Evaluation of Pulsatila nigra on breach presenting fetus and correlation of breach with biochemical parameters

Breach presentation is the condition in which the buttocks are the presenting part of the fetus in the intrauterine life before delivery. It is an abnormal position of fetus which is one of the indications for the caesarean section. Breach baby can be delivered vaginally but with multiple complications, mortality and morbidity to the baby as well as to the mother. Once the patient undergoes caesarean section, the next deliveries through the normal route are not usually attempted due to the risk of uterine rupture, especially when the patient is operated for the first baby. So the best route for delivery is normal vaginal delivery. The treatment/measures available in medical practice up till now are external cephalic version which needs the expert hands of obstetrician and chances of success are less. Acupuncture is another method to change the position of intra uterine fetus from breach to cephalic but it is tedious process. Maternal postural management is also a method applied to change the breach presenting fetus to normal cephalic position of fetus. All the above mentioned measures are not satisfactory and easy to apply. Pulsatila nigra, a homeopathic medicine, used in this malposition of fetus has significant effect in converting the fetus in normal cephalic position. Now it is easy to deliver the baby through normal vaginal route as compared to breach vaginal delivery and elected caesarean section which have much more mortality and morbidity for fetus as well as for mother. Furthermore it is the easiest way for rotation of fetus in intrauterine life as compared to external cephalic version, poisoning of mother (knee elbow position, raised hips and head down position) and moxibustion (acupuncture technique). In most of the ladies the single oral/sublingual dose of pulsatila nigra of 200X to the mother is sufficient for this purpose; in few cases second and third dose may be required after 15 days interval. No untoward side effects were noted in this study. The mechanism of correction in this situation is the increased mobility of the fetus which helps the fetus to adopt the best fit position in uterus. The study was performed on the women having intra uterine breach presenting fetus in the gestational age of 28 weeks to 38 weeks of gestation. No relationship/association of this breach presentation with socioeconomic status, blood pressure and biochemical parameters e.g. hemoglobin, blood glucose level, blood groups, hepatitis B surface antigen and hepatitis C virus was found. This mal-position was independent of these selected parameters. What changes occur at biochemical and cellular level by the pulsatila nigra is a matter of further research.