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Herbal medicine in pregnancy and childbirth
Abstract
Pregnant women often use medicinal herbs in an effort to maintain good health and reduce the need for medical intervention. A survey of the scientific and popular literature identified a number of therapeutic herbs used in North America. Three categories are discussed: tonics, herbs for preventing miscarriage, and herbs for inducing labor. Some of these preparations may address women's needs in ways that biomedicine has failed to do. Purported merits and hazards of these medications are discussed.
... In Ethiopia, a facility-based study conducted in Gondar revealed that 48.6% of pregnant women used herbal medicine and the commonly taken herbal medicines were garlic (19%) and ginger (40.7%) [24]. A facility-based study conducted among pregnant women in Nekemte; western Ethiopia showed that 69.8% of pregnant women used herbal remedies [25]. ...
... Before conducting the research, a pretest was carried out in another Kebele (non-selected) before two weeks of the data collection time on 63(10%) individuals and the pretest data was not incorporated in the data analysis. The questioner was adapted from similar kinds of published studies [11,[20][21][22][23][24][25]. The questioner was developed primarily in English and then translated into 'Amharic' and 'Gamotho', the local languages. ...
... Moreover, the average monthly income and the age distribution of the two participants were almost comparable [24]. Herbal medicine use in our study was lower than other researchers conducted in Ethiopia, for instance the Hossana town and Nekemete town reported 73.1% [34] and 50.4% [25], respectively. Our finding also lower than studies conducted in Mali (79.9%) [18], Bangladesh (70%) [10] and Nigeria (67.5) [19]. ...
... For instance, a recent report cited reproductive toxicity associated with some herbs used as food and remedy elsewhere (Wang et al., 2012). Relatedly, it was reported that some Chinese herbal medicines hitherto considered safe and effective (Marcus and Snodgrass, 2005;Ong et al., 2005;Westfall, 2001) produced serious congenital malformations in pregnant mice (Wang et al., 2012). We strongly suspect that with the long uneventful use of P. clappertoniana seeds in Ghana as food and remedy, it may present no maternal and developmental toxicities but rather improve reproductive performance. ...
... This study assessed the effect of PCE on the reproductive performance and toxicity in rodents. Oral PCE treatment improved reproductive performance and produced no observable maternal and developmental toxicity compared to reference drugs (folic acid and misoprostol), and these observations are important, especially at a time when many commonly used herbal resources are identified with a spectrum of adverse events (Marcus and Snodgrass, 2005;Ong et al., 2005;Rousseaux and Schachter, 2003;Westfall, 2001). ...
... But this study was limited by our inability to establish the effect of PCE on uterine contractility and the possible regulation of the uterine contractile proteins (CAV-1, GJAI, and PTGS2) as well as the site of action. Nonetheless, this study may be useful as a basis for further studies and also may allay fears and promote rationale and evidence-based usage of P. clappertoniana seeds in Ghana, given that many herbal resources used just like P. clappertoniana have been cited in connection with a spectrum of adverse effects (Marcus and Snodgrass, 2005;Ong et al., 2005;Rousseaux and Schachter, 2003;Westfall, 2001). ...
Ethnopharmacological relevance:
The seeds of Parkia clappertoniana Keay (Family: Fabaceae) are extensively used in food in the form of a local condiment called 'Dawadawa' in Ghana and consumed by all class of people including sensitive groups such as pregnant women and children. Also, crudely pounded preparations of P. clappertoniana seeds are used as labor inducing agent in farm animals by local farmers across northern Ghana where nomadism is the livelihood of most indigenes. Ecologically, P. clappertoniana is extensively distributed across the savannah ecological zone of many African countries where just like Ghana it enjoys ethnobotanical usage. Although, many studies have investigated some aspects of the pharmacological activity of P. clappertoniana, none of these studies focused on the reproductive system, particularly its effects on reproductive performance and toxicity. To contribute, this study assessed the effect of aqueous seed extract of P. clappertoniana (PCE) on reproductive performance and toxicity in Sprague-Dawley rats and ICR mice.
Methods:
After preparation of PCE, it was then tested on rodents at different gestational and developmental windows (1-7, 8-14, and 15-term gestational days) to assess the following: mating behavior, implantation rate, maternal and developmental toxicities. Generally, animals were randomly grouped into five and treated as follows: normal saline group (5ml/kg po), cytotec (misoprostol) group (200mg/kg po), folic acid group (5mg/kg po), and PCE groups (100, 200, and 500mg/kg po), however, these groupings were varied to suit the specific requirements of some parameters. For acute toxicity, animals were orally administered PCE (3 and 5g/kg for mice and rats respectively).
Results:
PCE-treated rats showed improved mating behavior compared to control rats. PCE improved implantation rate compared to misoprostol-treated rats. On the average, PCE-treated rats delivered termed live pubs at 21 days compared to that of folic acid-treated rats at 23 days. Also, PCE-treated rats showed no observable maternal and developmental toxicities compared to folic acid and control rats. PCE (3-5g/kg po) was orally tolerated in rodents.
Conclusion:
Oral administration of Parkia clappertoniana seed extract improves reproductive performance in rodents with no observable maternal and developmental toxicity.
... Allerdings lagen bis Mitte der 90er Jahre kaum Daten über den Gebrauch bzw. Nutzen-Risiko-Abschätzungen vor, was in den letzten Jahren zu verstärkter Forschung führte [1,[8][9][10][11][12][13][14][15]. ...
... Bei den Berichten wird auch nicht zwischen den unterschiedlichen medizinischen Traditionen, Medizinsystemen und der Herstellung von Heilpflanzenzubereitungen, geschweige denn den zugrundeliegenden medizinisch-pharmazeutischen Standards (industriell, traditionell) differenziert. Bei dieser Variationsbreite über die Art von «Naturheilmitteln» schwanken auch die Angaben über deren Gebrauch in Schwangerschaft und Stillzeit, je nach Land (Australien, Finnland, Frankreich, Nigeria, Südafrika, USA) und Studie zwischen 7 und 55% [13][14][15]. ...
Up to date there is a lack of systematically gathered data on the use of natural remedies (phytotherapeutic, homeopathic, anthroposophic, spagyric, Bach and Schussler remedies) during pregnancy and lactation. The aim of this non-representative pilot study on 139 women, who came for delivery to three institutions between mid-1997 and the beginning of 1998, was to receive data about how often and within which spectrum natural remedies are used during pregnancy and lactation. During pregnancy 96% and within the lactation period 84% of the women consumed at least 1 natural remedy. Phytotherapeutic drugs were used most frequently. In contrast to the widespread use of natural remedies by pregnant women and nursing mothers in this study, little information on the effectiveness and possible risks is available. Therefore it seems necessary to examine and evaluate natural remedies used during pregnancy and lactation.
... Our findings showed that this plant is viewed with some suspicion in the herbal literature, and considered unsafe (Wilkinson, 2000b). Also, this herb is identified as an emmenagogue and lists as contraindicated in pregnancy (Westfall, 2001), because it contains undisclosed levels of thujone and betain, two emmenagogic compounds (Anjum, Haque, Rahman, & Sarker, 2002 showed that there is a lack of evidence for safety and efficacy in promoting effective labor ). Cuzzolin et al. (2010) reported that cranberry safety remains unproven (Cuzzolin et al., 2010). ...
