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Prenatal care (garbhini paricharya) (view source)
Revision as of 07:42, 18 September 2020
, 07:42, 18 September 2020no edit summary
The guidelines for prenatal care start even before conception. The couple planning to have a progeny shall follow purification procedures (panchakarma), proper diet and life style modifications as part of preconception care. The prenatal care begins from the very first day when (usually due to missed menstrual cycle). [Su. Sa. Sharira Sthana 10/3].
The guidelines for prenatal care start even before conception. The couple planning to have a progeny shall follow purification procedures (panchakarma), proper diet and life style modifications as part of preconception care. The prenatal care begins from the very first day when (usually due to missed menstrual cycle). [Su. Sa. Sharira Sthana 10/3].
The conceived woman shall be treated with special care just like a pot filled with oil. As the slightest oscillation of such a pot causes spilling of the oil, similarly the slightest exertions or excitements to the pregnant woman can initiate adverse pregnancy outcomes. [Cha. Sa.Sharira Sthana 8/22]
The conceived woman shall be treated with special care just like a pot filled with oil. As the slightest oscillation of such a pot causes spilling of the oil, similarly the slightest exertions or excitements to the pregnant woman can initiate adverse pregnancy outcomes. [Cha. Sa.[[Sharira Sthana]] 8/22]
{{Infobox
{{Infobox
b) Providing nourishment to the growing fetus
b) Providing nourishment to the growing fetus
c) Helping the formation of breast milk. [Cha. Sa. Sharira Sthana 6/23]
c) Helping the formation of breast milk. [Cha. Sa. [[Sharira Sthana]] 6/23]
Whatever the diet consumed by the pregnant woman becomes congenial to the fetus. So, diet of a pregnant woman should be designed considering the place of living, time, season and digestive capacity. [Ka. Sa. Sutra Sthana 18/24,25]
Whatever the diet consumed by the pregnant woman becomes congenial to the fetus. So, diet of a pregnant woman should be designed considering the place of living, time, season and digestive capacity. [Ka. Sa. Sutra Sthana 18/24,25]
!Month !! Dietary regimen
!Month !! Dietary regimen
|-
|-
|1st Month || •Milk frequently in desired quantity (considering the digestive power and strength)*
|'''1st Month''' || •Milk frequently in desired quantity (considering the digestive power and strength)*
•Sweet, cold and liquid diet**
•Sweet, cold and liquid diet**
•Glycyrrhiza glabra(madhuyashti), Grewia asiatica(parushaka) and Madhuka indica(madhukapushpa) with butter and honey, sweetened milk ##
•Glycyrrhiza glabra(madhuyashti), Grewia asiatica(parushaka) and Madhuka indica(madhukapushpa) with butter and honey, sweetened milk ##
|-
|-
|2nd month || •Milk medicated with sweet (madhura)herbs*
|'''2nd month''' || •Milk medicated with sweet (madhura)herbs*
•Sweet, cold and liquid diet**
•Sweet, cold and liquid diet**
•Sweetened milk with Lilium polyphyllum(kakoli )##
•Sweetened milk with Lilium polyphyllum(kakoli )##
|-
|-
|3rd month || •Milk with honey and ghee*
|'''3rd month''' || •Milk with honey and ghee*
•Cooked rice of Shashtika variety along with milk.**
•Cooked rice of Shashtika variety along with milk.**
•Mixture of cooked rice and pulse(krisara)##
•Mixture of cooked rice and pulse(krisara)##
|-
|-
|4th month || •Milk with 12 gm(one aksha) of butter.*
|'''4th month''' || •Milk with 12 gm(one aksha) of butter.*
•Cooked rice (shashtika)with curd**
•Cooked rice (shashtika)with curd**
•dainty and pleasant food mixed with milk/ butter/ meat of wild animals**
•dainty and pleasant food mixed with milk/ butter/ meat of wild animals**
|-
|-
|5th Month ||•Ghee prepared with butter extracted from milk.*
|'''5th Month''' ||•Ghee prepared with butter extracted from milk.*
•Cooked rice (shashtika) with milk, ghee and meat of wild animals**
•Cooked rice (shashtika) with milk, ghee and meat of wild animals**
•Rice cooked with milk and sweetened(payasa)##
•Rice cooked with milk and sweetened(payasa)##
|-
|-
|6th Month || •Ghee prepared from milk (ksheerasarpi) medicated with the herbs of madhura group*
|'''6th Month''' || •Ghee prepared from milk (ksheerasarpi) medicated with the herbs of madhura group*
•Ghee or rice gruel medicated with Tribulus terrestris(gokshura).**
•Ghee or rice gruel medicated with Tribulus terrestris(gokshura).**
