Case of Hyperemesis Gravidarum - homeopathy360

Case of Hyperemesis Gravidarum

Abstract: Homeopathy is a science based on logic. In present century, people want miracles in very short span of time.  This is a case of Hyperemesis gravidarum. The baby had choroid plexus cyst which normally resolves with time. We only hope the baby is normal without trisomy of chromosome 18. The constitutional treatment as Ante-natal care is all we can aim on.
Introduction
A 19 years female, Mrs Azha Zahir Mohd. Momin, residing at Bhiwandi, married since 23/05/2009, educated upto 2nd yr B.Sc., came on 25/11/2009 with chief complaint as below:

 

Location Sensation Modalities Concomitants
G.I.T.
Since 2nd month of gestation
 
Urinary system
since a week
 
Lumbar region
since 2-3 days
 
Nausea & vomiting watery without bile
 
 
Frequency increased
 
 
Pain
 
< Morning3
< Smell of beaf3
< Smell of food3
 
< Night3
 
 
> Rest3
 
 
 
 
 
Sleep disturbed

 
She was fair, lean, thin and delicate. She had profuse perspiration, since childhood. Her appetite was reduced since she conceived with nausea and vomiting even at the smell of food. Thirst less. She had desires marked for highly seasoned food+3, Milk+3, Cheese+3, Sour+3, Warm food+3, Ice-cream+3. Bowels were constipated; frequency of urination  increased especially at night. Sleep disturbed due to urination since a week. No dreams. She required fanning throughout, used luke warm water for bathing, takes 1 covering compulsory throughout the year, so thermally she is ambithermal.
Past History:  Malaria in childhood
Family History:
Brother: 13 yrs old: Muscular dystrophy since 4 yrs.
Maternal Grand Mother: Diabetes Mellitus
Mother: Spondylosis,
Obstetric history
Married on 23/05/2009; she is primigravida with h/o 5 months amenorrhoea.
L.M.P.: 17/06/2009
E.D.D.: 24/03/2010.
Life space: Her father is working in Municipality, Mother is House wife, 1 Elder sister married & 1 younger brother is totally dependent on Mother as he is having Muscular dystrophy. Her Father-in-law is a Businessman, Mother-in-law is a House wife, Brother-in-law is studying in 11th Std, 1 Sister-in-law is married & other has completed D. Pharmacy but not working. Patient’s husband has done B.Com & I.C.A. and has a Mobile shop in Bhiwandi. She being very delicate had been always pampered and over protected by parents and elder at in-laws place. She had been taken care of and pampered since she conceived. Her childhood was very happy without stress. She was average in studies. She had completed her 2nd year BSc and then got married. Has no ambition to continue the education ahead. She was very sensitive to slightest matters and reacts immediately by weeping. She doesn’t mix easily with anybody, feels that she is lacking behind and is mismatch in the group. She has no say of her own; she is dependent on her in-laws for any decision (before marriage on parents). Also she was very slow at doing any work; she does the work told by her Mother-in-law but slowly. She has fear of dark and of being alone. Always needs somebody to accompany. Very mild and withdrawing, can’t quarrel with anybody. Carries causeless anxiety for everybody, especially her brother who has muscular dystrophy.
Actually after seeing her investigation reports her in-laws got a bit anxious and worried so they approached me. The investigation reports were as follows:
Investigations:
Sonography of Gravid Uterus:  2nd Nov 2009
The real time, B Mode, gray scale sonography was performed. Single live fetus was seen in changing position. Placenta is fundal posterior & shows grade ‘I’ maturity. Liquor is adequate for the gestational age. Internal os is closed at this stage. Cervical length measures 3.1 cm.
Parameter                                          Measurement                         Age in weeks
Bi-parietal diameter (BPD)                        4.0 cm                              18 wks 2 days
Head circumference (HC)                          15.3 cm                            18 wks 2 days
Abdominal Circumference (AC)               12.8 cm                            18 wks 3 days
Femoral length (FL)                                   2.7 cm                              18 wks 2 days
There is discontinuity noted in right choroid plexus with hypoechoic structure measuring 5mm noted within? Cyst formation.
Fetal movement & fetal cardiac pulsation well visualized. Fetal structure grossly appears normal.
Fetal heart rate – 146 BPM
Expected fetal weight – 236 (+/- 34) gm
Expected EDD – 03/04/2010 (+/- 15 days)
Impression:

  • Single live intrauterine fetus in changing presentation with approximate gestational age “18 wks 2 days”
  • Discontinuity in right choroid plexus with hypoechoic structure noted within? Cyst formation

Ultrasound: 3rd Nov 2009: Targeted Scan for Fetal Anomalies:
Single fetus was seen in uterus in changing position. Cardiac pulsations were seen well. Liquor was adequate. Placenta was fundal and  along left lateral wall. Cervical length was 3.2 cm. Os  closed.
Target Scan reveals:
Nuchal fold = 2.7 mm             Cerebellum = 20.9 mm            Cisterna magna = 4.3 mm
Lateral ventricles = 6.2 mm    Facial structures = Normal      Spine = Normal
Upper extremities = Normal   Lower extremities = Normal   Cord insertion = Normal
3 Vessels cord seen                 Kidneys = Normal                  Urinary bladder = Normal
Bowel = Normal                     Stomach = Normal                  Four chambers = Normal
Out flows = Normal                No obvious mediastinal shift seen at present
Bilaterally tiny choroid plexus cysts were seen. Right sided measures 3.0 mm & left sided measures 3.4 mm
B.P.D. – 4.10 cm (18 wks 4 days)      H.C. – 15.11 cm (18 wks 2 days)
A.C – 12.59 cm (18 wks 2 days)        F.L. – 2.61 cm (18 wks)
18 wks gestation. E.D.D. by USG 04/04/2010
Dated – 4th Nov 2009
Alpha Feto Protein (AFP) – 110.46 IU/ml
Beta Human Chorionic Gonadotropin (BHCG) – 32,524.94 mIU/ml
Unconjugated Estriol (E-3) – 4.95 ng/ml
Treatment:
After studying the detailed case history, it stroked my mind regarding two remedies; they were Calcarea carbonica and Baryta carbonica. After giving a thought, I came to conclusion that her constitutional remedy is Calcarea–carbonica as she is not backward or idiot like Baryta but pampered, lazy, dependent & overprotected like Calcarea. Also, she has no say of her own and she is fearful & indecisive, this again points towards Calcarea. Acute remedy was Symphoricarpus (for morning sickness
On 25th Nov 2009, she was given single dose of Calcarea–carb 200 and placebo three times a day for a month. Symphoricarpus 1M was given and told to take as per necessity.
She was advised that her nightly frequency of urination is physiological and it will go on for whole of the gestational period. Her lumbo-sacral pain also will be fluctuating and she need not worry but take rest when in pains. She should do some non exertional work to keep self busy so that attention towards the complaint will be diverted. Took Symphoricarpus 1M SOS for nausea & vomiting.
 9th Jan 2010: Targeted Scan for Fetal Anomalies:
Single fetus is seen in vertex presentation with back to left. Cardiac pulsations are well seen. Liquor is adequate. Placenta is fundal and posterior. Cervical length is 3.1 cm. Os is closed.
Target Scan reveals:
Cerebellum = 30 mm               Cisterna magna = 9.0 mm
Lateral ventricles = 5.0 mm    Facial structures = Normal      Spine = Normal
Upper extremities = Normal   Lower extremities = Normal   Cord insertion = Normal
3 Vessels cord seen                 Kidneys = Normal                  Urinary bladder = Normal
Bowel = Normal                     Stomach = Normal                  Four chambers = Normal
Out flows = Normal                No obvious mediastinal shift seen at present
Visualization of fetal structures is suboptimal due to advanced gestational age
B.P.D. – 7.24 cm (29 wks 1 day)       H.C. – 26.28 cm (28 wks 5 days)
A.C. – 23.01 cm (27 wks 3 days)       F.L. – 5.17 cm (27 wks 5 days)
E.F.W. – 1.1 Kg (+/- 200 gm)
Comment

  • 28 wks gestation
  • Fetal structures grossly appear normal
  • Choroid plexus cyst seen earlier has completely regressed

 
On 10th Jan 2010 her Mother-in-law came with happy and surprise face showing the Sonography report of her Daughter-in-law. The complaints of nausea and vomiting were not present. Now, she was given again placebo three times a day for another month and has been advised that medicine is to be continued till the birth of baby to avoid further complications.

Team Homeopathy 360
Posted By: Team Homeopathy 360