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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.


Views: 278

Comment by Dr Jigar Shah on July 14, 2010 at 10:01am
Wonderful experience doctor.
Perfectly managed case, well documented and worth to share to group.
Dr Jigar Shah MD(Hom)(ICR)
IPD co-ordinatar, MKSH hospital, Karjan, Vadodara, Gujarat
Comment by Debby Bruck on July 14, 2010 at 10:10am
This injury must have been quite severe for the CT Scan to be required and stay in hospital 4 days. What is the usual length of hospital after normal delivery? Arnica to the rescue. Thank you for details of complete case, potential remedy selection, explanation of decisions, and follow up on the case. Congratulations to mother and child.
Comment by Debby Bruck on July 14, 2010 at 10:11am
Please tell how you selected the title for this presentation?
Comment by Ranga Sai on July 14, 2010 at 1:48pm
Nice.
The lady would need Hypericum at a later stage of life.

:-)
Comment by HOMEOPATIA SOUZA MARQUES on July 15, 2010 at 7:54am
Arnica mounts is the drug most suitable in this case. Congratulations on the case.
Comment by hiral shah on July 15, 2010 at 12:17pm
very nicely detailed case. plz tell hw would you select potency n dossage?
Comment by Dr. Aadil Chimthanawala on July 16, 2010 at 1:57am
Thanx for ur valuable comments Jigar, Marques, Hiral and Debby.. @ Debby -The common name of Arnica mon is Leopards Boon.. hence the title. @ Ranga, plz tell us why do U think that the pt wud require Hypericum at a later stage? @ Hiral - The dose selected is quite an easy subject. We always start with the lowest potency. The repetition depends upon the response of the pt to the first dose.
Comment by Dr Muhammed Rafeeque on July 16, 2010 at 8:13am
Good case indeed. Such cases can be managed only by doctors having IP facility. But, sadly majority of homeopaths are having only out-patient consultation. Of course, more than the facility and infrastructure, the confidence of the physician is the most important. Please do post such cases and double our confidence level.
Comment by Dr. Nripendra Choudhary on July 29, 2010 at 3:07pm
Hello sir,
very good case management sir, @ Rafeeque sir , i saw Aadil sir's Hospital , it is full of facilities and well equiped.please Rafeeque sir visit one time Saad Hospital nagpur.

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