•Sweetened curd##
•Sweetened curd##
|-
|-
|7th month || •Ghee prepared from milk (ksheerasarpi)medicated with the herbs of madhura group*
|'''7th month''' || •Ghee prepared from milk (ksheerasarpi)medicated with the herbs of madhura group*
•Ghee medicated with prithakparnyadi (vidarigandhadi) group of herbs**
•Ghee medicated with prithakparnyadi (vidarigandhadi) group of herbs**
•A sweet dish called Gritakhanda.##
•A sweet dish called Gritakhanda.##
|-
|-
|8th month || •Rice gruel prepared with milk and mixed with ghee.*
|'''8th month''' || •Rice gruel prepared with milk and mixed with ghee.*
•Unctuous gruels and meat soup of wild animals.**
•Unctuous gruels and meat soup of wild animals.**
•A kind of sweet preparation called Gritapooraka.##
•A kind of sweet preparation called Gritapooraka.##
|-
|-
|9th month || •Meat soup with cooked rice and fat (preferably ghee), rice gruel mixed with large quantity of fat.***
|'''9th month''' || •Meat soup with cooked rice and fat (preferably ghee), rice gruel mixed with large quantity of fat.***
•Different types of cereals.##
•Different types of cereals.##
|}
|}
* *[Cha. Sa. Sharira Sthana 8/32], **[ Su.Sa. Sharira Sthana 10/4], ***[A.S. Sharira Sthana 3/3-11], #[Bhe.Sa.Sharira Sthana 8/6], ##[Ha. Sa. Tritiya Sthana 49/2]
* *[Cha. Sa. [[Sharira Sthana]] 8/32], **[ Su.Sa. Sharira Sthana 10/4], ***[A.S. Sharira Sthana 3/3-11], #[Bhe.Sa.Sharira Sthana 8/6], ##[Ha. Sa. Tritiya Sthana 49/2]
===Table 2: Nutritional analysis of the major components of diet for the pregnant lady:===
===Table 2: Nutritional analysis of the major components of diet for the pregnant lady:===
!Source !!Properties explained in Ayurveda !!Nutritional benefits
!Source !!Properties explained in Ayurveda !!Nutritional benefits
|-
|-
|Milk ||Sweet taste(madhura), unctuous(snigdha), cold(sheeta) in potency, vitality enhancer(ojasyam),tissue growth promoting(dhatu vardhaka),alleviates [[vata]] and [[pitta]],galactogogue (sthanyakaram) ||Complete food source of sugar, protein, fat, calcium, sulphur, magnesium, manganese, iodine, zinc, riboflavin, and vitamin B12, A, and K.
|'''Milk''' ||Sweet taste(madhura), unctuous(snigdha), cold(sheeta) in potency, vitality enhancer(ojasyam),tissue growth promoting(dhatu vardhaka),alleviates [[vata]] and [[pitta]],galactogogue (sthanyakaram) ||Complete food source of sugar, protein, fat, calcium, sulphur, magnesium, manganese, iodine, zinc, riboflavin, and vitamin B12, A, and K.
Lactose - helps in growth and development.
Lactose - helps in growth and development.
Proteins -casein, lactoglobulin, lactalbumin, and lactoferrin- provide immunological benefits.
Proteins -casein, lactoglobulin, lactalbumin, and lactoferrin- provide immunological benefits.
Milk has all amino acids to promote growth.<ref name=young>Young WP, Haenlein GFW, editors. Milk and dairy products in human nutrition: Production, composition and health. In: Butter, Ghee, and Cream Products. John Wiley & Sons; 2013. p. 412-34</ref>
Milk has all amino acids to promote growth.<ref name=young>Young WP, Haenlein GFW, editors. Milk and dairy products in human nutrition: Production, composition and health. In: Butter, Ghee, and Cream Products. John Wiley & Sons; 2013. p. 412-34</ref>
|-
|-
|Ghee || Intellect promoting(dhee,smriti,medha),
|'''Ghee''' || Intellect promoting(dhee,smriti,medha),
improves digestion (agnivardhana),
improves digestion (agnivardhana),
promotes strength(balyam), cold(sheeta) in potency,alleviates [[vata]] and [[pitta]]
promotes strength(balyam), cold(sheeta) in potency,alleviates [[vata]] and [[pitta]]
•vitamin E-essential for normal pregnancy, birth, and breast milk production <ref name=young />
•vitamin E-essential for normal pregnancy, birth, and breast milk production <ref name=young />
|-
|-
|Butter||alleviates [[Vata]] and [[Pitta]], promote digestion, promote intellect (medhya), not producing gastric irritation(avidahi), improves taste sensation(rochanam), promotes strength and nourishment (balyam, brihmana), improves vitality (Ojovivardhanam )
|'''Butter'''||alleviates [[Vata]] and [[Pitta]], promote digestion, promote intellect (medhya), not producing gastric irritation(avidahi), improves taste sensation(rochanam), promotes strength and nourishment (balyam, brihmana), improves vitality (Ojovivardhanam )
||•High calorie food as 100 g of butter provides almost 700 kcal.
||•High calorie food as 100 g of butter provides almost 700 kcal.
