Intrauterine Death Of Fetus In Ayurveda

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

This condition is explained as Mruta Garbha or Mrita Garbah

Causes

Below mentioned are the causes for the death of fetus inside the uterus–

• Ati matra dosha upachaya – excessive accumulation of the doshas
• Tikshna ati matra sevana – excessive use of pungent foods
• Ushna ati matra sevana – excessive use of hot substances / foods
• Vata mutra purisha vega dharana – forcibly suppressing the natural urges of defecation, urination and passing of fart
• Vishama asana shayana sthana – sitting, sleeping or standing in an abnormal way or in uneven place
• Sampidana abhighataih va – compression or injury over the abdomen
• Krodha – anger
• Shokha – sorrow / grief
• Irshya – jealousy
• Bhaya – fear
• Trasa – horror
• Sahasa – excessive courage
• Aparaih karmabhih – some other causes which can trouble the fetus in the uterus
• Vayu kopa – excessive aggravation of vata
  Read – Different Causes For Vata Dosha Imbalance, Increase

Other causes

• Manasa agantuh upatapa – mother or child being afflicted by mental or physical disorders
• Ati vyavaya – excessive coitus
• Vyadibhih purvopachitena – deeds of previous life of mother or fetus
• Apathya – unwholesome diet
• Daiva – fate / destiny / effect of deeds of previous birth
• Nirahara – lack of diet for mother or fetus or both
  Read – Importance Of Diet (Pathya) For Specific Diseases

The below mentioned conditions are all characterized with repeated still births. The explanation of these conditions in Ayurveda treatises appears to be a description of repeated still births. The reason from modern perspective could be infection or genetic abnormality. They are –

• Nakini Jataharini – explained by Kashyapa
• Jataghni Yonivyapad – explained by Vagbhata
• Putipraja – mentioned under congenital anomalies of genital organs

All these conditions explain only one condition, intrauterine death of fetus.

References

1. Cha.Sha.8/30
2. Su.Ni.8/13
3. A.S.Sha.4/27
4. A.Hr.Sha.2
5. Ha.Sam.Tr.Sth.52/16
   Read – Child Seized By Pitru And Shakuni Graha – Symptoms, Treatment

Analysis of the causes

Read – Essential Elements For Conception – Garbha Sambhava Samagri

Pathogenesis of Mruta Garbha

The pathogenesis of intrauterine death of fetus is the same as that of abortion. Due to the above mentioned etiological factors the fetus gets detached from its bonds just like a fruit gets detached from the tree and falls down.

The fetus thus having got detached from its bonds, transgressing the uterus descends into the hollow spaces between liver, spleen and bowels and irritates the abdominal cavity.

The apana vata getting obstructed or moving abnormally due to this irritation produces pain in the pelvic region, region of urinary bladder, flanks, belly and vagina / uterus. It causes distension of abdomen, retention of urine and feces. It also expels the young fetus from the uterus along with bleeding.

Signs and Symptoms

According to Master Charaka (Charaka Samhita Shareera Sthana 8/30)

• Stimita stabda udara – still and stiff abdomen
• Atata udara – stretched abdomen
• Shita udara – cold abdomen
• Ashma antargatam iva – stony hard abdomen / feeling as if a big stone is located inside the abdomen
• Aspandano garbhah – disappearance of fetal movements
• Adhika shulam – severe pain
• Na cha avi pradurbhavanti – the labor pains do not start
• Yonih na prasravati – absence of discharges from vagina
• Akshini asya sraste bhavatah – eyes become lax / drooping of eyelids
• Tama – feeling of darkness in front of the eyes
• Vyathate – uneasiness
• Bhramate – giddiness / loss of consciousness
• Svasa – dyspnea
• Arati bahula – excessive restlessness
• Na cha vega pradurbhava – absence of natural urges

According to Master Sushruta (Su.Ni.8/12)

• Shyava panduta – blackish or whitish discoloration of skin
• Shvasa putitvam – foul smell in expiration
• Shula – pain
  Read – Ayurvedic Treatment For Stretch Marks During Pregnancy

Dalhana adds by telling that the dead fetus swells up and fills the abdomen of the woman. Because of this the expectant mother suffers from the below mentioned conditions –

• Abdominal distension / flatulence (Harita)
• Throws her body parts upwards
• Feels splitting pain in the region of urinary bladder, pancreas, spleen, liver, heart and lungs
• The vayu moves upwards being compressed by fetus
• Edema
• Loss of consciousness / giddiness (Harita)
• Dyspnea
• Foul smell from the body
• Excessive sweating
• Dryness of tongue and palate / thirst (Harita)
• Convulsions
• Giddiness

Sanskrit Verses

Treatment of Mrta Garbha

The mrta garbha or dead fetus is considered as garbhashalya i.e. a foreign body or extraneous substance located in the body of the woman giving severe pain. It should be treated

• Samshamana – suppressive / palliative measures and medicines
• Jarayu patana chikitsa – on the lines of treating retained placenta
• Atharva vedokta mantra – by usage of hymns mentioned in Atharvaveda
• Haranam – extracted by an experienced surgeon
  Read – Symptoms That Hint Towards Different Diseases In Babies

Treatment after extraction of fetus

The woman should be prescribed the below mentioned things according to her strength after the extraction or expulsion of immature / dead fetus. They will help in cleansing of uterus, alleviation of pain and provide strength. They are –

• Sura
• Sidhu
• Arista
• Madhu
• Madira
• Asava
• Other alcoholic drinks

The woman later should be given with fat free, strengthening and satiating rice gruel and appropriate diet. These will protect her health and replenish her with health and energy. These dietetic regimens should be continued till the kleda i.e. moisture of the doshas and tissues is cleared.

Following this, unctuous substances, enemas and specific diet medicated with appetizing, longevity providing, strengthening, anabolic, and sweet and vata suppressing herbs should be prescribed.
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