gynecology in reference to Ayurveda

1. MEDICAL ILLNESS OF
PREGNANCY
Salina abdulmajid manek (34)
3rd profession of BAMS.

2. MEDICAL ILLNESS OF
PREGNANCY
1. Hematological
disorder
2. Heart disease
3. Diabetes mellitus
4. Thyroid dysfunction
5. Jaundice
6. Viral hepatitis
7. Epilepsy
8. asthma
1. Systemic lupus
erythematosus
2. Tuberculosis
3. Syphilis
4. Parasitic
&protozoal
infestations
5. Pyelonephritis in
pregnanacy
6. Viral infection
7. HIV/AIDS

3. Preganacy
at high risk
High blood
pressure
Polycystic
ovary
syndrome
diabetes
Kidney
disease
Atuoimmune
disease
Recreational
disease
Obesity
HIV/AIDS
Age
First-time
pregnancy
age 35

4. HEMATOLOGICAL DISORDERS
ANEMIA: It is most common hematological
disorder that may occur in pregnancy, the other
being rhesisus isoimunization & blood coagultion
disorder.
Hb =11g/100ml or less ; considered as anemia.
Classification:
•Pathological
I. Deficency anemia ( iron, folic acid,vitamin
B12,protien deficency anemia)
II. Hemorrhagic ( acute: following bleeding in early
months. Chronic: hookwrom infestion, bleeding
piles.)
III. Hereditary (thalasemia, sickel cell
hemoglobinopathies, other hemoglobinopathies,
hereditary hemological anemia
IV. Bone marrow insufficient

5. EFFECT ON BABY
Amount of iron transferred to the fetal
is unaffected even if m other suffering
from iron deficiency anemia, then
neonatal does not suffer from anemia
at birth.
1. There is high incedence of low
birth weight babies with its
incidental hazards.
2. Intauterien death- due to severe
maternal anoxemia. The sum effect
is increased in perinatal loss.
3. Anemia in infancy due to reduced
iron store.

6. HEART DISEASE
 SYMPTOMS: Breathingness,
nocturnalcough, syncope, chest pain.
 SIGNS: chest murmurs, cardiac
enlargement, late systotic
 CHEST RADIPGRAPHY: cardiomegaly,
increases pulmonary vascular marking,
enlargement of pulmonary veins.
 ELECTROCARDIOGRAPH: T wave
inversion, biatrial enlargment,
dysrhythmia
 गर्भदाह- heart burn: hot water should not
be given in case of pregnancy heartbrun.

7. FEATAL:
 In rehumatic heart lesions, the fetal
outcome is usually good and in ni way
diffrenet from the patient without any
heart lesion.
 In cynotic group of heart lesion, there
is increased fetal loss (45%) due to
abortion, IUGP & prematarity.
 Fetal congenital cardiac disease is
increased by 3-10% if either of the
parents have congenital lesion

8. HIGH RISK PATIENT ARE:
I. Structure heart disease
II. Rheumatic heart disease
III. Cyanotic congenital heart disease
IV. Presence of dental &repiratory tract
infeaction
V. Prosthetic heart valve
VI. Prior history of infective endocarditis
VII. Cardic transplast

9. GESTATIONAL DIABETES
MELLITUS (GDM)
 Defined as carbohydrate intolerence of
variable severity with onset or first
recognition during the present pregnancy
 SCREENING: some advocate screeing
routin;ly to all pregnant mothers, others
resrve it only for the potential candidate.
a) Low risk- absence of any risk faoctors as
mentioned above ; blood glucose testing is
not routinely reqiured.
b) Average risk- some risk factors;prefrom
screening test
c) High risk-blood glucose test as soon as
feasiable

10. FETAL & NEO NATAL
 Fetal macrosomia (40-50%) with birth weight
>4kg probably result; a.)maternal
hypergycemia , b.) Elevation of maternal free
fatty acid (FFA) in diabetes leads to its
increased transfer to the fetus; accleration of
triglyceride synthesis; adiopsity
 Congenital malformation
 Neural tube defeact
 Double uteres
 Polycystic kidney
 Anorectal atresia
 Sngel umbilical artery

11. THYRIOD DYSFUNTION
 HYPERTHYROIDISM
 MATERNAL: miscarriage, pretrem delivery,
pre eclapsia, congestive cardiac failure,
placnetal abruption, thyroid strom infection.
 Fetal/neonatal: LBW, FGR, prematirity,
stillbirth, hyperthyriodisum, increased
perinatal morbidty & mortality.
 HYPOTHYROIDISM
 MATERNAL: myxedema rarely presence in
pregnancy because they tend to be infertiel.
 FETAL/NEONETAL: hihg fetal wastage in
from of abortion, stillbirth and prrmaturity and
deficient intellectual development of the child.

