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Herbal Medicine Use during Pregnancy: Benefits and Untoward Effects

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Chapter 7
Herbal Medicine Use during Pregnancy: Benefits and
Untoward Effects
Tariku Laelago
Additional information is available at the end of the chapter
http://dx.doi.org/10.5772/intechopen.76896
Abstract
The use of herbal medicine has been on an increase over time. The most commonly used
herbs are ginger, cranberry, valerian, raspberry leaf, chamomile, peppermint, thyme, fenu-
greek, green tea, sage, anise, garlic and bitter kola. The use of herbal medicine during
pregnancy is associated with educational status of women, income level of household and
age of women. Herbal medicines were used during pregnancy to treat nausea and vomiting,
reduce the risk of preeclampsia, shorten labour and treat common cold and urinary tract
infection. Using herbal medicine occasionally causes trouble. Heartburn, pre-mature labour,
miscarriage, increase in blood flow, abortion and allergic reactions are the common troubles
of herbal medicine use during pregnancy. Using herbal medicine during the first trimester
and the third trimester is unsafe for the foetus. Pregnant women should talk to health
professionals before consuming any herbal medicines. The unfortunate consequences of
using herbal medicine during pregnancy need further study for various herbs. Therefore,
clinical trial research should be done to identify unfortunate consequences of herbal medi-
cine use during pregnancy.
Keywords: benefits, herbal medicine, pregnancy, safety, untoward effect
1. Introduction
Herbal medicine has been used for disease prevention and treating ailments worldwide. It is
known that between 65 and 85% of the world population used herbal medicine as their primary
form of health care [1]. The prevalence of herbal medicine use during pregnancy ranges from 12
to 82.3% [2, 3]. Ginger, garlic, raspberry, cranberry, valerian, chamomile, peppermint and fenu-
greek are frequently used herbal medicines during pregnancy [2, 411]. Using herbal medicine
during pregnancy has controversial issues. Even though, herbal medicine is easily available as
© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
compared to other medicines, the safety issue during pregnancy is a concern. Using herbal
medicine in first 3 months and late in third trimester is dangerous for the foetus. Before using
any herbal medicine, it is better to consult the doctor and the pharmacist to ensure that the herbs
are appropriate and safe to use during pregnancy [12]. In pregnancy, mothers are concerned
about all medications that may affect their health, the health of the foetus, and the pregnancy
outcomes. Availing evidence-based information about benefits and untoward effects of herbal
medicine use during pregnancy is important for safer pregnancy and healthy foetus. The aim of
this chapter is to provide the best available information on benefits and untoward effects of
herbal medicine use during pregnancy. This chapter identified the prevalence of herbal medicine
use during pregnancy across regions and countries. The chapter also identified the commonly
used herbs and described the character of women who used herbs during pregnancy. The
benefits and untoward effects of commonly used herbal medicine during pregnancy are
reviewed based on scientific findings.
2. Herbal medicine use during pregnancy: benefits and untoward effects
Herbal medicine use during pregnancy is common across regions and countries. The preva-
lence of herbal medicine use during pregnancy is varied across regions and countries. Multi-
national study conducted in different countries showed that 28.9% of pregnant women used
herbal medicine during pregnancy [2, 4]. A literature review from the Middle East revealed
that up to 82.2% of the women used herbal medicine at some point during pregnancy. The
study also identified that many women used herbal medicine during the first trimester [5]. An
observational cohort study done in South West England found that 26.7% of the women used a
complementary or alternative medicine at least once during pregnancy. The use of herbs rose
from 6% in the first trimester to 12.4% in the second trimester and to 26.3% in third trimester
[13]. In Australia, 36% of the women took at least one herbal medicine during pregnancy [14].
Studies done in Africa showed the prevalence of herbal medicine use during pregnancy was
between 12 and 73.1% [3, 69, 1519].
The most commonly consumed herbal medicines during pregnancy include; ginger [2, 411],
cranberry [2, 4, 1011], valerian [2, 4, 10], raspberry leaf [2, 4, 1011, 13], chamomile [1314],
peppermint [5, 13], rosehip [13], thyme [5], fenugreek [5, 9], green tea, sage, and aniseed [5].
