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Case Study Details
Case Studies >> Pregnancy >> Pregnancy with enteric fever & obstructive jaundice
Pregnancy with enteric fever & obstructive jaundice

  EXPERIENCE
PREGNANCY WITH ENTERIC FEVER & JAUNDICE
Smt. U.kaur 26 yrs, psychiatrist at New-Delhi consulted on dated 20-12-2006 with following complaints:
1. Pregnancy of seven months duration.
        2.  Pyrexia since beginning of pregnancy. High
fever reaching up to 102*f. During fever red checks. Dryness mouth with thirst for large quantity during fever.
Food taste bitter during fever.
3. Hyper emesis gravidavum since beginning of pregnancy. Nausea looking at food. Because of fever and nausea taking no extra diet except fiber diet. Nausea with vomiting of food. Offensive vomiting. Nausea while, after eating amel.    
4.Cough with retching and gagging since beginning of  pregnancy. Nausea after cough.
5.      Constipation since beginning of pregnancy. Urging for stool after eating. Every time she eats, she must evacuate.

Sleep: - Insomnia during fever. If occurred sleepless after waking.

Dreams: - Not Particular.

Appetite: - Less. Nausea looking at food.

Thirst: - dryness mouth with thirst. Thirst for large quantity.

Perspiration: - NAD.

Stool: - Offensive, semisolid sometime watery.

Urine: - Yellowish, Offensive.

Desire: - Salty, Spicy Things.

Aversion: - Milk

Tongue: -  Bitter taste. Every food she eats tastes bitter.

Thermal: -  Sensitive to both hot and cold.

Treatment History: -      Took a/t earlier.

Mental Symptoms: -
1.      Ambitious
2.      Bold
3.      Conscientious
4.      Loquacity
5.      Fastidious
6.      Fast Speed
Repatriation: - 20-12-2006

 

    On dated 20-12-2006 Phosphorous 200 one dose was prescribed followed by placebo tds. After this prescription nausea gets slightly better. Fever morning and evening high, low grade afternoon. Stool habit slightly gets better.

     On dated 06-01-2007 patient’s improved symptoms start relapsing. Phosphorus 1M one dose was given followed by placebo tds. After raising potency few symptoms such as nausea, stool habit improved slightly.
   
On dated 09-01-2007 advised for routine blood tests along with Serum Billirubin and Widal test as nausea and vomiting during last trimester force me to think that must she be jaundiced?

     Reports of dated 09-01-2007 confirmed my thoughts. Her serum billirubin was raised along with Widal titer positive for TO 1:160 & TH 1:320. Her hemoglobin was 8.8 gm%. (Photocopy of reports attached)

      Situation was: -
1. Seven Months of Pregnancy was completed.
2. Two Months remained.
3.  Well being of mother as well as fetus.
4.  Dietary Restrictions.
5. Growth of fetus without solid diet.
6.  Protection of fetus from complications of enteric fever and jaundice.
7.       Prevention of HEMORRHAGE which is main risk factor for PREGNANCY WITH ENTERIC FEVER & JAUNDICE
Task was difficult but not impossible for a
Hahnemannian Follower Homoeopath.
First of all I must understand the cause of Jaundice. Per abdomen examination reveals the cause of jaundice. Tendency of growth of fetus was towards right side which was probably pressing the gall bladder and obstructing the flow of bile. So the jaundice in this case was Obstructive jaundice. During pregnancy obstructive jaundice sometime represent with violent itching during last trimester, sometime with nausea, vomiting, malaise and fever. In the above case latter condition was present.
Now case again repertoriesed considering obstructive jaundice.    

                                                                                

Repatriation: - 11-01-2007

On dated 11-01-2007 SULPHUR 200 prescribed in Bd doses. Potency 200 was decided because of threat of hemorrhage (Syphilitic Miasm). Prescription was given in Bd doses because of MAINTAINING CAUSE. Here in this case maintaining cause of obstructive jaundice was enlarged uterus in which fetus was lying. Until and unless delivery of baby not occurred omission of cause was difficult. With Sulphur 200*Bd her nausea, vomiting, cough, fever, stool habit, taste, thirst, appetite, sleep gets better. Fever off and on occurring 99*f to 100*f. I tried once by giving placebo, instead of Sulphur 200*Bd dose. That day when I prescribed her placebo her nausea, vomiting, cough relapse. Fever increased up to 102*f. So it was safe for both (mother as well as for coming baby) to prescribe Sulphur 200 in Bd doses & patient advised to lie on left side.