•Vitamin K, folate, and vitamin B12 in small amounts.<ref name=young />
•Vitamin K, folate, and vitamin B12 in small amounts.<ref name=young />
|-
|-
|Honey ||alleviates [[Kapha]] and [[Pitta]] || •Primarily a high-energy carbohydrate food anti-inflammatory, immune boosting property, broad spectrum antibacterial activity.
|'''Honey''' ||alleviates [[Kapha]] and [[Pitta]] || •Primarily a high-energy carbohydrate food anti-inflammatory, immune boosting property, broad spectrum antibacterial activity.
•Honey sugars are easily digestible sugars <ref>Honey Abeshu MA, Geleta B. Medicinal uses of honey. Biol Med (Aligarh) 2016;8:279.</ref>
•Honey sugars are easily digestible sugars <ref>Honey Abeshu MA, Geleta B. Medicinal uses of honey. Biol Med (Aligarh) 2016;8:279.</ref>
|-
|-
|Rice gruel || Pacifies thirst (Trishnahara), clears bladder (Basti shodhana), pacifies [[vata]] (vataanulomana) , light for digestion(laghu) || •Starch molecules, which are the source of calories in diets, prepared from rice, when heated in an aqueous or moist environment, swell and rupture and thus permits greater enzymatic digestion by the activity of enzymes such as amylases.
|'''Rice gruel''' || Pacifies thirst (Trishnahara), clears bladder (Basti shodhana), pacifies [[vata]] (vataanulomana) , light for digestion(laghu) || •Starch molecules, which are the source of calories in diets, prepared from rice, when heated in an aqueous or moist environment, swell and rupture and thus permits greater enzymatic digestion by the activity of enzymes such as amylases.
•Resistant starch acts like soluble fiber in the gastrointestinal tract, thus providing the health benefit.
•Resistant starch acts like soluble fiber in the gastrointestinal tract, thus providing the health benefit.
Contemporary medical science gives importance to diet in terms of supplementation of essential macro and micro nutrients. In pregnant women’s diet the emphasize is given mainly in supplementation of iron, calcium, folic acid, DHA, iodine, and vitamin D.
Contemporary medical science gives importance to diet in terms of supplementation of essential macro and micro nutrients. In pregnant women’s diet the emphasize is given mainly in supplementation of iron, calcium, folic acid, DHA, iodine, and vitamin D.
The World Health Organization guides use of multiple micronutrient powders for point-of-use fortification of foods consumed by pregnant women. However, routine use of multiple micronutrient powders during pregnancy is not recommended as an alternative to standard iron and folic supplementation during pregnancy for improving maternal and infant health outcomes.<ref>https://www.who.int/nutrition/publications/micronutrients/guidelines/mmpowders_pregnant_women/en/</ref>
The World Health Organization guides use of multiple micro nutrient powders for point-of-use fortification of foods consumed by pregnant women. However, routine use of multiple micro nutrient powders during pregnancy is not recommended as an alternative to standard iron and folic supplementation during pregnancy for improving maternal and infant health outcomes.<ref>https://www.who.int/nutrition/publications/micronutrients/guidelines/mmpowders_pregnant_women/en/</ref>
High food quality, together with adequate macro- and micronutrient intake in pregnancy, is crucial for the health status of the mother and child. Most conditions that occur in adulthood originate in fetal life. Moreover, some epigenetic events, modified by diet impact more than one generation.<ref>Danielewicz H, Myszczyszyn G, Dębińska A, Myszkal A, Boznański A, Hirnle L. Diet in pregnancy-more than food. Eur J Pediatr. 2017;176(12):1573-1579. doi:10.1007/s00431-017-3026-5</ref>
High food quality, together with adequate macro- and micro nutrient intake in pregnancy, is crucial for the health status of the mother and child. Most conditions that occur in adulthood originate in fetal life. Moreover, some epigenetic events, modified by diet impact more than one generation.<ref>Danielewicz H, Myszczyszyn G, Dębińska A, Myszkal A, Boznański A, Hirnle L. Diet in pregnancy-more than food. Eur J Pediatr. 2017;176(12):1573-1579. doi:10.1007/s00431-017-3026-5</ref>
===Life style guidelines for pregnant woman===
