cup Siddha Kshirpak (made of 1 cup milk + 1 cup water+ Sunthi choorna ¼ TSF + one Yela /cardamom) daily till she conceived. Meanwhile 15 days after Sadhhovaman, we repeated Vaman with 5 days Sneha-pan(30,30,40,50,60ml Tiktaghrit)along with Sansarjankram for 5 days.
As per Charakacharya Vata gives rise to such anomalies in the body and Garbhashay belongs to Apankshetra. For chikitsa of Vata, Bastichikitsa is the best treatment advised by Granthkaras. Bastichikitsa is beneficial not only on Vatadushti but on Pitta, Kapha and Raktadushti also. Bastichikitsa has been mentioned as half Chikitsa by Granthkaras. Therefore Bastichikitsa in the form of Yogbasti-Niruha( Dashmool + Erandmool kadha 350 ml + Madhu/ Honey 3 ml + Saindhav 3 gm + Narayan tail 20 ml) and Anuvasan/ Matra Basti (Sahachar tail 50 ml/ Narayan tail 50 ml ) was given on alternate day. Thereafter she was advised to keep vaginal Pichu whole night by Phal-ghrit and Bala tail A/D till next menstrual cycle. This treatment was continued for every cycle for 4 months till November 2014.In December 2014, she was given Garbhashaygat-Uttarbasti following all aseptic precautions;by Phalghrit / Bala tail 4 ml A/D for 5 days from 5th day of Menstruation. This Uttarbasti helped to pacify Vata and to increase Laghavata in all Ashayas and to increase elasticity of Garbhashay. (Cha. Si.1/7). Thus with the help of Yog- basti and Uttarbasti Vat-Prakop was pacified. Similarly Snehan in various forms e.g. Phal ghritorally, Matra- basti, Uttar- basti, Vaginal Pichu carried out Shaman of Vat.
" Sneho Anilamhanti, Mrudukarotideham, Malanamvinihanti Sangam" Cha. Si. 1/7
She was asked to take chance for conception from January 2015 onwards.
Accordingly she shortly conceived. Her L.M.P. was 23/2/2015. She was advised not to travel till 3 months of pregnancy.
She was given Tab Garbhapal rasa 2BD, Tab Madhumalini vasant 1 BD, Sidhha- kshirpak made up of Shatawari, Ashwagandha, Sariva and Sunthi 1gm each + Sita (Khadi sakhar) 1 cup BD throughout gestational period.
Shirodkar stitches were given in Stri rog and Prasutitantra department of Seth Tarachand Ayurvedic Hospital, Pune in the 20th week of gestation to prevent risk of miscarriage or premature delivery.
She came for regular monthly follow up
She had to undergo LSCS in K.E.M. Hospital, Pune due to premature rupture of membranes on completion of 32 weeks of pregnancy and a male baby was delivered having birth-weight of 1800 gm on 13th October 2015. Baby was free of any deformity.
Baby was placed in NICU for 3 days and subsequently discharged.
Follow up: The baby was perfectly normal having weight of 7 kg with no disability found on 1 year follow up.
Thus, successful outcome of pregnancy was possible only by following the basic principles of Ayurveda in such a difficult case of congenital anomaly of uterus without any surgical intervention.
*Assistant Director, Ayurved and HOD, Ayurved department
Newborn baby with mother
Follow up after 1 year