The use of herbal medicine has considerably grown worldwide in the past two decades. Studies have shown that the prevalence of herbal diet therapy in pregnancy ranged from 1% to 60% in different societies. Many clinical reports have shown that some herbal medicines may have toxic effects on pregnant women and their fetuses because active ingredients of some medicinal plants can readily pass through the biological barriers (e.g., placental barrier). In the present study, we aimed to systematically review the literature to discover potential benefits versus the hazards of herbal therapy during pregnancy. For this purpose, a comprehensive literature review was performed, and after the literature search and selection of the appropriate documents, the desired data were extracted and reported. From 35 articles with a total of 39,950 study population, the results showed that some medicinal plants could cause severe toxicity on mothers and fetuses, in addition to abortion during pregnancy. It was also shown that some plants may lead to developmental abnormalities or fetal death. Findings of this survey showed that some herbal medicines have toxic, teratogenic, and abortive potential, particularly in the first trimester of pregnancy because active ingredients of some medicinal plants are able to pass through the placental barrier and reach the fetus.
... Herbal medicines and nutraceuticals are often used to manage various forms of reproductive health problems, especially in pregnancy. ere has been increased use of such medications in women's health management [30][31][32]. Reports can be found on seed extracts of some medicinal plants in pregnant animals and also with a spectrum of adverse events [33][34][35][36]. ...
Unsweetened natural cocoa (UNCP) was evaluated for reproductive toxicity in rats. A preliminary genotoxic potential was evaluated by the DNA comet assay test using C57Bl/6 mice. Both therapeutic dose (TD; 900 mg/kg) and high dose (HD; 9000 mg/kg) of UNCP were used. White Wistar rats were used in two experimental groups. The females received UNCP 15 days before crossing with untreated males. The males received UNCP for 48 days before mating with untreated females. Subacute toxicity was observed during a 14-day oral administration of UNCP. Results show that a high tail DNA% was observed with methyl mesylate administration in all tissues analysed. The lowest tail DNA% value was observed in the liver (1.64 ± 0.26) and kidney (1.63 ± 0.30) during UNCP (TD) administration. UNCP did not induce observable physical congenital malformations on the pubs of treated female and male rats, lacks genotoxic potential, and did not adversely affect pregnancy index, pub weights, and survival index, but UNCP exhibited proimplantation potential (p>0.05).
... Moreover, the use of CAM to support health in pregnancy is on the increase worldwide (Westfall, 2001;Dugoua, 2010). Some researchers posit that this rise in the popularity of CAM is related to increased ethnic influences resulting from migration and globalisation (Coulter and Willis, 2004). ...
The prenatal use of medicines and recreational substances is of significant importance because there is insufficient information on the effects of medicines and recreational substances on pregnancy outcomes. In addition, literatures on health beliefs of pregnant women about medicine and recreational substance use are lacking. The aim of this thesis was to investigate medicine and recreational substance use during pregnancy in an antenatal population of London. The study was approved by the ethics committee. The first part of the thesis was a prospective cohort study of medicine and substance use across all trimesters (using survey methods), and the pregnancy outcomes (using the medical records); the second part was a qualitative study of the health beliefs of pregnant women which employed semi-structured telephone interviews and the Health Belief Model as a framework for data collection and analysis. The results of the prospective study demonstrated that the prevalence of use of prescription, over-the-counter and complementary and alternative medicines during at least one trimester were 32.5%, 50.2% and 57.1% respectively. The prevalence of exposure to alcohol, cigarette and illicit substances were 16.0%, 3.5% and 0.9% respectively. However, due to limited sample size, the study could not demonstrate an association between the medicines and substances used and increased risk of congenital anomalies in the baby. The qualitative study indicated that pregnant women’s adherence to medicines could be explained by women’s perception of the severity of a medical condition, risks of non-adherence to the medicine as well as anxiety about the risks of the medicine on the foetus. In the case of substance use, a low risk perception could be used to explain women’s behaviour. Healthcare professionals have a responsibility to counsel pregnant women about the benefits or risks of medicines and substances, informed by the best evidence, and guided by the women’s perceptions.
... 29,30 The herbal extract has continued to be used for regulating menses, promoting fertility, and preventing miscarriage. 31,32 It was noted in 2012 that surprisingly limited phytochemical characterization of this herb had been performed, especially given its commercial medicinal use and inclusion in herbal mixtures in both a mouse model study and a human clinical trial. 33 When investigating the open-chain saponins present in C. luteum, Challinor and De Voss reported detailed structural and stereochemical features, in addition to preliminary bioactivity data. ...
Herbal medicines, although significant components of health care for much of the global populace, are still far less stringently regulated than conventional pharmaceuticals. Safety and efficacy concerns arise because of the limited information regarding many of the phytochemicals present in herbal medicines. Chamaelirium luteum (false unicorn) is an indigenous American herb marketed for "women's issues". Recently, the potential bioactives, a new class of open-chain steroidal saponins, have been fully characterized and preliminary bioactivity assays have been performed. The present study utilized the Caco-2 cell monolayer model to evaluate metabolic vulnerability and potential bioavailability of eight saponins and sapogenins from false unicorn. No compound metabolism was detected in Caco-2 cell homogenate. One sapogenin, helogenin, exhibited low-to-moderate permeability across the monolayers. Three saponins - chamaeliroside A, heloside A, and 6-dehydrochamaeliroside A - were found to have moderate permeability. Transport studies indicated active transport of these saponins. In contrast, all saponins with more than two sugar units exhibited low permeability.
... [8][9][10][11][12] This widespread use extends into pregnancy, where reportedly between 10 and 74% of pregnant women in Africa, Australia, Europe, the United Kingdom, and the United States use herbal medicinal products. [13][14][15][16][17][18][19][20][21][22][23] In the United Kingdom, approximately 40% of pregnant women use herbal medicinal products to treat pregnancy related problems or as nutritional supplements to better pregnancy outcomes. 16,17 This use of herbal medicinal products appears to extend into the postnatal period with 31% of breastfeeding women reporting the use of complementary and alternative medicines, including herbal medicinal products, to treat a variety of ailments 24 or to improve milk flow. ...
Objective:
To report the incidence and nature of herbal medicinal products' adverse events and herb-drug interactions used by some pregnant and postnatal women.
Data sources:
The Allied and Complementary Medicine Database, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, the Cochrane Library, MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov were searched from inception until August 2018.
Methods of study selection:
Any studies reporting adverse events, herb-drug interactions or absence thereof associated with herbal medicinal products used during pregnancy or the postnatal period were included. Conference abstracts, pilot studies, and nonhuman studies were excluded. All included studies were critically appraised by two independent reviewers.
Tabulation, integration and results:
Database searches retrieved 3,487 citations. After duplicate removal and review of titles, abstracts, and full-text, 115 articles were critically appraised. After excluding irrelevant and low-quality articles, 74 articles were included for data extraction and synthesis. Adverse drug reactions, congenital malformations, fetal growth retardation or herb-drug interactions were the primary study objective reported by 19 of the 74 included studies, 16 cohort studies, one cross-sectional survey, and two randomized controlled trials. A total of 47 herbal medicinal products and 1,067,071 women were included in this review. Use of almond oil was associated with preterm birth (odds ratio 2.09, 95% CI 1.07-4.08), oral raspberry leaf was associated with cesarean delivery (adjusted odds ratio [AOR] 3.47, 95% CI 1.45-8.28); heavy licorice use was associated with early preterm birth by 3.07-fold (95% CI 1.17-8.05). African herbal medicine mwanaphepo was associated with maternal morbidity (AOR 1.28; 95% CI 1.09-1.50), and neonatal death or morbidity. Fourteen studies reported absence of adverse events. Four studies reported herb-drug interactions, but none studied adverse events arising from them.