12. JAUNDICE
 When the serum bilirubin level exceed 2mg%,
visible yellow staining of the tissue appear.
•AYURVED : गर्र्भणी अतिसार
•का.सं.खि 20
•Treatment :nuse of pippali and root of
ankotha mixed with juice of hourse milk
is benificial. Decocotion of prsni parini,
bala & vasa should be prescribed.

13. HYPERTENSION IN
PREGANNACY
•Hypertension is one of common medical complication of pregnancy
and contributes significantly to maternal and perinatal morbidity and
mortality
•Maternal DBP>110 is associated With high risk of
placental abruption and fetal growth restriction
•Superimposed preeclampsia cause most of the
morbidity.
•4 categories
1. Chronic hypertension
2. Pregnancy induced hypertension
3. Preeclampsia eclampsia
4. Preeclampsia superimposed on chronic HTN

14. Hypertensive disorder of
pregnancy
Pregnant woman with
blood pressure highrt than
140/90 mmHg
Before 20 week of
gestation
No or stable protein uria
Chronic hypertension
New or increased
proteinuria, development
of increase blood
pressure, or hellp
syndrome
Preeclampsia
superimposed on chronic
hypertension
After 20 week of gestation
Proteinuria
preeclampsia
No proteinuria
Gestation hypertension

15. PRE- ECLAMPSIA (PE)
Definition:
It is a multisystem disorder of unknown etiology characterized by
development of hypertension to the extended of 140/90mmHg or more with
proteinuria after the 20th week in a previously normotensive and
nonproteninuric woman.
Diagnostic creteria:
An absolute rise of blood pressure of at least 140/90mmHg, if
previous blood pressure is not known or rise in systolic pressure of at least
30mmHg, or rise in diastolic pressure of at least 15mmHg over the
previously known blood pressure is called pregnancy-induced
hypertention.
• A rise of 20 mmHg MAP (mean arterial pressure) over the pervious
reading, or when the MAP IS 105mm/Hg or more should be considered as
significant.
•EDEMA: demonstration of pitting edema over the ankels after 12 hours
bed rest or excessive gain in wegiht of more than 4Ib(1.814 kg) a week in
the later months of pregnancy may be the earliest evidence of pre-
eclamsia

16. GESTATIONAL
HYPERTENSION
A sustained rise of blood pressure to 140/90mmHg or more at least
two occasions 4 or more hours apart beyond the 20th week of
preganancy or within the first 48 hours of delivery in perviously
normotensive woman is called gestational hyperytension.
IT should filfill the folloeing criteria:
1) Absence of any evidence for the underlying cause of
hypertension
2) Genrally unassociated with other evidence of preeclampsia
3) Majority of cases are more tham or equal to 37 weeks
pregnancy
4) Genrally not associated with hemoconcentration or
thromnocytopenia, raised serum uric acid level or hepatic
dysfunction.
5) The blood pressure should come down to normal within 12 week
folloeing delivery

17. HYPERTENTION IN
PREGANANCY IS USUALLY
CAUSED BY:
•Preclamsia
•Maternal age more than 35 years or less than 15 years
•Obesity
•Angiotensin gene-235
•Antiphospholiod antibody
•Multiple gestation
EFECT ON FETUS:
Gestational hypertension can also lead to fetal problems including
intrauterine growth restriction (poor fetal growth) and stillbirth.
If untreated, severe gestational hypertension may cause dangerous seizures
(eclampsia) and even death in the mother and fetus. Because of these risks, it
may be necessary for the baby to be delivered early, before 37 weeks
gestation.

18. SYMPTOMS:
 Increased blood pressure
 Absence or presence of protein in the urine
(to diagnose gestational hypertension or
preeclampsia)
 Edema (swelling)
 Sudden weight gain
 Visual changes such as blurred or double
vision
 Nausea, vomiting
 Right-sided upper abdominal pain or pain
around the stomach
 Urinating small amounts
 Changes in liver or kidney function tests

19. REFRENCES
 DC DUTTA’S TEXTBOOK OF
OBSTERTRIC
 CHAPTER 20- MEDICAL & SURGICAL
ILLNESS COMPLOCATING
PREGNANCY
 CHAPTER 18- HYPERTENSIVE
DISORDER IN PREGNANCY
 REFRED FROM PRESENTION BY Dr.
MOHAMMAD LIYAS, Dr.MANAVITA
 GATE RESEARCH BY Dr. TRITH
BHATTA
 PRASUTITANTRA EVUM STRI ROG –
P.V TIVARI