Case Study - High Risk Pregnancy

OBSERVATIONS

A 37 years old 20 weeks pregnant women walked into my office with the main problem of severe pain in the low abdomen which increase at night. The combination of the pain and the baby’s rapid movement at night time caused anxiety attacks for her. These anxiety attacks were characterized by a fast heart beat and chest pain. She also experience throbbing headaches. Her other concern is her daily nausea, vomiting and watery diarrhea that didn’t stopped since the beginning of the pregnancy. She is now eating only white rice and chicken.

DIAGNOSIS: Kidney Yang Deficiency and Qi and Blood Deficiency
(Restless Fetus or Threatened Miscarriage)

“Threatened Miscarriage” is the western medical term for my patient’s condition. In Chinese Medicine, it has three corresponding conditions, Vaginal Bleeding During Pregnancy (Tai Lou), Restless Fetus (Tai Dong Bu An), and Miscarriage (Duo Tai, Xiao Chan/Ban Chan, or Hua Tai). These reflect different stages of the same process.

The Chinese term Restless Fetus literally means the fetus is not at peace because it doesn’t get the nourishment it needs to grow properly and miscarriage can result. Some movement of the baby is normal but excessive movement or a change from quiet baby to rapid movement is pathology. 

The blood vessels that supply the uterus fall under the Directing (Ren Mai) and Penetrating Vessel (Chong Mai) and a weakness there is associated with a deficiency of the Kidneys.

TREATMENT

Treatment included acupuncture, soft tissue manipulation and Chinese herbs. 

Acupuncture was prescribed twice a week to tonify the Kidneys, strengthen the Governing (Du Mai), Directing and Penetrating Vessels and calm the fetus. The points that were used:

• Du 20 to raise Qi to counteract the downward movement of the fetus.
• UB20 and St36 to tonify the Spleen and raise Qi.
• UB23 and KI3 to tonify the Kidneys.
• Qimen with Moxa to strengthen the uterus and prevent miscarriage.
• UB17 with Moxa to tonify Blood.
• LIV8 to nourish liver blood.
• PC6 to relieve nausea and anxiety.

Moxa was used in combination with other points as well.

The patient was instructed to breathe into her low abdomen allowing the pain and contraction to ease and to reduce her anxiety. Chinese herbal supplements were prescribed.

OUTCOME

The patient was under my care for the rest of her pregnancy. With treatment, she could get through the night’s contractions with more ease. The intensity reduced and her headache and diarrhea were alleviated. She was able to introduce different food into her diet, which helped nourish her and the baby. The baby’s rapid moments also reduced.

At 41 weeks, she gave birth to a healthy boy.

GOING FORWARD

I recommended continued care while nursing because her kidneys still need the support. Spleen and Kidney Yang Deficiency is a chronic condition characterized by diarrhea and a weak digestive system and can worsen during pregnancy (as seen with this patient). While nursing, she is still trying to produce enough nourishment for herself and the baby which further weakens the mother. 

It is highly recommended that she continue regular acupuncture treatments and take Chinese herbs. There are Chinese Herbal formulas that help with normalization of the uterus. Safe to take while nursing, they are given for four to six weeks following childbirth or even twelve weeks in cases of hard or prolonged labor. These formulas treat combinations of Qi/Blood Deficiency and Blood Stasis. This patient needs a postpartum formula combined with a Kidney Tonic to replenish Jing lost during labor.

“Postpartum fatigue is a common presentation after childbirth. For many women, it may be the underlying cause of Qi and Blood Deficiency that lasts throughout the rest of their life.”

Pregnancy creates powerful changes in the body. How you balance and support your body during the pregnancy and afterward can lay the foundation for your baby’s and your health going forward.

Wellness is an active commitment to live a fulfilled life. I am happy I could alleviate my patient’s anxiety and pain so she could deliver a full-term, healthy baby.