International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 9 Issue 3, May-Jun 2025 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

Review Article on Garbhini Chardi WSR to Emesis Gravidarum

Dr. Trupti Anil Yadav1, Dr. Ishwari Patil2, Dr. Sonalika Hiremath3
1
PG Scholar, 2,3M.S Ayu,
1,2,3
NK Jabshetty Ayurvedic Medical College, Bidar, Karnataka, India

ABSTRACT How to cite this paper: Dr. Trupti Anil

Acharya charaka has given specific importance to pregnant women Yadav | Dr. Ishwari Patil | Dr. Sonalika
and has compared them with oil filled vessel, which can be split by Hiremath "Review Article on Garbhini
little displacement and to provide proper attention during pregnancy. Chardi WSR to Emesis Gravidarum"
Published in
Ayurvedic classics have mentioned Garbhini Chardi as one among
International Journal
the Vyakta garbha lakshanas, which can be correlated with emesis of Trend in
gravidarum. Emesis Gravidarum is a worldwide common obstetrical Scientific Research
problem seen in the first trimester of pregnancy in about 50% of and Development
pregnant women. Nausea and vomiting tend to be worse in the (ijtsrd), ISSN: 2456-
morning termed Morning sickness, they frequently continue 6470, Volume-9 | IJTSRD97150
throughout the day. Vomiting in the early weeks of pregnancy is very Issue-3, June 2025,
common. If we do not correct the simple vomiting it leads to severe. pp.1237-1240, URL:
So one should take care to treat this condition in initial stage and www.ijtsrd.com/papers/ijtsrd97150.pdf
prevent complications. Different formulations and recipes have been
mentioned in Ayurvedic classics which can easily be incorporated in Copyright © 2025 by author (s) and
International Journal of Trend in
day today life by a pregnant woman for Chardi. Hence in this study Scientific Research and Development
an effort is made to list out simple & effective management of Journal. This is an
Garbhini Chardi with the help of various herbal preparations. Open Access article
distributed under the
KEYWORDS: Garbhini Chardi, Emesis Gravidarum
terms of the Creative Commons
Attribution License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)

INTRODUCTION
The woman is considered as one of the most essential (insulting of desires) of Dauhrida (dual hearted i.e.
factor of the continuity of human race and pregnancy pregnant woman) or it may be caused by Garbha
is the biggest gift conferred on females by the nature, (presence of fetus). [3] Harita has described eight
same as stated by sage Charaka as ‘Women is the Garbha Upadravas which afflict the pregnant women,
origin of the progeny’.[1] Pregnancy is a time of and Hrillasa, Chardi are included among them. [4]
physical and hormonal changes and emotional and Kashyapa have not used the word Dauhridajanya or
psychological preparation for motherhood. During this Garbhajanya chardi under Antaravatnichiktisa but he
nine months long journey, pregnant women may explained management of Doshaja chardi in pregnant
suffer from minor to major ailments which are specific woman. It appears that he mentioned about the
to pregnant state. Hrillasa and Chardi are the associated type of vomiting. The commentator of
commonest minor ailments experienced during the Madhukosha on Madhavanidana described Utpidana
first trimester of the pregnancy. All most all of Garbha as a causative factor for vomiting during
compendiums and therapeutic lexicons of Ayurveda pregnancy.
dealt in detail about Chardi as independent disease as Sharangadhara has mentioned seven types of Chardi
well as a symptom of different diseases. Garbhini and included Garbhadhan as seventh one. [5] Emesis
chardi is described as a sub-division of a type of
gravidarum (nausea and vomiting) are the common
Chardi. It is also mentioned under the clinical features
complaints during the first half of pregnancy. They
of Vyaktagarbha. Sushruta while describing the causes are of varying severity usually commenced between
along with intake of different food materials etc., the first and second missed menstrual period and
Apannasatva or Garbhini is also mentioned. He has
continue until 14 to 16 weeks. Although nausea and
classified Chardi into five types and under fifth type vomiting tend to be worse in the morning-thus
that is Agantuja Chardi the Dauhridaja is also erroneously termed morning sickness, they frequently
enumerated as a cause.[2] Dalhana explained that continue throughout the day. Lacroix and co-workers
Dauhridaja means that is caused by Vimanana