===Life style guidelines for pregnant woman===
The lifestyle protocol is indicated for maternal and fetal health commonly. [A.S. Sharira Sthana 2/58]
The lifestyle protocol is indicated for maternal and fetal health commonly. [A.S. Sharira Sthana 2/58]
The pregnant woman desirous of a healthy progeny should avoid all non-congenial diet and activities. She should protect and uplift herself through good conduct. [Cha. Sa. Sharira Sthana 8/21]
The pregnant woman desirous of a healthy progeny should avoid all non-congenial diet and activities. She should protect and uplift herself through good conduct. [Cha. Sa. [[Sharira Sthana]] 8/21]
Daily bath and worshiping the rising sun are recommended.[ Ka. Sa. Sharira Sthana 5/15]. Anointment with cooling agents, musk, sandal and camphor, wearing garlands, moonlight bath and gentle massage are also recommended. [Y.R. Ksheera dosha Chikitsa]
Daily bath and worshiping the rising sun are recommended.[ Ka. Sa. Sharira Sthana 5/15]. Anointment with cooling agents, musk, sandal and camphor, wearing garlands, moonlight bath and gentle massage are also recommended. [Y.R. Ksheera dosha Chikitsa]
===Diet to be avoided===
===Diet to be avoided===
*Excessive heavy to digest, hot and pungent substances [Cha .Sa. Sharira Sthana 4/18]
*Excessive heavy to digest, hot and pungent substances [Cha .Sa. [[Sharira Sthana]] 4/18]
*Intoxicating substances like wine[Cha .Sa. Sharira Sthana 4/18]
*Intoxicating substances like wine[Cha .Sa.[[ Sharira Sthana]] 4/18]
*Excessive use of meat[Cha.Sa. Sharira Sthana 4/18]
*Excessive use of meat[Cha.Sa. [[Sharira Sthana]]4/18]
*Dried up, stale, putrefied and wet food. [Su.Sa. Sharira Sthana 10/3]
*Dried up, stale, putrefied and wet food. [Su.Sa. Sharira Sthana 10/3]
===Activities to be avoided===
===Activities to be avoided===
*Harsh or violent activities [Cha.Sa. Sharira Sthana 4/18]
*Harsh or violent activities [Cha.Sa. [[Sharira Sthana]] 4/18]
*Ride over vehicle running on uneven path [Cha.Sa. Sharira Sthana 4/18]
*Ride over vehicle running on uneven path [Cha.Sa. [[Sharira Sthana]] 4/18]
*Coitus [Su.Sa. Sharira Sthana 10/3]
*Coitus [Su.Sa. Sharira Sthana 10/3]
*periodic increase in size of abdomen [A.S. Sharira Sthana 2/8]
*periodic increase in size of abdomen [A.S. Sharira Sthana 2/8]
*growth of breast [Cha. Sa. Sharira Sthana 4/16]
*growth of breast [Cha. Sa. [[Sharira Sthana]] 4/16]
*blackish discoloration of areola [Cha. Sa. Sharira Sthana 4/16]
*blackish discoloration of areola [Cha. Sa. [[Sharira Sthana]] 4/16]
*milk secretion from breast [Cha. Sa. Sharira Sthana 4/16]
*milk secretion from breast [Cha. Sa. [[Sharira Sthana]] 4/16]
*blackish discoloration of lips [Cha. Sa. Sharira Sthana 4/16]
*blackish discoloration of lips [Cha. Sa. [[Sharira Sthana]] 4/16]
*corpulent cheeks. [A.S. Sharira Sthana 2/10]
*corpulent cheeks. [A.S. Sharira Sthana 2/10]
*development of linea nigra(lomaraji) [Cha. Sa. Sharira Sthana 4/16]
*development of linea nigra(lomaraji) [Cha. Sa. [[Sharira Sthana]] 4/16]
*edema in lower limbs. [Cha. Sa. Sharira Sthana 4/16]
*edema in lower limbs. [Cha. Sa. [[Sharira Sthana]] 4/16]
===Palpation(sparshana)===
===Palpation(sparshana)===
*fetal movements (garbhasphurana/spandana) [A.S. Sharira Sthana 4/13]
*fetal movements (garbhasphurana/spandana) [A.S. Sharira Sthana 4/13]
*expansion of vagina(yoni). [Cha. Sa. Sharira Sthana 4/16]
*expansion of vagina(yoni). [Cha. Sa. [[Sharira Sthana]] 4/16]
===Interrogation (prashna)===
===Interrogation (prashna)===
The symptoms of pregnancy are elicited through proper history taking. The first symptom, i.e. amenorrhea in a married woman is taken as an indicator for suspecting the pregnancy. [Cha. Sa. ShariraSthana 4/16]
The symptoms of pregnancy are elicited through proper history taking. The first symptom, i.e. amenorrhea in a married woman is taken as an indicator for suspecting the pregnancy. [Cha. Sa. [[Sharira Sthana] 4/16]
Symptoms related to the gastro intestinal system are mentioned as initial symptoms of pregnancy.
Symptoms related to the gastro intestinal system are mentioned as initial symptoms of pregnancy.
*Interest in sour substances(amlakamata).
*Interest in sour substances(amlakamata).
