Ayurvedic Management of Garbha Chalana (Threatened Miscarriage) Using Mrinala (Nelumbo nucifera) and Nagakesara (Mesua ferrea) as an Adjunct to Conventional Therapy: A CARE - Compliant Case Study

Abstract

Background: Threatened miscarriage, characterized by vaginal bleeding during early pregnancy with a viable intrauterine fetus and a closed cervical OS, remains a significant obstetric concern. In Ayurveda, this condition is comparable to Garbha Chalana or Garbhasrava, which is primarily attributed to vitiation of Vāta and Pitta Doṣa. Harita Saṃhitā recommends the administration of Mrinala (Nelumbo nucifera) and Nagakesara (Mesua ferrea) with cow's milk and cow's ghee for stabilization of pregnancy (Garbha Sthāapana). However, clinical evidence supporting this classical intervention is limited.

Aim: To evaluate the clinical efficacy of a classical Ayurvedic intervention comprising Mrinala Churna and Nagakesara Churna administered with cow's milk and cow's ghee as an adjunct to conventional management in a case of threatened miscarriage (Garbha Chalana), with the objective of promoting maternal and fetal well-being.

Case Presentation: A 27-year-old gravida 2 para 1 woman at 11 weeks and 5 days of gestation presented with intermittent painless vaginal bleeding of 15 days' duration. Ultrasonography confirmed a viable intrauterine pregnancy with a posterior low-lying placenta. Clinical evaluation and laboratory investigations ruled out major systemic abnormalities.

Intervention: The patient received conventional obstetric management with micronized progesterone along with Ayurvedic therapy consisting of Mrinala Churna (3 g) and Nagakesara Churna (3 g) twice daily, administered with 100 mL lukewarm cow's milk and 10 mL cow's ghee for 30 days. Routine antenatal care, including iron, folic acid, calcium supplementation, dietary advice, and regular follow-up, was continued.

Results: Vaginal bleeding subsided following treatment, and pregnancy progressed uneventfully to term. The patient delivered a healthy female infant by spontaneous vaginal delivery without maternal or fetal complications. The combined Ayurvedic formulation appeared to contribute to pregnancy stabilization through its Rakta-stambhana , Garbha-sthāpana, Vāta-Pitta Śamana, antioxidant, anti-inflammatory, and placental protective properties.

Conclusion: This case suggests that the classical Ayurvedic combination of Mrinala, Nagakesara, cow's milk, and cow's ghee may serve as a safe, non-invasive, cost-effective adjunctive therapy in the management of threatened miscarriage. The encouraging maternal and fetal outcomes warrant further validation through well-designed randomized controlled clinical trials.