                        Reports of dated 25-01-2007

Hemoglobin =   11.0 gm%, earlier 8.8 gm %( Reports photocopy attached)

Bleeding Time= 3’50”

Clotting Time= 4’10”

HbsAg = negative

Serum Billirubin= 9.0 mgm/dl

S.G.P.T. = 1180 I.U/L

Prothrombin Time Index (P.T.I.) = 77.7% (50-67%NORMAL RANGE)

                        Reports on dated 31-01-2007(Reports photocopy attached)

Hemoglobin = 11.2%

Total platelets count = 228000 per cmm.

Serum Billirubin = 8.24 mgm/dl

S.G.O.T. = 128 I.U. /L

S.G.P.T. = 170 I.U/L

Widal test was still positive under titre TO 1:120 & TH 1:240

Prothrombin Time Index (P.T.I.) = 62% (WNL)

                        In spite of above report her Symptoms nausea, vomiting, fever, cough, appetite, thirst, taste, sleep, stool habit was better.

                        Constant Gynecological check-ups was continues by a famous Gynecologist. She was continuously threatening her & insisting her to take allopathic treatment in spite of patient’s will. Patient was totally satisfied with Homoeopathic Treatment & was faithful for Homoeopathy. As I mentioned at the beginning of article patient is psychiatrist at New-Delhi & knew the good and bad aspects of allopathic treatment. 

Ultrasonography Report (Fetal Doppler study) done on date 05-02-2007 on completion of eight month pregnancy. (Photocopy of report attached) to see the fetal well being. Gynecologist was faithful towards the maldevelopment or developmental error of fetus due to jaundice & enteric fever, but USG SHOWS NORMAL DOPPLER STUDY (Photocopy of report attached).

Sulphur 200*Bd was continuous.

On dated 07-02-04 patient reported that some colored fluid running per vagina. Advised for check it & it was found amniotic fluid was running and bags was ruptured means its time to deliver the baby which was waiting since eight months and seven days to see the beautiful outside world.

Prothrombin Time Index (PTI) was done and that was 60%. Gynecologist refused to deliver the baby for threat of excessive bleeding. Situation was:-

1.      Bag of fluid was ruptured.

2.      Gynecologist refused for threat of excessive hemorrhage.

3.      OS was dilating two fingers and labor pains were continuous.

4.       All the family members were helplessly watching us.

Prothrombin Time index after giving Sulphur 200*1dose checked, three hours after remedy. PTI comes 80%  CT,BT was also within normal limit & we again request Gynecologist now PTI is as which she wanted but Gynecologist replied us you save mother’s life, forgot the baby. Baby will not deliver alive. Gynecologist referred her for higher medical institution. But condition of patient was not allowing us for shifting patient to higher medical institution.

Reports of dated 07-02-2007

PTI = 80%

CT = 3’25”

BT= 2’50”

SERUM BILIRUBIN= 6.60 mgm/dl

S.G.P.T. = 41 I.U/dl

Another Gynecologist of city was consulted & she agreed for delivery of child. She advised to arrange two units fresh blood & advised to lie on left side to reduce excessive fetal distress. Two units of fresh blood were arranged. Dilatation was still two fingered and fetal distressing so C-Section was performed. No need of blood transfusion and arranged two units of blood were donated by patient’s guardian to hospital where new born female baby born. (Dated 07-02-2007, evening hours)

Two months baby is normal and free from any developmental abnormality. Mother as well as her family members is enjoying. Dietary articles which I advised in the above case was plenty of fresh fruits such as anar, papaya, ambla, apple which help to maintain her hemoglobin level above 10 gm%. I never prescribed my patients tonics or so called power gaining syrups. I always stressed on natural dietary articles to fulfill the deficiencies. Normalize the body’s defects and body will accept itself nutrients from natural dietary articles.

After the delivery of baby, maintaining cause gradually removing and same also serum billirubin level. On dated 11-02-07, four days after delivery, serum billirubin level was 1.8 mg%.

Sulphur here does a great job.

Thanks to Dr. C.F.S.Hahnemann & to those who pay their marvelous contribution for the development of this great art of healing HOMOEOPATHY.     

                                                           

                                               

 

 

 

    

 

 

 

 

 

 

 

 

 

 

 

     

 

 

 

 

 

 

 

 

  

 
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