*Vomiting(chardi)[Cha. Sa. ShariraSthana 4/16]
*Vomiting(chardi)[Cha. Sa. [[Sharira Sthana]] 4/16]
Psychological symptoms like alternate desire for things with opposite qualities, aversion of previously appreciated fragrance etc.[Su. Sa. Sharira Sthana 3/15] are also observed as symptoms of pregnancy.
Psychological symptoms like alternate desire for things with opposite qualities, aversion of previously appreciated fragrance etc.[Su. Sa. Sharira Sthana 3/15] are also observed as symptoms of pregnancy.
'''Calculation of the expected date of delivery:'''
'''Calculation of the expected date of delivery:'''
This is done according to Naegele’s formula by adding 9 calendar months and 7 days to the first day of LNMP.<ref>D.C Dutta,D.C Dutta’s text book of obstetrics, edited by HiralalKonar, Antenatal care ,preconceptional counseling and care, Jaypee brothers medical publishers, New delhi, edition 8, 2015, chapter 10, page no:108.</ref>
This is done according to Naegele’s formula by adding 9 calendar months and 7 days to the first day of LNMP.<ref>D.C Dutta,D.C Dutta’s text book of obstetrics, edited by Hiralal Konar, Antenatal care ,preconception counseling and care, Jaypee brothers medical publishers, New delhi, edition 8, 2015, chapter 10, page no:108.</ref>
Examination includes general physical examination, systemic examination and obstetrical examination.
Examination includes general physical examination, systemic examination and obstetrical examination.
'''a) Inspection:'''
'''a) Inspection:'''
To note the condition of uterine ovoid, contour of uterus, undue enlargement of uterus, skin condition of abdomen, incisional scar mark on abdomen etc.
To note the condition of uterine ovoid, contour of uterus, undue enlargement of uterus, skin condition of abdomen, incision scar mark on abdomen etc.
'''b) Palpation:'''
'''b) Palpation:'''
Height of the uterus is measured by placing the ulnar border of the left hand placed on the upper most level of fundus and an approximate duration of pregnancy is ascertained in terms of weeks of gestation. Alternatively, the symphyseal fundal height (SFH) is measured with a measuring tape.
Height of the uterus is measured by placing the ulnar border of the left hand placed on the upper most level of fundus and an approximate duration of pregnancy is ascertained in terms of weeks of gestation. Alternatively, the symphyseal fundal height (SFH) is measured with a measuring tape.
Obstetrical grips (Leopold maneuvers)<ref>D.C Dutta, D.C Dutta’s text book of obstetrics, The Fetus- in utero, Jaypee brothers medical publishers, Newdelhi, edition 8, 2015, chapter 8, page no:88-90. are helpful to get an idea about the presentation of foetus, position of different body parts of foetus, attitude, engagement etc.</ref>
Obstetrical grips (Leopold maneuvers)<ref>D.C Dutta, D.C Dutta’s text book of obstetrics, The Fetus- in utero, Jaypee brothers medical publishers, New delhi, edition 8, 2015, chapter 8, page no:88-90. are helpful to get an idea about the presentation of foetus, position of different body parts of foetus, attitude, engagement etc.</ref>
'''c) Auscultation:'''
'''c) Auscultation:'''
'''Genetic Screening:'''
'''Genetic Screening:'''
This includes maternal serum alpha-fetoprotein (MSAFP), triple test at 15-18 weeks for mother at risk of carrying a fetus with neural tube defects, down syndrome or other chromosomal anomaly. Non-invasive screening for chromosomal anomaly should be a routine to all pregnant women irrespective of their age.<ref>D.C Dutta, D.C.Dutta’s Text book of Obstetrics, edited by HiralalKonar, Jaypee brothers medical publishers, New Delhi, edition 8,Chapter 12 , page no:127</ref>
This includes maternal serum alpha-fetoprotein (MSAFP), triple test at 15-18 weeks for mother at risk of carrying a fetus with neural tube defects, down syndrome or other chromosomal anomaly. Non-invasive screening for chromosomal anomaly should be a routine to all pregnant women irrespective of their age.<ref>D.C Dutta, D.C.Dutta’s Text book of Obstetrics, edited by Hiralal Konar, Jaypee brothers medical publishers, New Delhi, edition 8,Chapter 12 , page no:127</ref>
*'''Ultrasound Examinations :'''
*'''Ultrasound Examinations :'''
All the information of second trimester sonography can be obtained in third trimester. Effective fetal weight, placental maturation, amniotic fluid index etc. are also evaluated.
All the information of second trimester sonography can be obtained in third trimester. Effective fetal weight, placental maturation, amniotic fluid index etc. are also evaluated.