Conclusion:
The use of herbal medicinal products during pregnancy and the postnatal period should be discouraged until robust evidence of safety is available.
Systematic review registration:
PROSPERO, CRD42017081058.
... It is traditionally used as a vegetable in Kenya where it is boiled and eaten [1] . The leave extracts are rich in proteins, vitamins, minerals and all the essential amino acids [3] . ...
Urtica massaica (Urticaceae) and Croton megalocarpus are used either as vegetables or as food additives and as medicine in traditional African societies. However, in spite of the widespread consumption of these plants as folklore remedies and for diet, there is a scarcity of scientific data on their teratogenicity. Hence this study sought to assess the teratogenic effects of these plants extracts in an animal model. The study was conducted using Swiss albino mice. The extracts of these plants were administered orally in mice which were then euthanized. The weights of the gravid uterus and pups, as well as the number of pups were determined. The pups were examined for gross malformations. The data set was analysed using one-way analysis of variance and Tukey as the post-Anova test. P < 0.05 was the limit of significance. U. massaica and C. megalocarpus caused 40% and 20% fetal partial resorption respectively. The latter also caused microcephaly and polyhydramnios. Hence U. massaica leaves and C. megalocarpus extracts exhibited teratogenic activity and should be used with care during pregnancy.
... Vitex was used by one woman who was undergoing in-vitro fertilization (IVF) treatment, and she showed signs of mild ovarian hyperstimulation (Cahill et al., 1994). Pregnant women use medicinal plants to give them greater control over their experience, and this control improves birth satisfaction (Clark et al., 2013;Hall et al., 2012;Shannon et al., 2010;Smith et al., 2010;Westfall, 2001;Zeyneloglu and Onalan, 2014). There are case reports of women who have become pregnant following alternative treatments. ...
This paper serves to fill a gap in the literature regarding evidence for the use of botanical remedies in the promotion of fertility. It examines the botanical remedies that were used in North America (1492–1900) for all stages of reproduction from preconception to birth, and discusses their potential for future use with present-day infertility treatments. Each medicinal plant discussed in this paper is assessed using an ethnomedicinal methodology that entails examining the published ethnobotanical, phytochemical and pharmacological data. A few clinical trials have shown that there is potential for medicinal plants to improve the success rate of assisted reproductive technology (ART) treatment if used in an integrated manner, similar to the integrated use of traditional Chinese medicine with ART treatment. For example, research has shown that older women who become pregnant have a high miscarriage rate, and this is one area that complementary and alternative medicines can address.
... Vyskytnúť sa môžu tiež alergické reakcie a gastrointestinálne ťažkosti ako je nevoľnosť, zvracanie a hnačka 48,49) . Toxicita: Toxicita pŕhľavy pri orálnom podaní je považovaná za veľmi nízku 50) . Kontraindikácie: Užívanie pŕhľavy sa neodporúča pri hypersenzitivite na pŕhľavu alebo inú rastlinu z čeľade Urticaceae a pri stavoch, kedy je odporučený znížený príjem tekutín ako srdcové a renálne ochorenia 49) . ...
Subjective perception of insufficient milk supply is one of the most common problems of nursing mothers. For centuries, herbs have been used to increase lactation and remain popular even today. There is only a limited number of studies proving their safety and effectivity, so their use is based primarily on previous experience. The use of certain herbs has shown that they could be effective and safe, but further research is needed to define terms of use. This paper describes preliminary findings on the mechanism of action, adverse effects and possible interactions observed in some herbs frequently used to promote lactation.Key words: phytotherapy lactation herbal galactagogue.
... Women are recognised to be the major users of HNP for treatment of disease and maintenance of health [3-5, 19, 20], and this widespread use also extends into pregnancy, where reportedly between 10 and 74% of pregnant women in Australia, Europe, UK and the USA use these products [21][22][23][24][25][26][27][28][29][30]. Recent data suggest that approximately 40% of UK pregnant women use HNP to treat pregnancy related problems such as nausea and vomiting or as nutritional supplements to aid fetal development [26,27]. ...
Background
Pregnant women are routinely prescribed medicines while self-medicating with herbal natural products to treat predominantly pregnancy related conditions. The aim of this study was to assess the potential for herb-drug interactions (HDIs) in pregnant women and to explore possible herb-drug interactions and their potential clinical significance. MethodsA cross-sectional survey of women during early pregnancy or immediately postpartum in North-East Scotland. Outcome measures included; Prescription medicines use excluding vitamins and potential HDIs assessed using Natural Medicines Comprehensive Database. ResultsThe survey was completed by 889 respondents (73% response rate). 45.3% (403) reported the use of at least one prescription medicine, excluding vitamins. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1–12). A total of 91 different prescription medicines were reported by respondents using HNPs. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1–12). Thirty-four herb-drug interactions were identified in 23 (12.7%) women with the potential to increase the risk of postpartum haemorrhage, alter maternal haemodynamics, and enhance maternal/fetal CNS depression.Almost all were rated as moderate (93.9%), one as a potentially major (ginger and nifedipine) and only one minor (ondansetron and chamomile). Conclusion
Almost half of pregnant women in this study were prescribed medicines excluding vitamins and minerals and almost half of these used HNPs. Potential moderate to severe HDIs were identified in an eighth of the study cohort. Healthcare professionals should be aware that the concurrent use of HNPs and prescription medicines during pregnancy is common and carries potential risks.
... [9] Scientific validation for the use of most of these plants parts and species in the management and treatments of antenatal and postnatal complications have been reported in various animal models. [10] Tridax procumbens Linn. (Asteraceae) is a plant that is native to tropical America and naturalized in tropical Africa. ...
Objective: In order to provide pharmacological rationale for folkloric use, this study was designed to investigate the effect and possible mechanisms of action of the ethanol leaf extract of Tridax procumbens (ELETP) on uterine smooth muscle. Methods: Isometric contractions of uterine muscle strips (UMS) preparations of non-gravid (NPRGR), early (EPRGR) and late gravid (LPRGR) rats, mounted in 50 ml organ bath were studied under an initial tension of 1 g, at 37 0C and pH of 7.4. Uterine muscle strip (UMS) were pre-contracted with phenylephrine (PE) (10-7 M) before being treated with various doses of ELETP (0.2-1.0 mg/ml). Mechanism of ELETP- induced contraction was further examined using atropine (10-4 M), L-NAME (10-4 M), indomethacin (10-4 M) and nifedipine (10-4 M). Results: The results showed that ELETP significantly increased contraction of UMS in a dose dependent manner with the gravid having higher responses. Also in the presence of ELETP the responses of UMS to acetylcholine (10-9 -10-5 M) and oxytoxin (10-6 -10-2 M) induced contraction were significantly (p<0.05) increased. The uterotonic effects caused by ELETP were significantly reduced when uterine strip were pre-incubated with calcium blocker (Nifedipine) by 94.6 %, 98.1% and 87.9%; Nitric oxide synthase inhibitor (L-NAME) 71.1 %, 41.4 % and 51.6 %; prostacyclin inhibitor (indomethacin) 57.7 %, 98.1 % and 87.9 % ; and muscarinic blocker (atropine) 82.4 %, 80.5 % and 81.9 % in NPRGR, EPRGR and LPRGR groups respectively. Conclusion: The results showed that ELETP enhanced contraction of uterine smooth muscle and this activity may probably involve calcium exchange as well as NO and prostacyclin pathways.
