An Ayurvedic Approach on Habitual Abortion Due to Torch Infection W.S.R. to Putraghni Yoni Vyapada: A Case Series

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Introduction
Early pregnancy loss is defined as a nonviable, intrauterine pregnancy with either an empty gestational sac or a gestational sac containing an embryo or fetus without fetal heart activity within the first 12 weeks of gestation. [1,2].Recurrent miscarriage or Recurrent Pregnancy Loss is defined as the loss of two or more consecutive pregnancies before 20 weeks of gestation.The common cause responsible for habitual abortion are: Genetic factors like chromosomal abnormalities, endocrine and metabolic ,immunological factors, lifestyle system, and TORCH2 (Taxoplasmosis, rubella, Cytomegalovirus,herpes virus) infection is a leeding cause of pregnancy loss.According to Ayurveda, at the time of the Formation of the foetus (Garbha), due to vitiated blood (Shonita), the product of conception expels repeatedly before Attaining viability, which is known as Putraghni Yonivyapad.So it is important to achieve a full-term pregnancy with Healthy progeny.It is evident that maternal infections play a vital role in the loss of pregnancy. 3onsidering description from Ayurvedic classics collectively probable Causes of Yonivyapada include Mithyaachara, Pradushta artav, Bija dosha and Daiva karma.Aharaja, viharaja and manasika nidana like stress-induced Hormonal disturbances leads to apana kshetra dushti, vataprakopa which causes disturbances in menstruation, and destroys foetus repeatedly due to Vitiated shonitha. 4Putraghni • Email: editor@ijfmr.com

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Volume 6, Issue 3, May-June 2024 2 Yonivyapad leads to Vandhyatva asComplication if left untreated. 5As per Ashtanga hridaya, Uttarbasti is the Treatment of choice along with Madhura, Sheeta, Balya and Rasayan dravyas.This Line of treatment given before conception Inhibits Garbha strava and helps in Restoration of pregnancy till full term. 6 Case study 1: A 30-year old lady came for in obstetrics and gynaecology (striroga-prasutitantra) department opd.With chief complaint of wants to convince issue along with stress and fear of previous

Time of administration of Uttara Basti
In research studies, in 25% of the patients Uttara Basti was administered from 6th day to 12th day of the cycle.In 20% of studies 7th day to 12th day of the cycle.In 55% of studies 10 th day to 12th day of the cycle.Acharya Charaka has mentioned, Ritu Kala is the best time for administration of the Uttara Basti as Yoni Mukha will be Avaranarahita (Cervix will be open). 7sture Acharya Charaka has mentioned Women should be made to sleep in Uttanayashayanaha Samyak Sankochya Sakthini position (supine position with flexed thighs and elevated knees). 8The patient is given dorsal lithotomy head low position on the OT table after Yoni Prakshalana with Triphala Kashaya.

Procedure
According to Samhitas, after giving theposition the nozzle of the Uttara Basti Yantra is slowly inserted following the direction of the passage.In 24hours, 2-3 times Uttara Basti is given for 3 nights with gradual increase in dose of the Sneha. 9 Currently Practiced Method: 10 After making patient relaxed Sim's speculum Should be inserted into vagina.Cervix should Be exposed with the help of the anterior Vaginal wall retractor and speculum.After this Process once again vagina and external OS Should be painted with diluted betadine for Removal of mucoid or any discharge.When the Sterilization is over, cervix should be caught With Allis forceps or vulsellum forceps.Uterine Sound is passed through external OS to find The position of uterus.After knowing the Position of uterus, Hegar's dilator is inserted Through external OS for dilating the cervix Properly.When cervix is dilated properly, then 5 ml Taila filled in 10/20 ml disposable syringe Fitted with angulated Uttara Basti cannula Should be inserted gently and oil is instilled.After this all instruments and towels should be Removed.Patient is advised to return to Supine position with legs folded on each other.In clinical studies, the dose used was 5 ml by 95% of the studies and only 5% of the studies Used 10ml.

Discussion
Recurrent pregnancy loss can be correlated with Putraghni Yonivyapad and Garbhasravi Vandhya Explained in Ayurvedic classics.Putraghni is a Yoniroga characterised by Repeated Pregnancy Losses due To the excessive use of Rooksha Ahara and Vihara which leads to Vata Prakopa further causing Shonita Dusti and Artava Dusti which in turn results in repeated loss of pregnancy. 11In Today's fast pace of life, this physiological Event exhibits with multiple and variable problems which resulted into termination of Pregnancy.So, it is important to keep the Fetus nourished and protected throughout Pregnancy.Putraghni yonivyapad i.e.Recurrent abortion can be treated Successfully with proper Ayurvedic Intervention.According to Ayurveda, the four key components for fertility are rutu, Kshetra, ambu, and beeja.Any of these four factors Dushti, results in vandhyatva (infertility). 12According to Ashtanga Hridaya (one of the Brihattrayi), Uttarbasti (mode of administration of drug by urethral or genital route) is indicated in treatment of all types of Yoni vyapad (gynaecological disorders).In this particular case of recurrent miscarriage, we used Phalghrita Uttarbasti along with internal medications such as Shatavari-Ashwagandha siddha kshirapaka . 13Uttarbasti removes strotorodha and maintains hormonal balance in uterus and ovaries.Good result was obtained in this case.An informed consent was taken from the patient for this study.Results obtained in this case demonstrate that the management of recurrent abortion.Clinical condition known as putraghni Yonivyapad is typified by recurrent miscarriages Brought on by an excessive intake of rooksha ahara Vihara.This results in vata prakopa, which causes Shonita dushti and artava dushti, both of which lead to Repeated garbha vinasha.

Conclusion
Here in present Case study, a positive case of TORCH infection ie putraghni yonivyavad is treated By ayurvedic treatment only.Pregnancy is successfully Carried as it crossed that critical period of first trimester.The medicines used here alleviates Tridoshas specially Pitta & Vata & having Garbhasthapaka, Rasayana & Balya, antimicrobial, antioxident, anti-inflammatory, Immunomodulatory properties.Thus, helps to maintain Pregnancy & promotes the growth of fetus.These medications Are Garbhasthapaka and nourish the foetus as well.