There are many biophysical tests for prenatal fetal surveillance during late pregnancy which includes ultrasonography, doppler ultra sound velocimetry, cardiotocography(CTG), non-stress test(NSS), fetal biophysical profile(BPP), vibroacoustic stimulation test, contraction stress test (CST)etc.<ref>D.C Dutta, D.C.Dutta’s Text book of Obstetrics, edited by HiralalKonar, Jaypee brothers medical publishers, New Delhi, edition 8,Chapter 10 , page no:121</ref>
There are many biophysical tests for prenatal fetal surveillance during late pregnancy which includes ultrasonography, doppler ultra sound velocimetry, cardiotocography(CTG), non-stress test(NSS), fetal biophysical profile(BPP), vibroacoustic stimulation test, contraction stress test (CST)etc.<ref>D.C Dutta, D.C.Dutta’s Text book of Obstetrics, edited by Hiralal Konar, Jaypee brothers medical publishers, New Delhi, edition 8,Chapter 10 , page no:121</ref>
===Special therapies recommended during pregnancy===
===Special therapies recommended during pregnancy===
===Medicated Enema===
===Medicated Enema===
During the eighth month of pregnancy, evacuative enema (asthapanabasti) is advised for the elimination of retained fecal matter followed by unctuous enema (anuvasanabasti)with oil medicated with madhura group of drugs. [Su Sa. ShariraSthana 3/11]
During the eighth month of pregnancy, evacuative enema (asthapanabasti) is advised for the elimination of retained fecal matter followed by unctuous enema (anuvasanabasti)with oil medicated with madhura group of drugs. [Su Sa. Sharira Sthana 3/11]
Acharya Vagbhata advises unctuous enema using ghee processed with madhura group of drugs for cleaning the collected feces and then therapeutic enema(niruhabasti) is given.[A.Hr.ShariraSthana 1/34-35]
Acharya Vagbhata advises unctuous enema using ghee processed with madhura group of drugs for cleaning the collected feces and then therapeutic enema(niruhabasti) is given.[A.Hr. Sharira Sthana 1/34-35]
Unctuous enema is continued in ninth month also.
Unctuous enema is continued in ninth month also.
===Vaginal Tampon===
===Vaginal Tampon===
During the ninth month, vaginal tampon(yoni pichu) with medicated oil is advised. [ Cha. Sa. ShariraSthana 8/32].
During the ninth month, vaginal tampon(yoni pichu) with medicated oil is advised. [ Cha. Sa. Sharira Sthana 8/32].
Oil processed with sida cordifolia(bala taila), formulations like dhanwanthra taila are in current practice for vaginal tampon during ninth month of pregnancy.
Oil processed with sida cordifolia(bala taila), formulations like dhanwanthra taila are in current practice for vaginal tampon during ninth month of pregnancy.
===Medicated water for bath===
===Medicated water for bath===
The cold decoction of pulp of Aegle marmelos(bilva), Gossipiumherbaceum(karpasa), petals of rose(patali),pounded leaves of Azadirachta indica (pichumanda), Clerodendrum phlomidis(agnimantha),Nardostachys jatamansi(jatamamsi), and Ricinus communis (eranda) or water prepared with all fragrant drugs(sarvagandhodaka) should be used for bathing by the pregnant woman.[A.S. Sharira Sthana 3/14] Cold decoction of pounded leaves of drugs capable of suppressing [[vata]] is generally advised. [A.Hr.ShariraSthana 1/68]
The cold decoction of pulp of Aegle marmelos(bilva), Gossipium herbaceum(karpasa), petals of rose(patali),pounded leaves of Azadirachta indica (pichumanda), Clerodendrum phlomidis(agnimantha),Nardostachys jatamansi(jatamamsi), and Ricinus communis (eranda) or water prepared with all fragrant drugs(sarvagandhodaka) should be used for bathing by the pregnant woman.[A.S. Sharira Sthana 3/14] Cold decoction of pounded leaves of drugs capable of suppressing [[vata]] is generally advised. [A.Hr. Sharira Sthana 1/68]
==='''Commonly used medicines for promotion of health of mother and fetus:'''===
==='''Commonly used medicines for promotion of health of mother and fetus:'''===
!Month !! Drugs*
!Month !! Drugs*
|-
|-
|1st month || Madhuca longifolia(madhuka), seeds of Tectona grandis (sakabeeja), Pueraria tuberosa. (Willd.) DC. (payasya), Cedrus deodara (devadaru)
|'''1st month''' || Madhuca longifolia(madhuka), seeds of Tectona grandis (sakabeeja), Pueraria tuberosa. (Willd.) DC. (payasya), Cedrus deodara (devadaru)
|-
|-
|2nd month || Ficus rumphii Blume (ashmantaka), Sesamum indicum (black tila), Rubia cordifolia (tamravalli), Asparagus recemosus(shatavari)