... However, the evidence to support its therapeutic functions is still limited. Furthermore, although there is no scientific basis for its claims of safety, vast numbers of pregnant women use it to maintain good health and reduce the need for medication [73]. No data are available to confirm the efficacy and safety of Chinese medicines, and no regulations have been established for monitoring or controlling its clinical applications for use during pregnancy. ...
For over 3,000 years, Traditional Chinese Medicine has been used to treat pregnant women. Today, Chinese medicines have principally been applied in mainland China and have increasingly used worldwide to promote the health of both the mother and fetus and to treat common pregnancy disorders. To date, no data are available to provide an overview of the use of Chinese medicine in pregnancy. In this chapter, the clinical applications, therapeutic effects and safety of Chinese medicines for pregnancy were reviewed. Over 3,000 studies have assessed Chinese medicines for pregnancy, including its indications, contraindications, formulas, individual medicines, regimes, effectiveness, efficacy, safety, adverse effects and toxicity. Among all the clinical applications, threatened miscarriage was the most common clinical indication. The Shou Tai Pill - which contains 4 major herbal medicines including Chinese Dodder Seed, Chinese Taxillus Twig, Donkey-hide Glue, and Himalayan Teasel Root - is the most commonly used formula in preventing miscarriage and promoting the continuation of a pregnancy. The range of clinical doses of individual Chinese medicines varies considerably, and the dosage is not associated with the overall efficacy or effectiveness. However, high-quality, randomized, controlled trials evaluating the effectiveness of the Chinese medicines are very limited for a systematic review or meta-analysis. Chinese medicines, in combination with other pharmaceuticals, appear to be more effective than other pharmaceuticals alone for improving the clinical outcomes in threatened miscarriage. Reports of specific adverse pregnancy outcomes and safety problems are diffuse, but potentially adverse and toxic effects on the reproductive system by certain medicines have been identified. The main objective of this chapter is to review the available clinical studies on Chinese medicines for their use in threatened miscarriage and to evaluate their potential adverse effects, including side effects and toxicity, to both mothers and children.
... However, the evidence to support its therapeutic functions is still limited. Furthermore, although there is no scientific basis for its claims of safety, vast numbers of pregnant women use it to maintain good health and reduce the need for medication [73]. No data are available to confirm the efficacy and safety of Chinese medicines, and no regulations have been established for monitoring or controlling its clinical applications for use during pregnancy. ...
... The use of plant remedies is also documented in native Northern American, where herbal medicines are taken as tonics during pregnancy to prepare for labour (e.g., raspberry leaf, patridge berry and stinging nettle), to prevent miscarriage (e.g., black haw and false unicorn) and to induce labour (blue cohosh, black cohosh and beth root) [4]. Other traditionally used medicines, such as raspberry leaves (Rubus idaeus L.), Castor oil (Ricinus communis L) and cotton bark root (Gossypium hirsutum L) are again receiving attention from midwives for application during pregnancy and labour [5,[6][7]. ...
The bark root of Steganotaenia araliacea Hochst (Umbelliferae) nicknamed " herbal pitocin " is used by traditional circle in Zambia to induce labour in pregnant women. This work was aimed at investigating the contractile stimulatory effects of the aqueous extracts of Steganotaenia araliacea (SAEª) on isolated smooth muscle preparations of the rat uterus to explain its reported local use. Objective of the study was to determine the physiological effect of SAEª root extract (nicknamed " herbal Pitocin'') on pregnant and non-pregnant uterine muscle. This work examined the effect of the aqueous extract of SAEª extract on rat uterus pre-treated with 1 mg/kg stilboesterol for 24 h and also on the pregnant rat uterus. The effects of reference agonists like oxytocin (OT) and Acetylcholine (Ach) were used and also antagonists like atropine (AT), indomethacin (Indo) and Salbutamol (SBM) on the uterine contractile effect of the extract were investigated. In vitro studies of SAEª on uterine tissue showed contractile activity which was dose dependant similar to OT and Ach while pre-treating the tissue with atropine, indomethacin or Salbutamol before administering the extract showed the inhibitory effects of the drug Salbutamol on the activity of the extract. The inhibition of contractile effect of the crude aqueous extract of Steganotaenia araliacea shown by Salbutamol (p < 0.05) suggests the probable stimulation of the Oxytocin-like receptors of the uterus by the extract. These physiological finding justify the traditional use of the plant for its uterotonic properties.
... Chinese medicines are generally regarded by the public and some health care providers as gentle and safe (Marcus and Snodgrass, 2005). Although there is no scientific basis for the safety claim, about 30-50% of pregnant women use it to maintain good health and reduce the need for Western medication (Westfall, 2001;Ong et al., 2005). Unlike other pharmaceutical drugs not recommend for use during pregnancy because of known or suspected adverse or teratogenic effects evidenced by animal studies and/or clinical trials, Chinese medicines have been historically utilized in the cultural context, there is no sufficient record or statistics regarding the adverse pregnant outcomes of using these herbs. ...
Chinese medicine is a common name for a collection of Chinese Materia Medica with therapeutic properties for medical treatment and healing. Similar to Western pharmaceuticals, Chinese medicines are not free of risk, and have the potential to cause adverse pregnancy outcomes and affect embryonic and fetal development. However, most clinical data concerning safety of maternal exposure to Chinese medicines during pregnancy are not available and the conclusion remains elusive. Some individual clinical trials of Chinese medicines reported some minor adverse effects during pregnancy, whereas few animal studies identified some adverse maternal and perinatal effects, as well as embryotoxic potentials. Basic research and mechanistic studies of the teratogenicity of Chinese medicines are still lacking. There is an urgent need for testing the safety of Chinese medicines before recommendation and commercialization. Until more reliable and scientific research data become available, clinicians should consider both the risks and benefits before recommending Chinese medicines to pregnant women. More systematic investigations of the safety implications of the use of Chinese medicines are highly recommended, in addition to more clinical trials with a larger sample size to confirm its safety during pregnancy. This review includes a critical overview of available clinical and experimental data and provides directions to study the safety issue of Chinese medicines for pregnancy. Birth Defects Research (Part C) 99:275-291, 2013. © 2013 Wiley Periodicals, Inc.
... Many medicinal plants have been used in the treatment of menstruation-, pregnancy-and birth-related problems (Westfall, 2001;Born et al. 2005;Zhu et al. 2008), with varying amounts of success (Gruber & O'Brien, 2011); however, scientific studies investigating the effects of medicinal plants on uterine contraction are scant. Thus, it is of interest to examine whether the traditional uses are supported by physiological and pharmacological evidence or merely based on folklore. ...