Eucalyptus, tenaadam (Ruta chalepensis), damakess (Ocimum lamiifolium), feto, omore are also
other herbal medicines used during pregnancy [68]. Garlic [68, 1518], palm kernel oil, bitter
kola and dogonyaro (Azadirachta indica) are other herbs that are used during pregnancy [1518].
Being students, having no education, having low income and having tertiary education level
make women more likely to use herbal medicine during pregnancy [2, 4, 68, 1518]. The other
factors that make women more likely to consume herbal medicines are being primiparas [2, 4, 9],
non-smoking [2, 9] and old age women [1314].
Based on the available researches and literature reviews, the most commonly used herbal
medicines during pregnancy are identified. The benefits and untoward effects of the herbs are
also reviewed.
Herbal Medicine104
2.1. Ginger (Zingiber officinale)
Common names of ginger is African ginger, black ginger, Cochin ginger, gingembre, ginger
root, imber, and Jamaica ginger [20].
2.1.1. Benefits of ginger
Ginger is used as anti-nauseant and anti-emetic for nausea and for hyperemesis gravidarum.
The recommended daily dose of ginger is up to 1g dried powder [21]. A single blind clinical
trial showed ginger as an effective herbal medicine for decreasing nausea and vomiting during
pregnancy. This study also suggested a daily total of 100 mg ginger in a capsule [22].
A randomized controlled clinical trial conducted on 120 women over 20 weeks of gestation with
symptoms of morning sickness showed consumption of 1500 mg of dried ginger for 4 days
improves nausea and vomiting. The study also revealed that newborns whose mothers con-
sumed ginger during pregnancy had normal birth weights and normal APGAR score [23].
Consumption of ginger in amounts used in food preparation is likely to be safe. Taking 12g
dried ginger over the course of a day has been shown to relive symptoms of minor disorder of
pregnancy [2426]. Using higher doses of ginger is not safe for pregnant women. Thus, pregnant
women should not use higher dose of ginger.
2.1.2. Untoward effects of ginger
A literature review reported that ginger is not a safe herb. It is a potential abortifacient with
high doses (>1000 mg daily consumption). Higher doses of ginger can cause thinning of blood,
stomach discomfort and heartburn [2427].
2.2. Garlic (Allium sativa)
Garlic is a perennial herb cultivated in different countries. It is commonly used as a food
ingredient and as a spice in different countries [28].
2.2.1. Benefits of garlic
Study conducted on antimicrobial and antifungal activity of garlic showed antibacterial and
antifungal features of garlic make it nutritious to consume during pregnancy [29]. Garlic
enhances a womans immune system; this in turn helps women to have healthy pregnancy and
healthy babies. Eating garlic during pregnancy is important to reduce the risk of preeclampsia
and protein retention in urine [30]. A randomized controlled study was conducted where 100
primigravida were treated with either garlic tablets (800 mg/day) or placebo during the third
trimester of pregnancy to determine the effect of garlic tablets supplementation on preeclampsia.
With the exception of a garlic odour, the few side effects like nausea were reported because of
garlic consumption during the third trimester of pregnancy. Pregnancy outcomes were compa-
rable in both treated with garlic and the placebo group. The study did not report any incidence
of major or minor malformations in newborn infants and there were no spontaneous abortions of
the foetuses [31].
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2.2.2. Untoward effects of garlic
Excessive use of garlic should be avoided in early pregnancy. Pregnant women with thyroid
disorders should avoid its use. Pregnant women should also avoid using garlic prior to
surgery including caesarean as it may interfere with blood clotting. Another untoward effect
of using garlic during pregnancy is that it may aggravate heartburn [32].
2.3. Cranberry (Vaccinium macrocarpon)
There are different types of cranberries: American cranberry, Arandano Americano, Arandano
Trepador, Cranberries, European cranberry, Grosse Moosbeere, kranbeere, large cranberry,
Moosebeere, Mossberry [20].
2.3.1. Benefits of cranberry
Using cranberry during pregnancy is important to prevent urinary tract infection [33], stomach
ulcer [3435], periodontal diseases [3638] and influenza [39]. A survey conducted on 400
Norwegian postpartum women reported that cranberry was one of the most commonly used
herbs during pregnancy, mostly for urinary tract infection [40].