|'''2nd month''' || Ficus rumphii Blume (ashmantaka), Sesamum indicum (black tila), Rubia cordifolia (tamravalli), Asparagus recemosus(shatavari)
|-
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|3rd month|| Dendrophthoe falcata (Vrukshadani), Pueraria tuberosa. (Willd.) DC.(payasya), Callicarpa macrophylla Yahl. (priyangu), Nymphaea alba Linn (utpala), Hemidesmus indicus (shariba)
|'''3rd month'''|| Dendrophthoe falcata (Vrukshadani), Pueraria tuberosa. (Willd.) DC.(payasya), Callicarpa macrophylla Yahl. (priyangu), Nymphaea alba Linn (utpala), Hemidesmus indicus (shariba)
|-
|-
|4th month || Cynodon dactylon (durva), Hemidesmus indicus (shariba), Pluchea lanceolata Oliver & Hiern (rasna), Clerodendrum Serratum (bharangi), Glycyrrhiza glabra Linn. (yastimadhu)
|'''4th month''' || Cynodon dactylon (durva), Hemidesmus indicus (shariba), Pluchea lanceolata Oliver & Hiern (rasna), Clerodendrum Serratum (bharangi), Glycyrrhiza glabra Linn. (yastimadhu)
|-
|-
|5th month || Solanum Indicum Linn. (bruhati) , Solanum Xanthocarpum (kantakari), Gmelina arborea (kasmari), stem bark and leaf buds of latex yielding trees,ghee
|'''5th month''' || Solanum Indicum Linn. (bruhati) , Solanum Xanthocarpum (kantakari), Gmelina arborea (kasmari), stem bark and leaf buds of latex yielding trees,ghee
|-
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|6th month || Uraria picta (prishniparni), Sida cordifolia (bala), Acorus Calamus Herb (vacha), Moringa oleifera (shigru), Tribulus terrestris (shwadamshtra), Glycyrrhiza glabra Linn. (madhuparnika)
|'''6th month''' || Uraria picta (prishniparni), Sida cordifolia (bala), Acorus Calamus Herb (vacha), Moringa oleifera (shigru), Tribulus terrestris (shwadamshtra), Glycyrrhiza glabra Linn. (madhuparnika)
|-
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|7th month || Trapa bispinosa Roxb. (Shringaaka), Nelumbo nucifera Gaertn(bias), Vitis vinifera (draksha), Scirpus grossus Linn. (kaseru), Madhuca longifolia(madhuka),sugar
|'''7th month''' || Trapa bispinosa Roxb. (Shringaaka), Nelumbo nucifera Gaertn(bias), Vitis vinifera (draksha), Scirpus grossus Linn. (kaseru), Madhuca longifolia(madhuka),sugar
|-
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|8th month || Feronia linonia (Linn.)(kapitha), Aegle marmelos L.(bilwa), Solanum Indicum Linn. (brihati), Trichosanthes Dioica.(patola), Saccharum Officinarum Linn. (ikshu), Solanum xanthocarpum(nidigdhika).
|'''8th month''' || Feronia linonia (Linn.)(kapitha), Aegle marmelos L.(bilwa), Solanum Indicum Linn. (brihati), Trichosanthes Dioica.(patola), Saccharum Officinarum Linn. (ikshu), Solanum xanthocarpum(nidigdhika).
|-
|-
|9th month || Hemidesmus indicus (shariba), Pueraria tuberosa. (Willd.) DC.(payasya), Glycyrrhiza glabra Linn. (madhuyashti)
|'''9th month''' || Hemidesmus indicus (shariba), Pueraria tuberosa. (Willd.) DC.(payasya), Glycyrrhiza glabra Linn. (madhuyashti)
10th month Zingiber officinale(Shundhi)+ Pueraria tuberosa. (Willd.) DC.(payasya)/ Zingiber officinale (shundhi)+ Glycyrrhiza glabra Linn (madhuyashti)+ Cedrus deodara devadaru/ only Pueraria tuberosa. (Willd.) DC.(payasya)
10th month Zingiber officinale(Shundhi)+ Pueraria tuberosa. (Willd.) DC.(payasya)/ Zingiber officinale (shundhi)+ Glycyrrhiza glabra Linn (madhuyashti)+ Cedrus deodara devadaru/ only Pueraria tuberosa. (Willd.) DC.(payasya)
|}
|}
!Month !! Drug<ref>KrishnanA.K.V,GopalapillaA .S,editors, Sahasrayoga with Sujanapriya Commentry, Kashaya prakarana, Ver. 1,. Edition 32.Alappuzha: Vidyarambham Publishers; 2013.p. 104.</ref>
!Month !! Drug<ref>KrishnanA.K.V,GopalapillaA .S,editors, Sahasrayoga with Sujanapriya Commentry, Kashaya prakarana, Ver. 1,. Edition 32.Alappuzha: Vidyarambham Publishers; 2013.p. 104.</ref>
|-
|-
|1st month || Sida cordfolia(bala)
|'''1st month''' || Sida cordfolia(bala)
|-
|-
|2nd month || Ipomea sepiaria(lakshmana)
|'''2nd month''' || Ipomea sepiaria(lakshmana)
|-
|-
|3rd month || Solanum Indicum Linn. (bruhati) and Solanum xanthocarpum (kantakari)
|'''3rd month''' || Solanum Indicum Linn. (bruhati) and Solanum xanthocarpum (kantakari)
|-
|-
|4th month || Desmodium gangeticum(shalaparni)
|'''4th month''' || Desmodium gangeticum(shalaparni)
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|5th month || Tinospora cordifolia(guduchi)