... Chinese medicines have commonly been used in pregnancy (Sionneau, 1995;Westfall, 2001). In our systematic literature research, Largehead Atractylodes Rhizome (LAR) is the most commonly used Chinese medicine to prevent early pregnancy loss due to threatened miscarriage (Li, 2011;Li et al., 2012b). ...
Largehead Atractylodes Rhizome (LAR) is the most commonly used Chinese herbal medicine for threatened miscarriage. Potential reproductive toxicity of LAR
was identified in early pregnancy in animals. Skeletal anomalies including loss of ulna and distal digits, shortening of humerus
and radius were observed in higher clinical dose groups. Here, we aimed to study the molecular mechanism of the congenital
malformation induced by LAR. In vitro whole mouse embryo culture was used to confirm the embryotoxicity effects of LAR on developing limb buds during early organogenesis.
A pregnant mouse model was employed to study the developmental gene expression by quantitative PCR and whole hybridization
and apoptosis by terminal deoxynucleotidyl transferase dUTP nick end labeling staining, in the forelimbs and hindlimbs during
development in vivo. Severe growth retardation, multiple embryonic malformations and delayed limb bud development were observed. Limb-specific
Tbx gene expressions in both developing forelimbs and hindlimbs were significantly decreased. Increased developmental apoptosis
in apical ectodermal ridge and mesenchymal mesoderm of the developing limb buds was identified. Overexpressions of Tbx2 and Tbx3 in embryos in vitro rescued LAR-induced abnormal limb development and reduced apoptosis in the developing forelimb buds. In conclusion, LAR affects
limb development by suppressing the expression of limb developmental genes and disturbing programmed cell death during limb
formation in mice.
... Chinese medicines are regarded by the public and some health-care providers as gentle and safe (Marcus and Snodgrass, 2005). Although there is no scientific basis for the safety claim, 30-50% of pregnant women use Chinese medicines to maintain good health and reduce the need for Western medication (Westfall, 2001;Ong et al., 2005). Despite the potential beneficial effects of Chinese medicines in threatened miscarriage , no data are available to confirm the safety of Chinese medicines and no regulations have been established to monitor and control its clinical applications in pregnancy. ...
Threatened miscarriage is very common in early pregnancy. Chinese medicines have been widely used to prevent spontaneous pregnancy loss. However, the safety of Chinese medicines is still unknown. A systematic review was performed to identify and describe adverse events of Chinese medicines used for threatened miscarriage.
Clinical studies of Chinese medicines for threatened miscarriage were selected. Primary outcomes were occurrence of adverse effects or toxicity of Chinese medicines. Secondary outcomes were failure of treatment and adverse pregnancy and perinatal outcomes.
Thirty-two relevant articles included 9 randomized controlled trials, 1 quasi-randomized controlled trial and 2 controlled trials comparing Chinese medicines alone or combined medicines with pharmaceuticals and 20 case series with no controls. Sample sizes of each study were generally small. There was variation in Chinese medicine formulation, dosage and duration of treatment. In the pooled randomized controlled trials, dry mouth, constipation and insomnia (2-10%) and intervention failure (3.1-22.3%), diabetic complications (3%), preterm delivery (5%) and neurodevelopmental morbidity (1.8%) were recorded. Meta-analysis demonstrated that intervention failure was significantly lower in the combined Chinese medicines groups than in the Western medicines controls (relative risk = 0.46; 95% confidence interval: 0.30-0.70, I(2)= 0%). No significant differences were found between these groups for adverse effects and toxicity or for adverse pregnancy and perinatal outcomes.
Studies varied considerably in design, interventions and outcome measures, therefore conclusive results remain elusive. In the absence of placebo-controlled trials, the safety of Chinese medicines for the treatment of threatened miscarriage is unknown. Rigorous scientific and clinical studies to assess the possible risks of Chinese medicines are needed.
... Herbal medicines are generally regarded by the public and some health-care providers as safe and effective (Marcus and Snodgrass, 2005). Despite the lack of scientific basis for the safety claims, vast numbers of pregnant women use it to maintain good health and reduce the need of medication (Westfall, 2001;Ong et al., 2005). Although therapeutic effects of Chinese herbal medicines for complicated pregnancy has been shown in our latest meta-analysis (Li et al., 2012), evidences of adverse events in the use of the medicines during pregnancy are very limited. ...
It is unclear how safe the use of Chinese herbal medicine is during pregnancy and if the herbal medicines do any harm to pregnancy, embryo-fetal development and prenatal and post-natal growth. A large-scale preclinical study was conducted to detect the adverse effects of Chinese herbal medicines during pregnancy.
Twenty of the most commonly used Chinese herbal medicines prescribed for pregnancy were selected and the crude extract was administered to pregnant mice at clinical doses during five different gestational stages, namely post-implantation, gastrulation, organogenesis, maturation and whole gestation periods. Maternal effects on side effects, weight loss, litter reduction, implantation failure and fetal resorption and perinatal effects on growth restriction, developmental delay, congenital malformations and post-natal mortality were determined.
Adverse pregnancy outcomes were commonly observed after maternal exposure to the herbal medicines, particularly during early pregnancy. Major events included maternal and perinatal mortality were recorded. Maternal weight gain, embryo growth and post-natal weight gain were significantly decreased. Fetal resorption and skeletal malformations were significantly increased.
Reproductive toxicity of Chinese herbal medicines commonly used during pregnancy was identified in mice. Caution should be taken in the clinical use of herbal medicines during pregnancy.
... Most Chinese medicines are derived from nature, including herbs, animal and mineral products (Chinese Pharmacopeia, 2010). Chinese medicines have been commonly used in pregnancy (Westfall, 2001), for reducing the chance of threatened miscarriage (Liang, 2008) and recurrent miscarriage (Shu et al., 2002), for promoting recovery from abortions (Wang et al., 2006) and for stabilizing pregnancy (Sionneau, 1995). ...
Largehead Atractylodes Rhizome (LAR) is the most commonly used Chinese medicine to prevent early pregnancy loss due to threatened miscarriage. However, its safety profile during pregnancy is still not available. Here we aimed to identify the potential adverse effects of LAR on embryo-fetal development as well as prenatal and post-natal growth.
Pregnant mice, rats and rabbits were orally administered with LAR extracts in various doses (from 1×, 2×, 3× and up to 6× clinical doses) at different gestational periods (implantation, gastrulation, organogenesis, maturation and whole gestation). Maternal effects on weight loss, implantation failure and fetal resorption and perinatal effects on developmental delay, growth restriction and congenital malformations were studied.
In mice, with early LAR exposure, a significant decrease in fetal growth parameters and a significant increase in post-implantation loss were identified. With late LAR exposure, significant increases in gestational duration as well as prenatal and post-natal mortality were found. At high clinical doses, congenital skeletal malformations were recorded. In rabbits, fetal resorption, hydrops fetalis and short ear anomaly were observed. No significant adverse effects were found in rats.
Potential reproductive toxicity of LAR in pregnant animals was identified within the clinical dose. Caution should be taken in clinical applications of LAR during pregnancy.
... The use of plant remedies is also documented in native Northern America, where herbal medicines are taken as tonics during pregnancy to prepare for labour (e.g., raspberry leaf, partridge berry and stinging nettle), to prevent miscarriage (e.g., black haw and false unicorn) and to induce labour (blue cohosh, black cohosh and beth root) [99]. Preparations of black cohosh root (Actaea racemosa [Nutt.] ...