2.3.2. Untoward effects of cranberry
The untoward effects of cranberry use during pregnancy needs further investigations.
2.4. Valerian (Valeriana officinalis)
Valerian is native to Europe and Asia and has naturalized in Eastern North America. It has
been extensively cultivated in Northern Europe [41].
2.4.1. Benefits of valerian
Valerian is used as a mild sedative to help patients fall asleep and relieve stress and anxiety.
There is a lack of safety information on consumption of valerian during pregnancy. It is highly
recommended that pregnant women talk to the doctor before taking valerian during preg-
nancy [24, 26, 42]. Study conducted on effect of valerian consumption during pregnancy on
cortical volume and the levels of zinc and copper in brain tissue of mouse foetus showed
valerian consumption in pregnancy had no significant effect on brain weight and cerebral
cortex volume and copper level in foetal brain [43].
2.4.2. Untoward effects of valerian
Studies conducted on mouse foetus presented that consumption of valerian during pregnancy
had significant decrease in the level of zinc in the brain [43]. This finding suggests that valerian
use during pregnancy should be limited.
Herbal Medicine106
2.5. Bitter kola
Bitter kola is a plant that comes from Africa. Africans have been using bitter kola for pregnant
women since ages. Nowadays, bitter kola popularity has spread worldwide [44].
2.5.1. Benefits of bitter kola
Drinking bitter kola is good for pregnancy. Bitter kola contains nutrients and vitamins good for
pregnancy. For Africans, bitter kola is the best supplement for pregnant women. Health
benefits of bitter kola include treating nausea and vomiting, making uterus healthier, strength-
ening pregnant women and normalizing blood circulation in pregnant women. Bitter kola
contains very strong caffeine. One bean of bitter kola contains the same amount of caffeine as
two glasses of coffee. Thus, pregnant women have to drink the recommended dose (one small
cup of bitter kola in a day) [44].
2.5.2. Untoward effects of bitter kola
Using very high doses of bitter kola is not recommended. A very high dose of bitter kola is not
good for the uterus of the woman [45].
2.6. Fenugreek (Trigonella foenum-graecum)
Fenugreek is an annual leguminous herb that belongs to the family fabaceae, which is found as
a wild plant and cultivated in Northern India. It is a galactagogue [46].
2.6.1. Benefits of fenugreek
Consumption of fenugreek during pregnancy increases milk production in pregnant women.
The exact mechanism of fenugreek consumption and increasing milk production is not well
understood. However, it is believed that seeds of fenugreek contain the precursor of a hor-
mone that increases milk production [45, 46].
2.6.2. Untoward effect of fenugreek
Large amounts of fenugreek may cause uterine contractions, miscarriage or premature labour.
It could affect blood sugar levels, so pregnant women with insulin-dependent diabetes
mellitus should avoid it. It can also cause heartburn [47].
2.7. Red raspberry leaf (Rubus idaeus)
Red raspberry leaf is known as garden raspberry leaf. The deciduous raspberry plant produces
it [48].
2.7.1. Benefits of red raspberry
Red raspberry leaf has mineral rich nutritive and uterine tonic to promote an expedient
labour with minimal bleeding. It can also be used as an astringent to diarrhoea. In a study
Herbal Medicine Use during Pregnancy: Benefits and Untoward Effects
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107
based on two clinical trials, there was positive association with red raspberry use and
astringency in the case of diarrhoea. Daily recommended dose is 1.55g[2324]. Tradition-
ally, red raspberry leaf has been used in late pregnancy to shorten the duration of labour and
to reduce complications of pregnancy. Pregnant women should consult a doctor or a phar-
macist for advice before using red raspberry leaf in pregnancy in a tea or infusion [49]. Red
raspberry fruit is not believed to pose risk to the mother or to the baby during pregnancy.
Some women take it as a labour aid during the last 2 months before delivery, whereas others
take it throughout the pregnancy. In a randomized clinical trial, 192 women at 32 weeks of
gestation received 1.2 g of raspberry leaf tablets twice daily. The study reported no adverse
effects to mothers or infants. The active treatment with raspberry leaf shortened the second
stage of labour and lowered the rate of forceps delivery. A retrospective observational study
conducted on 108 pregnant women showed that 57 women who ingested raspberry leaves
were less likely to have an artificial rupture of membranes or to require caesarean section,
forceps or vacuum birth than 51 controls [5051]. Women have used red raspberry leaves for
painful periods in pregnancy, morning sickness, to prevent miscarriage, easing labour and
delivery and enriching breast milk [52].
