TREATED SUTIKA MAKKALA WITH AYURVEDA
According to Ayurveda, a woman who has just given birth to a child followed by the expulsion of the placenta is called Sutika. Expulsion of the placenta is the criteria for the terminology Sutika. Sutika makkala the post-delivery complication frequently occurring in women due to vitiation of Vata, results in accumulation of Dushita rakta in the uterus causing severe pain in the abdomen, below umbilical & bladder & cardiac region. At times the pain is so severe that it is a prickly sensation with a possibility of tearing of bowel or its perforation. These are associated with flatulence and retention of urine.
Sutika is not a rogi, and the paricharya explained to Sutika in Prasavottara kaala is like dinacharya, ritucharya explained for Swastha. Sutika makkalla, the post-delivery complications frequently occurring in women, is associated with the accumulation of blood in the uterus due to vata prakopa. Makkalla is a Shoola pradhana vyadhis occurring during sutikavasta.
Stress during pregnancy & blood loss during labour often leads to dhatu, agni & bala kshaya, this dhatu kshaya causes shoonya shareera at Sutika. The purpose behind Sutika Paricharya is to protect her from various diseases and her recovery from stress of pregnancy and labour as well as to ensure adequate & quality lactation for the neonate. As per modern science makkalla shoola compared with after pains in which blood accumulates in the uterus and does not pass out. That accumulated blood causes spasmodic pain in the abdomen and back.
- A 32 years old female Hindu patient, who delivered a female baby vaginally a week back, an IT employee by occupation visited the OPD of AAMCH & RC, dept of prasooti tantra and stree roga on 5 November 2022 with complaints of severe pain abdomen, pain persisting below the umbilical region.
- Detailed history of present illness revealed that Patient was said to be apparently healthy after delivery. For 4 days she started feeling pain in abdomen region on and off for a day, later from the very next day the pain got aggravated. She started feeling of severe pain in lower abdomen & bladder region, for which she approached the same hospital where she got delivered, there she was prescribed with antispasmodic drugs, patient consumed the medicine for a day but she didn’t get relief, symptoms got aggravated where she was unable to get up from bed and feed the baby for the same she approached on 5th November 2022 PRASOOTI EVAM STREE ROGA department of AAMCH & RC for further needful.
TREATMENT
Cap Shudha Hingu with ghrita was administered. Also, Dashamoolarishta 2tsp along with water was given for 14 days.
ASSESSMENT CRITERIA
- SUBJECTIVE: Pain in abdomen was assessed using VAS (visual analogue scale) scale on which severity of pain was marked.
- OBJECTIVE: Pain in abdomen was assessed by palpation of uterus every day in the morning preferably at the same time. The patient will be instructed to empty her bladder before the examination.
- Assessment of involution of uterus:
Each morning at same time, after emptying the urinary bladder. The involution was assessed by measuring the distance between the pubic symphysis and uterine fundus (centralized).
- Assessment of yonigata srava (Lochia amount)
- Assessment of episiotomy pain as per VAS scale OBSERVATION
The patient presented with severe pain abdomen, subinvolution of uterus & lochial discharge was more than 3 pads per day on 1st day of assessment.
On 7th day of assessment, the patient presented with moderate pain abdomen, lochial discharge was reduced to 2-3 pads per day but the sub involution of the uterus remained the same.
Whereas on the 14th day of assessment the patient was presented with no pain, normal involution of uterus and lochial discharge was 1-2 pads/day.
So the treatment which was advised had progressive results in the patient at the end of 14th day.
DISCUSSION & CONCLUSION
During pregnancy there are progressive anatomical and physiological changes not only confined to the genital organs but all the systems of the body and during labour the woman is exhausted due to bearing down efforts, straining, loss of body fluids, blood, energy making her more vulnerable to infections. The woman who had faced the complications during labour & not followed regimen properly then she is more prone to various vata related disorders because of shoonya shareera, nisruta rakta dhatu, because of kshapita & shitila of shareera there could be jatharagni mandhya & dhatwagni mandhya leading to impairment in the metabolism.
The above said medications prescribed in this case are very much beneficial in curing and preventing Sutika related diseases. The ingredients used are having properties of Ushna Virya, Laghu Ruksha Guna, Agni Deepana & Ama pachana, which acts like Kapha Vata Shamaka, Garbhashaya Shodhaka, Shulahara & Sthanya janaka.
Hence it is concluded that Cap Shudha Hingu & Dashamoolarishta are found to be very effective. Sutika Makkala can be managed through Ayurveda by accurate dosha involvement and a structured protocol. Ayurvedic intervention in the above said case revealed the true potential and efficacy of our science.