Abnormalities in the process of uterine muscle contractility during pregnancy and birth can have major clinical implications, including preterm labour, which is the single largest cause of maternal and prenatal mortality in the Western world and a major contributor to childhood developmental problems. In contrast, induction of labour may be necessary in certain conditions. Currently used interventional therapies to suppress (tocolytic agents) or to induce (uterotonic agents) uterine contractions lack potency and/or selectivity and can have harmful side effects for mother and baby. Nature's diversity has always been, and still is, one of the biggest resources of therapeutic lead compounds. Many natural products exhibit biological activity against unrelated targets, thus providing researchers with starting points for drug development. In this review we will provide an overview of uterine muscle physiology, describe currently available biological screening procedures for testing of uterotonic plant compounds and will summarise traditionally-used uterotonic plants, their active components and their mechanisms, primarily focusing on uterotonic active circular plant peptides called cyclotides. Finally we will comment on the discovery of novel cyclotide-producing plant species and the possibility for the development of novel plant-derived uterotonic and tocolytic drugs.
Background
Although pregnancy has been an integral part of women’s lives for millennia, not all women have found the process comfortable. About 65 percent of women in India consume Indian traditional herbs during pregnancy. Herbal medicines are used nowadays by up to half of the world's population. Phytomedicines isolated from plants contain a wide variety of bioactive components that can have both negative and positive effects. Many herbal plants, such as Sage (Salvia fruticosa), golden cotula (Matricaria aurea), anise (P. anisum), peppermint (Mentha aquatica), and cumin (Cuminum cyminum), etc., are used in pregnancy. To minimize the adverse effects, the use of Indian traditional medicine can be the best possible alternative.
Objective
Regarding the usage of herbal medicines in India, there are large research gaps and a lack of a regulatory framework. This article aims to highlight the most common traditional Indian remedies used by pregnant women, along with their uses and any possible interactions between herbal remedies and prescription drugs.
Method
Several databases, including the WHO guidelines, PubMed, Bentham Science, Elsevier, Springer Nature, Wiley, and Research Gate, were used to compile the data for the article following a thorough analysis of the various research findings connected to pregnancy and herbs for pregnancy care.
Result
An overview of the use of herbal medicine is given in this review, along with information on its limitations and general safety. The prevalence of herbal medicine use during pregnancy in India is then discussed, along with the uses, adverse effects, side effects, and efficacy of the most popular herbal medications.
Conclusion
The use of herbal medicine during pregnancy is a common phenomenon. The outcomes of this study showed Indian Traditional medicines are known to have numerous advantages that can be helpful during or after pregnancy, including raising milk production, reducing nausea, easing labor pains, reducing morning sickness, or reducing flatulence, however, some herbal remedies have the potential to be teratogenic, poisonous, and abortive, especially during the first trimester of pregnancy because the active components of some medicinal plants can cross the placental barrier and get to the foetus. To determine the safety of taking herbal medications, studies, especially clinical trial trials, must be conducted.
Reproductive health care of women during pregnancy relies on both chemotherapy and Ayurvedic preparations. The preparation has both contraceptive and regulatory effects on different stages of pregnancy depending on different plants parts and plants. Although clinical trials have not been as fruitful as they should be but still a large population in India and abroad still have faith in prescriptions by faithful people around in addition to chance therapeutic treatment going on side by side. There are literature and ancient historical evidence giving strong evidence in favour of Ayurvedic preparations in healing side effects and containing consequences of unknown cause of termination of pregnancy and labour induction using Ayurvedic knowledge inherent in Garud Puran 198:27 and Yogachintamani : Mishradhikar I. India being rich in biodiversity and a population where every single person do not have access to chemotherapy millions out of them still explore and exploit the ancient historical perspectives to heal or to cure disease or reproductive health care. This short review present some factors that can leads to various reports available using different medicinal plant parts as traditional healers for curing gynaecological disorders.
Cancer is highly prevalent in the world and affects millions of people. Lung,
prostate, colorectal, and breast cancers are the most commonly identified among
cancer subjects and account for more than half of all cancer deaths. Surgery,
chemotherapy, radiotherapy, and hormonal therapy are the typical treatments for
cancer; however, the side effects of these treatments can be excessive and vary
widely according to subject’s health issues. At present, traditional herbal therapy
can be used in conjunction with conventional treatments. The use of anticancer
plants in medicine is becoming increasingly relevant, as they can reduce the side
effects of medical treatments and improve patients’ quality of life. Various tradi-
tional medical practices, including Chinese medicine, Ayurveda, Kampo, Unani,
and Korean medicine, use herbs as major ingredients of their practice, and the
effectiveness of these traditional medicines has been acknowledged after modern
scientific testing in many cases. The records of traditional anticancer plants used among various tribe, races, and nationalities are abundant. For instance, Liquorice
root (Glycyrrhiza glabra) and snake-needle grass (Oldenlandia diffusa) served
with hot water can help patients suffering from lung cancer. Likewise, Astragalus
membranaceus, Podophyllum hexandrum, Podophyllum petaton, and Arctium
lappa are commonly used all around the world to treat breast cancer. Colorectal
cancer is treated with ashwagandha (Withania somnifera), garlic (Allium sati-
vum), and ginger (Zingiber officinale). Therefore, there is an urgent need to doc-
ument these potential ethnomedicinal plants in terms of anticancer drug discovery
research. The scientific justification for these plants having a recuperative func-
tion in cancer must also be established. The main objective of this chapter is to
provide an overview on anticancer plants used in traditional medicine to treat
lung cancer, breast cancer, colorectal cancer, and prostate cancer.
Herbal medicines are widely used for centuries to treat illness and improve health in Asia and the use of these remedies has become a worldwide form of alternative therapy. However, there is very limited evidence from randomized controlled trials to support the efficacy of the vast majority of herbal products. Of the commonly used herbal medicines, systemic clinical experiences and promising experiments in animals have found potential evidence of efficacy for six herbal medicines (Unkei-to, Hachimijio-gan, Keishi-bukuryo-gan, Toki-shakuyaku-san, Shakuyaku-kanzo-to, Sairei-to) in the treatment for female reproductive dysfunction. Because herbs may contain potent bioactive substances, the physician should have an opportunity to outline more stringent regulation, similar to over-the counter drug.
Developmental toxicology and research in teratogenicity focus on xenobiotic substances that damage embryos and fetuses and lead to death, growth retardation, and/or malformation of offspring. While considerable information has been acquired about synthetic drugs and environmental xenobiotics, much less is known about the teratogenicity of herbal products. In this chapter we report on some major topics of developmental toxicity and teratogenicity, and discuss the safety of a few selected medicinal herbs in this context, i.e., Artemisia annua L., Caulophyllum thalictroides (L.) Michx., Echinacea spec,. Glycyrrhiza spec., herbs derived from Chinese medicine, Hypericum perforatum L., Panax ginseng C.A.Mey., Valeriana officinalis L., and Zingiber officinale Roscoe. Due to insufficient information on most herbal products, their safe use during pregnancy remains uncertain. Toxicological research for the professional development of safe herbal products should include
Measures of quality control (botanical, organoleptic, chemical, and molecular biological plant identification as well as standardization of cultivation, harvesting, and production processes and chemical constitution)
Identification of both pharmacological and toxicological modes of actions by means of state-of-the-art methods
Testing for the toxicity of herbal products in silico, in vitro, and in animal experiments.
