Biochemic approach in Anemia of Pregnancy
NATIONAL JOURNAL OF HOMOEOPATHY 2001 Jul / Aug VOL III NO 4.
Dr Vilma D'Souza
'Calc-ph / Ferr-ph / Nat-m / Kali-ph / Sep

Anemia is the commonest medical disorder found in pregnant women. Anemia in pregnancy is usually due to defective erythropoesis, most often from iron or folate deficiency or both.

Anemia is defined as a reduction in concentration of heamoglobin in the peripheral blood below the normal of age and sex of the patient. It varies in males and females (ie. Males below 13 gm/dl and females below 11.5 gm/dl).

According to the biochemic concept, anemia results from the deficiency of te organic salts, calcium phosphate and iron phosphate. Red cells are formed in the bone marrow. So calcium phosphate has a direct role to play in production of RBC. If the body is deficient in calcium phosphate, it obviously results in anemia. A deficiency of iron also has a impact on the hemoglobin levels resulting in anemia.

Causes of Anemia
Inadequate diet
Iron deficiency
Folic acid and vitamin B₁₂ deficiency
Malabsorption
Increase demand during pregnancy
Excessive bleeding - menorrhagia, DUB, metrorrhagea
Infections - bacterial, viral and parasitic.
Anemia may affect any of the systems -CVS, CNS, renal and reproductive systems. The signs and symptoms can be seen in the system so affected and the complaints are usually

·         weakness and lassitude

·         breathlessness on exertion

·         palpitation

·         fatigue

·         Dizziness

·         Dimness of vision

·         Insomnia

·         Diminished sensation of fingers and toes

·         Pallor of skin

·         Oedema, slight protienuria

·         Murmurs (systolic)

·         Amenorhea, infertility, etc.

Management
General 

·         Adequate diet, rich green vegetables, beetroot, fenugreek, soya bean, spinach etc.

·         Milk and milk products

·         Fruits- apple, apricot, mango etc.

Since anaemia results from the deficiencies of various inorganic salts especially Calcium Phosphate and Ferum Phosphate by introducing these salts from outside will definitely treat the condition of anaemia. Biocombination Cal-phos 3x,Nat-mur 6x, and Kali-phos 3x daily will improve the condition of anaemia.

I would like to highlight a case of anaemia in pregnancy.

Case
MrsX, 27 years, Hindu House wife, got married on 7.2.1994. She has no children, has 1 younger brother. The case was taken on 18.8.99

Past History
History of recurrent abortion 4 times
1st abortion 4 years back at 3rd month
2nd abortion 4 years back at 2½ month
3rd abortion 3 years back at 2½ month
4th abortion 2½ months back at 2nd month

Menstrual History
Menarche: 15 years age
LMP: 20.6.1999

Menses: Irregular once in 40-45 days always
Duration: 9-10 days, profuse
Character of blood: Dark, Stringy
Before menses: Leucorrhoea++, acrid, soreness of external genitals
During menses: Itching of the external genitals. Pain3 very severe, spasmodic, cutting, colicky type.
After menses: Leucorrhoea
Leucorrhoea is acrid, soreness of external genitals
Sexual function: Pain during coition

Family History No major illness in the family

Personal History
Appetite: Decreased
Desires: Oily food, sweets
Aversions: Non vegetarian food
Thirst: Increased, 7-8 glasses/day
Perspiration: Increased, no odor, no staining
Stool: Usually constipated - hard stool
Urine: 3-4 time/day. Now since 1 Month burning++

Thermal Reaction
Likes winter season. Likes fan always. Covers thin till neck. Bath-warm water. C²H² - C²H³

Emotional State
Weepy: weeps for trifles or if anybody says any thing about her.
While narrating her complaints
Anxious: about not having children
Fear: about her complaints
Company: Likes
Behavior: Shy
Memory: Weak

General Physical Examination
Per abdomen: Tenderness+ lower abdomen (hypogastrium)
Surface smooth
Percussion: Firm in consistency
Auscultation: Normal bowel sounds heard
CVS: S1S2 heard.
No murmurs
RS: Normal vesicular breath sounds heard
Weight: 42Kgs

Provisional Diagnosis ? Pregnancy Anaemia
Investigation Advised
-Hb; Blood group
-Pregnancy test - urine

Report Shows
Hb: 5.1 gm/dl
Blood group: O+
Pregnancy: Positive

Management
Advised for admission - complete bed rest
Advised antenatal diet
Blood transfusion

Repertorial Totality (Kent’s repertorial method)
Mind:
(12) Company desire for
(07) Anxiety - health about
(88) Shy (timidity)
(92) Weeping

Physicals C2H2-C2H3
(486) Stomach-desires-sweets
(1299) Perspiration-profuse

Characteristic Particulars
Genitalia: (714) Abortion
(721) Itching - pregnancy during
(720) Leucorrhoea - (721) burning
(722) Acrid excoriating - menses before
(726) Menses delayed
(727) Painful dysmenorrhora
(509) Stomach - nausea - during pregnancy
(608) Rectum constipation-pregnancy

Patient used to visit once every month and blood examination was done once in 1-2 months. Her Hb was 11.8 gm/dl in January (7th month). There was no complaint throughout her antenatal period. The constitutional remedy was selected based on her constitutional totality and was prescribed once in a month with Sac Lac, Ferrum phos 3x and Cal phos 6x tablets. She delivered a healthy female child weighing 3.1 kg by vertex presentation on 12.03.2000 at 6.30 pm. The mother and the child were healthy. Prescribed 2 doses of Arnica 1 M soon after the delivery. There was no complication to the mother as well as the child during peurperium.