Creating Waves of Awareness
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
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
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
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.