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Case Study

Inability to full term Pregnancy due to Positive Antibodies
Dr S K Mamagin
'Morb / Puls / Morb / Kali-carb

(Co-ordinating Editor:This case has been given since it is more important that the patient concieved but a word of caution. As only IgG was raised, IgG is an indication of OLD INFECTION. IgM indicates ongoing infection. IgG is known an Inmunoglobulin and is as per indication of immunity that the patient carries. Higher levels of IgG only indicate - higher levels of immunoglobulins against that particular antigen. In future we should remember to do IGM study.)

Two cases of inability to continue pregnancy to full term in women due to positive antigen to Rubella and Cytomegalo virus came after consulting the Gynaecologists, who declared that due to the positive Antigens, there is no possibility to continue the pregnancy to full-term so the patient informed me.

Case 1:
A lady aged 26 years, stocky, with one female child,of 5 years. She was desirous of having one more child. She had miscarried twice at third month, once in 1993 and again in April, 1996. After that she did not conceive till November 1996, therefore she consulted a Gynecologist; who advised her TORCH Profile: (IgG),
Toxoplasma IgG Microassay Titre on 24/11/1996:183 EU/ml.
Interpretation: > 300 EU/ml- indicative of toxoplasmosis. 1% of normal population has these values. 210 to 300 EU/ml-indicates fairly recent exposure approx in 10% of population has these values 45 to 210 EU/ml-usually indicates a past exposure but may mean early stages of disease. Upto 30% of the normal population has values in this range.
< 45 EU/ml infection-very unlikely.
Rubella IgG Microassay Titre 90 EU/ml

> 20 EU/ml Negative, non immune.
20 EU/ml or greater Positive, immune.
The identification and immunization of susceptible women is of utmost importance in preventing congenital rubella syndrome. The presence of rubella antibodies is indicative of previous infection and presumptive immunity.
Screening for rubella antibodies by serological methods will establish the immune status of individuals with regard to their resistance or susceptibility to primary rubella infection.
CMV Microassay Titre 98 EU/ml.

Greater than 23 EU/ml Positive, previous immunological exposure to CMV.
Less than 18 EU/ml. Negative, no previous CMV infection.
Between 18 to 23 EU/ml. Equivocal for IgG antibody to CMV sample should be tested & if still equivocal, the test sample has no significant IgG antibody to CMV.
Herpes 2 IgG Microassay Titre 19 EU/ml.

Less than20 EU/ml. Negative, no previous HSV infection.
Equal to or greater than 20EU/ml. Positive, previous or current HSV infection.
Due to shared antigens, infection with one HSV type may produce an anamnestic response with the pre-existing presence of antibody to HSV and that does not imply protection from disease. For example, previous oral HSV infection does not protect against genital infection.
Prior to this she had came to me on 31/8/1996 and complained of irregular menses. Much body pain before periods. Flow is profuse on first day and then scanty. Ustilago 30, few doses set her menses right.
Now she came on 12/12/1996, after being disappointed by the Gyneacologist’s prognosis. She asked if Homoeopathy could help. I simply told her that there was no harm in giving a try.
Due to the values of IgG Rubella and C M V IgG being positive it was supposed that the patient might have suppression of measles in her childhood. So a dose of Morbillinum 1M followed by occasional dose of Pulsatilla 200 was given. She reported on 3/3/1997 that she has missed her period for over 10 days. On 12/3/1997, she was advised urine test for pregnancy. It was positive!
A dose of Morbillinum 1M was repeated followed by a few doses of Pulsatilla 200 at long intervals. Unlike previous two occasions, this pregnancy continued to full term and she gave birth to a healthy male child.

Case 2:
A young lady, 23 years old, came to me with the following symptoms: Twisting pain in the pelvic region for about a year. Pain < any exertion, any jerk.
P H-About a year ago she met with an accident when she incurred injury in the hypogastrium. She started feeling the pain after the accident.
Menses: severe dysmenorrhoea. Pain used to be in the hypogastrium, back and calves.
Flow dark, clots ++, copious used to last 6-7 days.
During menses desire to weep.
Engorgement and tenderness of breasts during the menses.
Tendency to coryza with sneezing bouts < after the menses.
Feverishness for the past some time.
A number of times she had preliminary symptoms of measles but the eruption did not appear.
Miscarried once in fourth month of pregnancy in Oct1996.
P/A-hypogastrium hard and tender.
Appetite, thirst, stool, urine, normal.
The lady had no kids so far, hence her parents and husband were quite anxious, more so after the miscarriage.
They consulted a Gynecologist who advised serological tests on 19-12-1996.
IgG antibodies to Toxoplasma negative 8 EU/ml.

>10 EU/ml: Positive for IgG antibody to toxoplasma gondii and indicates the possibility of current or recent Toxoplasmosis.
<10 EU/ml Negative for IgG antibody to Toxoplasma gondii.
IgG antibodies to Rubella virus: positive 32 EU/ml

>15 EU/ml. Positive, immune.
<15 EU/ml. Negative, non immune.
IgG antibodies to cytomegalo virus positive 144 EU/ml.

>30 EU/ml: Positive for IgG antibodyto CMV and indicates the probability of current or recent infection.
<30 EU/ml: Negative for IgG antibody to CMV.
IgG antibodies to herpes 2 virus negative 12EU/ml

>20 EU/ml. Positive. Previous or current HSV infection.
<20EU/ml. Negative. No previous HSV infection.

The prognosis of the Gynecologist was the same as in case 1 above.
Therefore her mother brought her for Homoeopathy.
31-12-1996 Arnica 10 M one dose Kali-carb. 30 tds for a week.
08-1-1997 Felt > in pain in the hypogastrium. Fever persisted. Morbillinum 1M one
08-1-1997 Felt > in pain in the hypogastrium. Fever persisted. Morbillinum 1M one dose.Kali-carb. 30 t d s contd.
13-1-1997 Feeling much pain in lumbar region < sitting for some time, < stooping.A Sepia 200 once after every two days.
06-2-1997 Pain gone. Fever gone.
02-3-1997 No relapse in pain and fever. Menses did not appear though over due by 11 days. Urine test for pregnancy was advised, which was positive.During pregnancy she had some leucorrhoea, otherwise she completed her term safely and delivered a healthy male child.

Dr H C Allen, in Materia Medica - Some Important Nosodes writes under Morbillinum: "The well-known symptoms which characterize an attack of measles may be taken as guide for its homoeopathic use.
Its chief use hitherto has been as a prophylactic against infection, and to clear up after-effects of an attack." Practically I have used Morbillnum in 30 and 200 potencies successfully in numerous cases of measles and also as its prophylactic and it worked satisfactorily." So I thought that it should work in these cases where IgG antibodies to Rubella virus were found to be positive. It is the Rubella virus which is supposed to causes an attack of measles. And it worked in both the cases.
Other medicines were given on the basis of the symptoms of the patients.