Recurrent miscarriage is an uncommon complication during early pregnancy with vaiable prognosis. Chinese herbal medicines, regard as gentle, effective and safe, have been commonly used in mainland China and increasingly accepted as a complementary and alternative treatment worldwide nowadays for miscarriages, including recurrent miscarriage. However, no data are available to provide an overview of the use of Chinese herbal medicines for recurrent miscarriage. In this chapter, the clinical applications of Chinese herbal medicines for recurrent miscarriages were reviewed. The main objective is to review the available clinical studies on Chinese herbal medicines for their therapeutic use in prevention and treatment of recurrent miscarriage and for their potential adverse outcomes in mothers and babies. Bu Shen Gu Chong Pill and Tai Shan Pan Shan Powder were identified as the most popular formulae in preventing and treating recurrent miscarriage. The formulae mainly contain Radix Angelicae Sinensis, Radix Dipsaci, Radix Rehmanniae Praeparata, Rhizoma Atractylodis Macrocephalae and Fructus Amomi. The clinical doses of individual Chinese herbal medicines in the formulae varied considerably, but the dosage was not associated with the overall efficacy or effectiveness. Due to the lack of high-quality, randomized, and controlled trials in evaluating the effectiveness and safety of the Chinese herbal medicines, only few studies with relatively adequate methodology were included for the systematic review and meta-analysis. Combined Chinese herbal medicines with other pharmaceuticals were more effective than other pharmaceuticals or Chinese herbal medicines alone to prevent and treat recurrent miscarriage. Rarely adverse pregnancy outcomes and safety problems were studied and reported, so scientific evidences for the safety of Chinese herbal medicines as treatment for recurrent miscarriage are still limited. Conclusive results remain elusive.
ZusammenfassungBisher gibt es kaum systematisch erhobene Daten über den Gebrauch von Naturheilmitteln während Schwangerschaft und Stillzeit. Ziel dieser Pilotstudie an einem nicht repräsentativen Kollektiv von 139 Frauen, die von Mitte 1997 bis zum 2. Quartal 1998 zur Entbindung in drei geburtshilfliche Einrichtungen kamen, war es, Daten zu den Fragen nach der Häufigkeit und dem Spektrum der angewandten Naturheilmittel während Schwangerschaft und Stillzeit zu erheben. Während der Schwangerschaft nahmen mindestens 96% und in der Stillperiode 84% der Frauen mindestens 1 Naturheilmittel ein, wobei jeweils Phytotherapeutika am häufigsten benutzt wurden. Im Gegensatz zum weit verbreiteten Gebrauch von Naturheilmitteln bei Schwangeren und Stillenden in dieser Studie, und ihren Fragen dazu, existieren wenige nachvollziehbare Daten zur Wirksamkeit und zu einem eventuellen Risiko. Während der Schwangerschaft und Stillzeit benutzte Naturheilmittel sollten dahingehend gesichtet und beurteilt werden.
Many women use home remedies to maintain their health during pregnancy. Here, pregnant women's perspectives on herbal medicine are exposed in a small (n = 27) non-random sample of pregnant women in British Columbia, Canada, and follow-up interviews with six mentors from the community. While many of the women were cautious about using herbs during pregnancy, they considered them to be safer-as a general rule-than pharmaceutical drugs. Herbal tonics were widely used, and simple home remedies were usually the first line of defence against common health complaints. In choosing to self-medicate with herbs, the women said they were guided by prior knowledge (32%), trusted sources of advice (56%), and intuition (12%). A reliance on prior knowledge was not strongly correlated with the woman's age (r = -0.27) or the number of pregnancies she had experienced (r = 0.21). Trusted sources of advice included books, friends, family members, maternity care providers, herbalists, herb shops, and internet. The majority of herbal advice (69%) was received by word-of-mouth. The women's mentors were an important source of herbal self-care information.
The use of herbs to promote health or treat disease has become popular, and midwives increasingly encounter questions from childbearing clients regarding herbs. This article provides an overview of key concepts regarding the incorporation of herbs into clinical practice and discusses the preparation and administration of herbal treatments for common concerns of pregnancy. Safety issues are emphasized throughout.
U. dioica L. was used as medicinal plant since ancient times. Hydroalcoholic extract of the nettle root (Urticae radix) are currently used in the therapy of micturition disorders associated with slight and moderate BPH.
To document the use of herbal preparations for cervical ripening, induction, and augmentation of labor by certified nurse-midwives (CNMs) and nurse-midwifery education programs, a national survey of 500 members of the American College of Nurse-Midwives was conducted. Forty eight nurse-midwifery education programs were also surveyed to determine whether they were formally or informally educating students in the use of herbal preparations for cervical ripening, induction, or augmentation of labor. The results of this study, a review of the literature, professional issues, and recommendations for clinical practice are presented in this article. Of 500 questionnaires mailed to ACNM members, 90 were returned from CNMs who used herbal preparations to stimulate labor and 82 were returned from CNMs who did not use herbal preparations to stimulate labor. Three questionnaires were excluded due to incomplete data or blank questionnaires.
The use of herbs to promote health or treat disease has become popular, and midwives increasingly encounter questions from childbearing clients regarding herbs. This article provides an overview of key concepts regarding the incorporation of herbs into clinical practice and discusses the preparation and administration of herbal treatments for common concerns of pregnancy. Safety issues are emphasized throughout.
A newborn infant whose mother ingested an herbal medication, blue cohosh, to promote uterine contractions presented with acute myocardial infarction associated with profound congestive heart failure and shock. The infant remained critically ill for several weeks, although he eventually recovered. Other causes of myocardial infarction were carefully excluded. Blue cohosh, Caulophyllum thalictroides, contains vasoactive glycosides and an alkaloid known to produce toxic effects on the myocardium of laboratory animals. We believe this represents the first described case of deleterious human fetal effects from maternal consumption of blue cohosh.
Incluye un Database Manual of Biologically active phytochemicals and their activities Incluye bibliografía
La transmission par du lait de chevre d'une substance toxique presumee etre de l'anagyrine, un alcaloide du lupin, serait responsable du tableau malformatif et hematologique observe chez un nouveau-ne (aplasie erythrocytaire, veine azygos et hemimelie radiale bilaterale) dont la mere a bu ce lait de chevre durant la grossesse. Cette association s'observe aussi en pathologie veterinaire pour la meme raison
EtOH extracts of the rhizomes and aboveground portion of Trillium grandiflorum showed significant antifungal activity. Bioassay directed fractionation has led to the identification of the active components as the saponin glycosides 1 and 3.
Many compounds synthesized by plants are known to be teratogenic in laboratory animals, but only a few have been shown by feeding trials to produce terata in livestock. Studies of plant teratogens affecting livestock have not moved forward in a systematic nor rapid way because of the logistical problems connected with such experiments in large animals. Information that has accumulated can be conveniently separated into three categories: (1) known teratogens in known teratogenic plants, (2) known teratogenic plants with unidentified teratogens, and (3) suspected teratogenic plants. Included in the first group are the teratogens from Lupinus, Veratrum, Conium and Leucaena genera; in the second group are included the Astragalus , Nicotiana and Trachymene genera; and in the third group are included Datura, Prunus , Sorghum and Senecio genera. Total available information in each case varies, but in a few instances considerable fundamental as well as practical information is now known. Research has provided enough information in a few instances to enable elimination of the practical problem or significant reduction in incidence.