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
(2000) have found that nausea and vomiting were How garbhini chardi is developed
reported by three fourth of pregnant women and Nidanas will lead to vitiation of Kapha dosha and
lasted an average of 35 days. Half of them had relief Pitta dosha which inturn vitiate Vata which forces the
by 14 weeks, and 90% by 22weeks. In 80 percent of Doshas to move in upward direction leading to
women, nausea was lasted all through the day. [6] Chardi.
Hyperemesis gravidarum is defined variably and is
During pregnancy, Nidanas like Garbha peedana
sufficiently severe to produce weight loss,
together with lack of proper Garbhini Paricharya
dehydration, ketosis, alkalosis from loss of
resulting in Agnimandya. Manasika Karanaas like
hydrochloric acid and hypokalemia. [7] Hyperemesis
Douhrida avamana can lead to Vata vruddhi and may
gravidarum if prolonged or left untreated may leads to
also lead to Agnimandya causing Kapha dushti. The
severe damage to maternal as well as fetus,
Kapha dushti together with the Pitta dushti will lead
sometimes it may even cause abortion. [8]
Utklishtata of Dosha or Aamasanchaya. These
Garbhini Chardi Utklishta doshas can cause Avarodha to the Gati of
There is no separate chapter that explain about vata which inturn brings about Kshobha to Amashaya.
Garbhini chardi in classics. Acharya Charaka The Utklishta doshas are expelled out through the
described details of classification of Chardi and its mouth by the action of Udana and Vyana vata
chikitsa. Acharya Susruta also mentioned about resulting in Chardi.
Chardi in detail. In the Nidana of Chardi, Acharya
Etiology
Susruta has given one Nidana as Naryaascha aapanna
The etiology of hyperemesis gravidarum is largely
satwa and Dalhana in his commentary explains
unknown, but several theories exist (see
Aapanna satwa as Garbhini. He has explained
pathophysiology). There are, however, risk factors
Douhrudaya as Nidana for Agantuja chardi, and
associated with the development of hyperemesis
Dalhana commentary explains Douhrudaya as caused
during pregnancy. Increased placental mass in the
by Garbha. Acharya Vagbhata also explains types of
setting of a molar or multiple gestations has been
Chardi and mentioned Dwishtardhajanya as one
associated with a higher risk of hyperemesis
classification of Chardi and also explained Dauhrida
gravidarum. Additionally, women who experience
as a cause of Chardi. Acharya Hareeta has considered
nausea and vomiting outside of pregnancy due to the
Chardi as one of the Upadrava of garbha. Acharya
consumption of estrogen-containing medications,
Kashyapa has explained that there is no difference of
exposure to motion, or have a history of migraines are
the physical and psychological disorders of a
at higher risk of experiencing nausea and vomiting
pregnant woman from any other individual. The
during pregnancy. Some studies also suggest a higher
diseases manifested in her will also be like the
risk of hyperemesis in women with first-degree
diseases of other persons. So the Nidana panchakas of
relatives, for instance, if her mother or sister
Chardi can be considered for Garbhini chardi also.
experienced hyperemesis gravidarum.
Accordingly the principles of treatment differ because
those are aimed at the proper development of Garbha Protective factors include the use of multivitamins
and the Garbhini. before six weeks of gestational age and maternal
cigarette smoking.
Flow chart of Samprapti of Garbhini chardi:
Garbha vrudhi & Douhrauda Avamana Pathophysiology
The exact cause of hyperemesis gravidarum remains
unclear. However, there are several theories for what
Utklista Dosha may contribute to the development of this disease
process.

Vilomagati of utlista doshas by Hormone Changes

vyana & udana Mukhapurana  Levels of human chorionic gonadotropin (hCG)
have been implicated. hCG levels peak during the
first trimester, corresponding to the typical onset
Garbhini Chardi of hyperemesis symptoms. Some studies show a
General causative factor correlation between higher hCG concentrations
High level of serum human chorionic gonadotropin, and hyperemesis. However, this data has not been
estrogen & altered immunological states are consistent.
considered responsible for initiation of the  Estrogen is also thought to contribute to nausea
manifestations which is probably aggravated by the and vomiting in pregnancy. Estradiol levels
neurogenic factors. increase early in pregnancy and decrease later,

