Mudhagarbha 2
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The document defines Mudhagarbha as obstructed labor or prolonged labor caused by faults in the fetus, birth canal, or mother's ability to deliver. It can involve a macrosomic, malformed, or abnormal fetus. Types include presentations like breech or transverse lie. Diagnosis considers uterine contractions, dilation, and fetal position. Management includes techniques to change the fetal position like external and internal cephalic version. Destructive procedures like craniotomy or decapitation may be needed to remove a dead fetus and save the mother. The principles aim to remove the obstructing part of the fetus as quickly as possible. Postoperative care focuses on healing and nourishment over several days.
Mudhagarbha 2
- 1. Mudhagarbha Dr Jasmine Gujarathi Professor & Head Dept of Prasuti tantra and Stri roga G J Patel Institute of Ayurveda Studies and Research New Vallabh Vidyanagar
- 2. Definition
- 3. Definition
- 4. Definition
- 5. The descriptions of Mudhagarbha denotes obstructed labour / prolonged labour due to faults in power, passage or passenger. Alive or dead fetus after attaining development of all body parts, after seventh month of pregnancy, presenting abnormally, and or in abnormal passage associated with abnormal uterine contractions due to vitiation of Apana vayu is called Mudhagarbha
- 6. vivrudhdham Macrosomic foetus Polyhydramnios Conjoined twins Hydrocephalous Foetal ascitis Foetal meningoceles
- 10. Uterine inertia Diminished intensity Shortened duration Good relaxation in between two contractions Increased intervals P/A-Less hard uterus P/V-poor dilatation of cervix -association of CPD, malpositions or mal presentations
- 11. Anekadha pratipannnam Four bhedas of mudha garbha Astagathi of mudha garbha Trividha sanga Avaakmukha and jatarodaya of harita Asankhya gati ALL TYPES OF MALPRESENTATIONS AND COMPOUND PRESENTATIONS
- 12. Nidana
- 14. Urdhva – CPD Tiryaka - Transverse Nyubja - Breech
- 15. Lakshana
- 17. Kila -
- 18. Pratikhura
- 19. Bijaka
- 21. Parigha
- 22. Gati
- 26. ÎxTüaÉÑSrÉ AÉpÉÑalÉæ LMü xÉÌ£ü LMãülÉ
- 27. Frank breech AÉpÉÑalÉ xÉÌ£ü vÉUÏU ÎxTüMç SãvÉãlÉ ÌiÉrÉïaÉÉaÉiÉÈ Complete breech
- 30. Vishakambha
- 35. CHIKITSA SUTRA eÉUÉrÉÑ mÉÉiÉlÉ MüqÉï AÉæwÉkÉ, qÉl§É ÍcÉÌMüixÉÉ vÉx§É MüqÉï PREREQUISITES Consent Empty stomach Concept of sterilization
- 38. Operative manipulations / procedures
- 39. Version Procedure designed to change the lie to being the comparatively favourable pole to the lower pole of the uterus External Cephalic Internal Podalic Bipolar
- 40. External version Indications : Breech, Transverse lie Success rate – 70=80% Time – 32 -34 weeks with tocolytics Contraindications – Pre eclampsia, placenta praevia, post casarean, malformed uterus, contracted pelvis, hydrocephalus, dead fetus, multiple pregnancy
- 43. External version
- 44. Complications Maternal – Injury, Rupture, PPH, Abruptio placenta Fetal – Hypoxia, trauma, fracture, cord entanglement, knots
- 45. Internal version
- 47. Internal version is always podalic version and it is completed with extraction of fetus Indication – transverse lie second baby of twin Conditions – cx must be fully dilated, liquor sufficient, fetus live Contraindications – obstructed labour, contracted pelvis
- 48. Achetana Mudhagarbha Chikitsa siddhanta The main principle in dead fetus is that whichever anga (part) is causing obstruction should be cut and extracted to save the mother.
- 49. One should not wait or neglect condition of woman to detoriate, hence the fetus should be extracted immediately.
- 50. Shastras used for moodagarbha nirharana
- 51. SASTRA USED TO EXTRACT THE MUDHAGARBHA: a. Mandalagra (circular knife or round head knife, decapitating knife) b. Angulisastra (finger knife) c. Sanku (hook) d. Ardhachandra (curved knife)
- 52. Destructive operations Designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal. Not practiced because of severe injuries. In unorganized sector may have to perform
- 53. Destructive surgeries in moodhagarbha Craniotomy Evisceration Cleidotomy Decapitation
- 54. Craniotomy Indication – cephalic presesntation with obstructed labour – dead fetus Hydrocephalus in live fetus Interlocking head of twins – dead Contraindications – severe contracted pelvis Rupture of uterus Instrument used – oldham’s perforator / Mayo’s scissors
- 57. Decapitation Indication – neglected shoulder presentation where neck is accessible Instrument used – decapitation hook / knife Evisceration – Removal of thoracic and or abdominal contents Indications – shoulder presentation where neck is not accessible , fetal ascitis, monsters
- 58. Cleidotomy – division of one or both clavicle Indication – shoulder dystocia where clavicles are accessible Instrument – embryotomy scissor
- 59. Post operative care Pippali, Pippali mula, Sunthi, ela, hingu, bharangi, vacha, ativisha chavya – kalka / kwath / churna – with or without ghee for 3, 5 or 7 days Snehapana Asava / Arishta at night Swedana and abhyanga Milk processed with vatahara dravyas for 10 days Brimhana – Mamsa rasa for 10 days Pathya ahara
- 60. Operation with dead mother and live fetus Just like the killed goat, a woman dies during labour, with quivering still persisting, immediately laprotomy should be done to extract live fetus
- 62. THANK YOU