|'''5th month''' || Tinospora cordifolia(guduchi)
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|-
|6th month || Solanum xanthocarpum (kantakari)
|'''6th month''' || Solanum xanthocarpum (kantakari)
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|-
|7th month || Hordeum vulgare(yavaka)
|'''7th month''' || Hordeum vulgare(yavaka)
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|-
|8th month|| Marsedenia tenacissima (morata)
|'''8th month'''|| Marsedenia tenacissima (morata)
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|9th month || Asparagus racemosus(shatavari)
|'''9th month''' || Asparagus racemosus(shatavari)
|}
|}
===Therapeutic measures to be avoided===
===Therapeutic measures to be avoided===
*Excessive nourishment(santarpana) and excessive emaciation(apatarpana) [Su.Sa.Sharira Sthana 10/3]
*Excessive nourishment(santarpana) and excessive emaciation(apatarpana) [Su.Sa. Sharira Sthana 10/3]
*Untimely use of oleation(snehana) [Su.Sa.Sharira Sthana 10/3]
*Untimely use of oleation(snehana) [Su.Sa. Sharira Sthana 10/3]
*Blood-letting[Su.Sa.ShariraSthana 10/3]
*Blood-letting[Su.Sa. Sharira Sthana 10/3]
*Repeated excessive massage with oil and unguents. [Su.Sa. Sharira Sthana 10/3]
*Repeated excessive massage with oil and unguents. [Su.Sa. Sharira Sthana 10/3]
==General guide Lines for treatment of diseases during pregnancy==
==General guide Lines for treatment of diseases during pregnancy==
*The diseases of pregnant woman should be treated with use of soft(mrudu), sweet(madhura), cold(sheeta), pleasing and gentle drugs, dietetics and behavior. [Cha. Sa. Sharira Sthana 8/22]
*The diseases of pregnant woman should be treated with use of soft(mrudu), sweet(madhura), cold(sheeta), pleasing and gentle drugs, dietetics and behavior. [Cha. Sa. [[Sharira Sthana]] 8/22]
*Even though the purification procedures are contra indicated in pregnancy, in case of acute or serious conditions,emetics can be given followed by use of sweet and sour edibles mixed with carminative drugs. [Su.Sa. Sharira Sthana 10/67]
*Even though the purification procedures are contra indicated in pregnancy, in case of acute or serious conditions,emetics can be given followed by use of sweet and sour edibles mixed with carminative drugs. [Su.Sa. Sharira Sthana 10/67]
*Cleansing and nutritive enema (asthapana and anuvasanabasti) should not be used frequently,but if the disease is acute, moderate use of these can be done. [Cha. Sa. ShariraSthana 8/22]
*Cleansing and nutritive enema (asthapana and anuvasanabasti) should not be used frequently,but if the disease is acute, moderate use of these can be done. [Cha. Sa. [[Sharira Sthana]] 8/22]
*After eight months, diseases curable by purification measures like emesis etc. can be treated with gentle form of those therapies or procedures giving similar benefits. Strong emetics are contraindicated. Instead of strong oral purgatives, suppositories can be used.[Cha. Sa. Sharira Sthana 8/22]
*After eight months, diseases curable by purification measures like emesis etc. can be treated with gentle form of those therapies or procedures giving similar benefits. Strong emetics are contraindicated. Instead of strong oral purgatives, suppositories can be used.[Cha. Sa. [[Sharira Sthana]] 8/22]
*But, in case of very serious conditions, for saving the life of pregnant woman, the drastic measures and pungent drugs may be used even if those are harmful to the fetus.[ A.S. Sharira Sthana 2/63]
*But, in case of very serious conditions, for saving the life of pregnant woman, the drastic measures and pungent drugs may be used even if those are harmful to the fetus.[ A.S. Sharira Sthana 2/63]
[[Vayu]] moves into its right path and direction, urine, feces and placenta are excreted or expelled easily by their respective passages.
[[Vayu]] moves into its right path and direction, urine, feces and placenta are excreted or expelled easily by their respective passages.
Woman gains strength and complexion and she delivers easily at proper time a desired, excellent and healthy child possessing all the qualities and long life.[Cha. Sa. Sharira Sthana 8/32]
Woman gains strength and complexion and she delivers easily at proper time a desired, excellent and healthy child possessing all the qualities and long life.[Cha. Sa. [[Sharira Sthana]] 8/32]
==Current Researches==
==Current Researches==