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mirroring the typical course of nausea and same that of non pregnant women, the principles of
vomiting in pregnancy. Additionally, nausea and treatment differs from that of general Chardi. In
vomiting are the known side effects of estrogen- general Chardi chikitsa, Achararya charaka mentioned
containing medications. As the level of estrogen Langhana and Shodhana as line of treatment, which
increases, so does the incidence of vomiting. cannot be given to the pregnant women. Hence gentle
MODERN TREATMENT treatment adopted to minimize symptoms and also
Treatment should be guided by the American College maintains the growth of fetus.
of Obstetrics and Gynecology (ACOG) Nausea and Samanya chikitsa
Vomiting in Pregnancy guidelines. Pregnancy vomiting should be treated by providing
Initial treatment should begin with non-pharmacologic agreeable attendance and desired articles.
interventions such as switching the patient’s prenatal Chikitsa for Garbhini chardi is explained in
vitamins to folic acid supplementation only, using Samhitas:
Ginger supplementation (250 mg orally 4 times Use of Bhoonimba kalka with equal quantity of sugar.
daily) as needed and applying acupressure wristbands.
Shunti bilwa kashaya with Yava saktu. Paste of
If the patient continues to experience significant Dhanyaka with rice water and sugar.
symptoms, the first-line pharmacologic therapy should
Vilva phala majja with Lajambu.
include a combination of vitamin B6 (pyridoxine)
and doxylamine. Vishesha chikitsa
Acharya Kasyapa has mentioned doshanusara chikitsa
Three dosing regiments are endorsed by ACOG,
for chardi.
including –
1. pyridoxine 10 to 25 mg orally with 12.5 mg of A. Chikitsa in Vataja garbhini chardi
doxylamine 3 or 4 times per day. Leha of Matulunga rasa, Laaja, Kolamajja,
2. pyridoxine 10mg and doxylamine 10 mg up to 4 Daadimasara, Rasanjana, Sarkara & Madhu. Pakva
times per day. rasa of Amla dadima without salt.
3. pyridoxine 20mg and doxylamine 20mg upto 2 Samskaarita mahisha mamsa rasa.
times per day.
B. Chikitsa in Pittaja garbhini chardi
These are all FDA pregnancy category A Rice water with Laaja choorna, Sarkara and Madhu
medications. mixed with Chaturjata kalka and with Pushpa to make
 Second-line medications include Antihistamines Hrudya.
and Dopamine antagonists such as
dimenhydrinate 25 to 50 mg every 4 to 6 hours Peya of Laja with Sita and Kshoudra.
orally. Jangala mamsa rasa with Sarkara
diphenhydramine 25 to 50 mg every 4 to 6 C. Chikitsa in Kaphaja garbhini chardi-
hours orally, Kwatha of Jambu pallava and Amra pallava mixed
 If the patient continues to experience significant with Sita or madhu.
symptoms without exhibiting signs of Yoosha of Mudga and Dadima mixed with salt and
dehydration, metoclopramide, ondansetron, or Sneha.
promethazine may be given orally.
D. Chikitsa in Sannipataja garbhini chardi
 In the case of dehydration, intravenous fluid Combination of all above treatments should be given
boluses or continuous infusions of normal saline according to predominance of Dosha.
should be given in addition to intravenous
metoclopramide, ondansetron, or promethazine. E. Chikitsa in Krimija garbhini chardi
Electrolytes should be replaced as needed. Severe Kwatha prepared with Moola of Punarnarva and
refractory cases of hyperemesis gravidarum Bhadradaru along with honey.
may respond to intravenous or intramuscular Complication of Emesis gravidarum
chlorpromazine 25 to 50 mg or If proper care is not given, it may lead to
methylprednisolone 16 mg every 8 hours, orally Hyperemesis Gravidarum. Nutrition in Garbhini
or intravenously. chardi Vitamin B1, vitamin B6, vitamin C & vitamin
DISCUSSION B12 are needed. Research Information To confirm
AYURVEDIC MANAGEMENT scientific validity of these herbal formulations,
Even though Acharya Kashyapa has mentioned that number of pharmacological and clinical studies have
the diseases occurring in pregnant women is same as

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
been carried out by scientists of different faculties of [3] Sushruta, Sushruta Samhita, Nibandhasangraha
life sciences. Some of the studies are reviewed here. Commentary of Sri Dalhana Acharya, edited by
Vaidya Yadava Ji Tikrama Ji, Chaukambha
CONCLUSION
It can be concluded that in our classics various simple Surbharati Prakashan, Reprint 2010, Uttara
and safe herbal formulations have been explained for Tantra 49 Chapter, verse 3-5, Dalhana Acharya
Chardi which can easily be incorporated in day today teeka, page no.754.
life of pregnant woman and they are easy to prepare, [4] Harita Samhita, Pandit Hariharaprasad Tripathi,
easily available. Chaukhamba Krishnadas Academy, Varanasi,
REFERENCES reprint 2009, Chapter No:51/1
[1] Agnivesa, Charak Samhita, revised by Charak [5] Pandita Sharandharacharya, sharandhara
and Dridhabala, introduction with Sri Satya samhita, Annoted with Dipika Hindi
Narayan Shastri, with elaborated Vidyotinihindi Commentary, by Dr. Brahmananda Tripathi,
commentary by Pt. Kashinatha Shastri and Dr. Chaukambha Surbharati Prakashan, edition
Gorakhnatha Chaturvedi, Chaukhambha 2013, Purvakhanda 7/ 28, Page no.65.
Bharati Academy, Varanasi, part-two, Reprint
[6] Williams Obstetrics, 23 edition, McGraw Hill,
2012, Chikisthasthan 30/5, page no: 841 chapter 8, page no:210.
[2] Sushruta, Sushruta Samhita, edited with [7] Williams Obstetrics, 24 edition, McGraw Hill,
Ayurveda tatva sandipika by Kaviraj Ambika
chapter 54, page no:1071.
Dutta Shastri, Chaukhamba Sanskrit Sansthan,
Varanasi, part- two, edi: reprint 2011, [8] Williams Obstetrics, 24 edition, McGraw Hill,
Uttarasthana 49/13, page no: 459. chapter 54, page no:1071.

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