Numerous studies have documented that health care consumers all over the world are spending money out of pocket for alternative therapies and that billions of dollars are spent in the United States alone. In this article, the use of complementary and alternative therapies by women health care consumers is discussed, particularly as this phenomenon relates to women's reproductive health in the United States. Women use conventional health care services more frequently than men; thus, it is not surprising that women account for approximately two thirds of health care appointments for complementary and alternative therapies. The traditional conceptual frameworks of herbal medicine, homeopathy, acupuncture, and acupressure are presented, and common clinical applications to women's reproductive care are discussed.
PIP
Complementary and alternative therapies are gaining acceptance in the US and other countries, both among health providers and consumers. The potential for integration of complementary and alternative therapies into traditional patient care and contemporary models of science is a topic of increasing discussion. Women account for two-thirds of appointments with US practitioners of alternative medicine. Reproductive health problems, including menstruation disorders, infertility, menopause, and dysfunctions of pregnancy and delivery, offer opportunities for clinical applications of alternative approaches. Many midwives and nurses are interested in these approaches and have sought out special training. This article reviews three alternative approaches available in the US--herbal medicine, homeopathy, and acupuncture and acupressure--and discusses their potential applications to women's reproductive health care.
The reproducible quality of phytopharmaceuticals--herbal medicines--is an essential prerequisite for good efficacy and tolerability in the treatment of functional disorders. In clinical trials and scientific investigations, standardized assessments (i.e., validated, internationally recognized and accepted scales) provide the basis for establishing clinical efficacy and tolerability. Extracts (ethanolic and isopropanolic aqueous, Remifemin) of the rootstock of the herb Cimicifuga racemosa (black cohosh) are active ingredients developed for the treatment of gynecologic disorders, particularly climacteric symptoms. Drug-monitoring and clinical studies documenting experience with C. racemosa rootstock extracts comprise the database of this herbal treatment for menopausal symptoms (e.g., hot flashes, profuse sweating, sleep disturbances, depressive moods). These studies show good therapeutic efficacy and tolerability profiles for C. racemosa. In addition, clinical and experimental investigations indicate that the rootstock of C. racemosa does not show hormone-like activity, as was originally postulated.
To document the use of herbal preparations for cervical ripening, induction, and augmentation of labor by certified nurse-midwives (CNMs) and nurse-midwifery education programs, a national survey of 500 members of the American College of Nurse-Midwives was conducted. Forty eight nurse-midwifery education programs were also surveyed to determine whether they were formally or informally educating students in the use of herbal preparations for cervical ripening, induction, or augmentation of labor. The results of this study, a review of the literature, professional issues, and recommendations for clinical practice are presented in this article. Of 500 questionnaires mailed to ACNM members, 90 were returned from CNMs who used herbal preparations to stimulate labor and 82 were returned from CNMs who did not use herbal preparations to stimulate labor. Three questionnaires were excluded due to incomplete data or blank questionnaires.
Epidemiologic studies have suggested that consumption of phytoestrogen-rich foods may protect against breast cancer, and phytoestrogens such as genistein have been reported to both inhibit and stimulate the growth of some human breast cancer cells. The phytoestrogens genistein, daidzein, biochanin A, and coumestrol were tested and found to inhibit serum-stimulated growth in both T-47D and MCF-7 breast cancer cells at 10-100 microM. Extracts of several estrogenic herbs, including hops, black cohosh and vitex, inhibited growth of T-47D cells. These in vitro results suggest that certain herbs and phytoestrogens may have potential in the prevention of breast cancer.
Women in the United States are increasingly turning to botanical medicines to treat conditions throughout their life cycles. Many herbs traditionally used for women's health conditions have been found to contain phytoestrogens. Phytoestrogens and their metabolites can bind estrogen receptors and can have both estrogenic and anti-estrogenic effects. Many women are attracted to the idea of using phytomedicine as an alternative to hormone replacement therapy. It is unclear, however, whether these herbs are safe for women at risk for breast cancer or its recurrence. This paper considers the estrogenicity of herbs such as black cohosh (Cimicifuga racemosa) and the implications for women's health.
The novel alkaloid thalictroidine (1), as well as the known alkaloids taspine (2), magnoflorine (3), anagyrine (4), baptifoline (5), 5,6-dehydro-alpha-isolupanine (6), alpha-isolupanine (7), lupanine (8), N-methylcytisine (9), and sparteine (10), were identified from an extract of Caulophyllum thalictroides rhizomes. N-Methylcytisine exhibited teratogenic activity in the rat embryo culture (REC), an in vitro method to detect potential teratogens. The structure of 1 was elucidated using various spectroscopic methods, primarily by NMR techniques. Thalictroidine, anagyrine, and alpha-isolupanine were not teratogenic in the REC at tested concentrations. Taspine (2) showed high embryotoxicity, but no teratogenic activity, in the REC.
The purpose of this study was to examine the safety and efficacy of raspberry leaf products consumed by a group of mothers during their pregnancy, by comparison with a group of mothers who did not. A retrospective observational design was used. Subjects were women who birth their babies at Westmead Hospital between January 1998-July 1998. The sample consisted of 108 mothers; 57 (52.8%) consumed raspberry leaf products while 51 (47.2%) were in the control group. The findings suggest that the raspberry leaf herb can be consumed by women during their pregnancy for the purpose for which it is taken, that is, to shorten labour with no identified side effects for the women or their babies. The findings also suggest ingestion of the drug might decrease the likelihood of pre and post-term gestation. An unexpected finding in this study seems to indicate that women who ingest raspberry leaf might be less likely to receive an artificial rupture of their membranes, or require a caesarean section, forceps or vacuum birth than the women in the control group.
Eight new triterpene glycosides named cimiracemosides A-H, respectively, and eight known triterpene glycosides were isolated from the rhizome extracts of black cohosh (Cimicifuga racemosa). The new compounds were determined by spectral data to be 21-hydroxycimigenol-3-O-alpha-L-arabinopyranoside (1), 21-hydroxycimigenol-3-O-beta-D-xylopyranoside (2), cimigenol-3-O-alpha-L-arabinopyranoside (3), 12beta-acetoxycimigenol-3-O-alpha-L-arabinopyranoside (4), 24-acetylisodahurinol-3-O-beta-D-xylopyranoside (5), 20(S),22(R), 23(S),24(R)-16beta:23;22:25-diepoxy-12beta-acetoxy-3be ta,23, 24-trihydroxy-9,19-cycloanost-7-ene-3-O-beta-D-xylopyranoside (6), 20(S),22(R),23(S),24(R)-16beta:23;22:25-diepoxy-12beta -acetoxy-3beta, 23,24-trihydroxy-9,19-cycloanost-7-en-3-O-alpha-L-arabinopyrano side (7), and 20(S),22(R),23(S), 24(R)-16beta:23;22:25-diepoxy-12beta-acetoxy-3beta,23, 24-trihydroxy-9,19-cycloanostane-3-O-beta-D-xylopyranoside (8).
Pharmacological studies demonstrate that the outstanding action of a crystalline glycoside isolated from Caulopbyllum thalictroides is that of a smooth muscle stimulant.
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