GARBHA VYAPAD

GARBHA VYAPAD: ELABORATE NIDANA, SAMPRAPTI, LAKSHANA AND CHIKITSA OF UPAVISHTAKA, NAGODARA, LINAGARBHA, MAKKALA, AND JARAYU DOSHA

Garbha Vyapad refers to abnormalities and disorders of pregnancy described in Ayurvedic texts. These conditions can affect the mother, fetus, or both. They are caused due to vitiation of doshas and improper Garbha-sthapana (implantation and development of the fetus). Among the 20 Garbha Vyapads mentioned in Ayurvedic classics like Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya, certain specific conditions are notable for their clinical relevance and identifiable symptoms such as Upavishtaka, Nagodara, Linagarbha, Makkala, and Jarayu Dosha. Each of these conditions relates to abnormal fetal development or complications related to the uterus and placenta.

NIDANA (ETIOLOGY)

The causes of Garbha Vyapad are generally based on:

• Mithya Ahara-Vihara (improper diet and lifestyle of the pregnant woman)

• Beeja (gametes), Beeja Bhaga (genetic components), and Kshetra (uterine environment) dusti

• Daiva (karmic or unseen factors)

• Suppression or forceful initiation of natural urges during pregnancy

• Psychological stress or trauma

General Nidana Quote:
"त्रिविधं गर्भदोषाणां हेतुमाहुः प्रकीर्तितम्। बीजं क्षेत्रं तथा रितुं दोषाश्चेति विचारयेत्॥
(Ashtanga Hridaya, Sharira Sthana 1/27)

UPAVISHTAKA

NIDANA

• Excessive physical activity or trauma in early pregnancy

• Rajo-nasha (amenorrhea due to uterine pathology)

• Garbhapatana hetu sevana (abortifacient drugs)

SAMPRAPTI
Due to excessive physical or psychological stress, Vata gets vitiated leading to disruption in the fetal positioning and development. It causes incomplete abortion with retained products of conception.

LAKSHANA

• Recurrent abortion, especially in early months

• Incomplete expulsion of the fetus

• Vaginal bleeding, abdominal pain

• Weakness and fatigue

Sanskrit Reference:
"तत्र दोषैः प्रमोहैश्च हेतुभिः कुपितैस्तथा। निपत्य गर्भो यन्नैव निष्क्रामति सम्यक्॥ स ज्ञेयोऽविसृते गर्भे रोग उपविष्टकः॥"
(Ashtanga Hridaya, Uttarasthana 2/30)

CHIKITSA

• Mridu Shodhana to clear retained products (under supervision)

• Garbha-sthapana drugs in early pregnancy

• Abhyanga, Sneha-Pana to pacify Vata

• Use of preparations like Phalaghrita, Ashokarishta

NAGODARA

NIDANA

• Dominance of Vata and Kapha dosha

• Abnormal fetal movement or twisting of the fetus due to excessive space or improper uterine development

SAMPRAPTI
Vata vitiation leads to displacement and abnormal rotation of the fetus. Kapha may contribute to obstruction and heaviness in the uterus.

LAKSHANA

• Abnormally shaped abdomen

• Unnatural fetal movements

• Pain or discomfort in abdomen

• Delayed or obstructed labor

Sanskrit Reference:
"यदा वातेन गर्भोऽन्तः संचाल्येत बिभेति च। न गोदरेति विख्यातं तद्विकारं प्रचक्षते॥"
(Ashtanga Hridaya, Uttarasthana 2/33)

CHIKITSA

• Use of Vata-pacifying treatments

• Abhyanga, Swedana to relax muscles

• Basti with medicated oils like Narayana Taila

• Prasava-karaka measures in late pregnancy

LINAGARBHA

NIDANA

• Vitiation of Vata and Pitta

• Forceful attempts to remove fetus

• Psychological trauma

• Beeja bhaga dusti (genetic component defects)

SAMPRAPTI
The fetus, though alive, does not move or grow properly due to obstructed channels and disturbed doshas.

LAKSHANA

• Fetal growth retardation

• No perceivable fetal movement

• Abdominal pain

• Dull or absent fetal heart sounds

Sanskrit Reference:
"गर्भो यदा न विकसति स्थिरो भवति चापि सः। लीनगर्भो विकारोऽयं दोषैः स्यात् कुपितैस्तथा॥"
(Ashtanga Hridaya, Uttarasthana 2/34)

CHIKITSA

• Sneha-pana and Swedana to facilitate movement

• Vatahara basti

• Fetal monitoring through ultrasonography (modern)

• Early induction if intrauterine fetal death is suspected (modern)

MAKKALA

NIDANA

• Daiva and Beeja dosha

• Kshetra dushti leading to congenital anomalies

• Exposure to teratogenic substances

SAMPRAPTI
Due to improper genetic factors or uterine conditions, the fetus develops abnormally, often without definite form.

LAKSHANA

• Birth of unformed, non-viable fetus

• Fetal anomalies

• Incomplete differentiation of limbs and organs

Sanskrit Reference:
"गर्भो यदा नायाति पूर्णतां विकृतिं लभेत्। निराकारो भवेद्यस्तु स ज्ञेयो मक्कलाभिधः॥"
(Ashtanga Hridaya, Uttarasthana 2/31)

CHIKITSA

• Shodhana before conception

• Preconceptional Panchakarma for both partners

• Avoidance of garbhopaghati dravyas

• Anomaly scan (modern)

• Medical termination if fetus is nonviable (modern approach)

JARAYU DOSHA

NIDANA

• Improper implantation

• Vitiation of Rakta and Kapha

• Beeja-Kshetra dushti

SAMPRAPTI
Defective or diseased placenta leads to improper nutrition to fetus or abnormal placental position (e.g., placenta previa, abruption).

LAKSHANA

• Heavy bleeding during pregnancy

• IUGR (Intrauterine Growth Retardation)

• Retained placenta

• Placental previa or abruptio (modern)

Sanskrit Reference:
"दोषैः कुपितैः सम्यक् न वर्धते यदा पुनः। तदा दोषात् कुपिता स्यात् जारायुर्दोषसंभवा॥"
(Ashtanga Hridaya, Uttarasthana 2/36)

CHIKITSA

• Garbha-poshaka and Rakta-prasadaka drugs like Draksharishta, Arjunarishta

• Dhoomapana, Yonipichu with medicated ghee

• Monitor for signs of placental abruption or previa (modern)

• Caesarean section if required (modern)

MODERN CORRELATIONS AND MANAGEMENT APPROACHES

• UPAVISHTAKA: Recurrent miscarriage or incomplete abortion – managed by D&C or medical evacuation, followed by evaluation of causes (hormonal, genetic, uterine).

• NAGODARA: Fetal malpresentation or polyhydramnios – monitored via USG and managed with postural changes or cesarean if needed.

• LINAGARBHA: Intrauterine growth restriction (IUGR) or IUFD – managed by Doppler study, fetal monitoring, and timely induction.

• MAKKALA: Anencephaly, holoprosencephaly, or other lethal congenital malformations – anomaly scan and MTP as per law.

• JARAYU DOSHA: Placental abnormalities – monitored via serial USGs; placenta previa or abruption requires emergency management.