2.7.2. Untoward effects of red raspberry
The untoward effect of red raspberry needs further investigations.
2.8. Chamomile (Matricaria recutita)
There are two types of chamomile: German and Roman. The common German variety comes
from the flower Matricaria recutita, and the less common Roman variety comes from the flower
Chamaemelum nobile. German chamomile is used in teas and other supplements such as capsule
and oils [53].
2.8.1. Benefits of chamomile
Chamomile is used as a mild sedative and to aid digestion [32]. It has been used for the
treatment of morning sickness [54]. German chamomile is the type used most often as a
medicinal herb, extracts of which have been reported to increase the tone of uterus muscle
[53]. Chamomile does not contain caffeine, which makes it safer for pregnant women, but
there is some controversy over the safety of certain herbs not fully described by the Food
and Drug Administration. There is insufficient information to say for sure whether cham-
omile can cause harm during pregnancy. As with many other herbs, the full effect of
chamomile, especially in association with other medicines and herbs, has not been studied
conclusively [55].
2.8.2. Untoward effect of chamomile
Chamomile may cause increased blood flow, contractions, miscarriage or premature labour. It
can also cause allergic reactions [47].
Herbal Medicine108
2.9. Clary sage (Salvia officinale)
Clary sage is a plant native to Italy, Syria and Southern France and grows in dry soil. The
essential oil is distilled from the flowers and flowering tips [56].
2.9.1. Benefits of clary sage
It is recommended that clary sage only be used from 37 weeks onwards. It may be used to
induce labour if the body is ready to go into labour. It may stimulate the release of oxytocin in
pregnant women [56]. Using clary sage is highly recommended during labour to help contrac-
tions to intensify and become more effective in pulling up the horizontal uterine muscles to
open the cervix and move the baby down into the pelvis and into the birth canal. The simplest
and most common way to use clary sage during labour is to put a few drops on to dry cloth;
the mother will inhale the aroma when she needs it to help herself become more calm and
relaxed during contractions [5657].
2.9.2. Untoward effects of clary sage
Large doses best avoided for concern of potential miscarriage and abortifacient effect [47].
2.10. Anise (Pimpinella anisum)
Anise is known as aniseed. There are two types of anise: anise (Pimpinella anisum) and star
anise (Illicium verum) Chinese star anise [58].
2.10.1. Benefits of anise
Orally, anise is used for dyspepsia, flatulence, rhinorrhoea (runny nose) and as an expectorant,
diuretic, and appetite stimulant. Anise is also used to increase lactation and facilitate birth.
Topically, anise is used for lice, scabies and psoriasis treatment. Using anise during pregnancy
is likely safe when used orally in amounts commonly found in food. There is insufficient
reliable information available about safety of anise when taken orally in medicinal amounts
during pregnancy [59]. Anise used in small amounts in herbal tea is safer in pregnancy because
exposure is relatively low [58].
2.10.2. Untoward effects of anise
When used topically, anise in combination with other herbs can cause localized pruritis. In
allergic patients, inhaled or ingested anise can cause rhino conjunctivitis, occupational asthma
and anaphylaxis [59]. Essential oil and concentrated anise should be avoided in pregnancy for
the concern that they might trigger early labour [58].
2.11. Green tea (Camellia sinensis)
Green tea is mostly consumed in Middle East.
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2.11.1. Benefits of green tea
Green tea is important to regulate blood sugar, cholesterol and blood pressure levels. It also
speeds up the bodys metabolic rate and provides a natural source of energy. It can help
stabilize a pregnant mothers mood [60]. However, drinking too high a dose of green tea is
not recommended. The recommended dose of caffeine per day is 300 mg [61].
2.11.2. Untoward effect of green tea
Pregnant women who consumed green tea are at risk of spontaneous abortion as shown by the
following two studies. A case control study conducted on 3149 pregnant women showed that
serum paraxanthine (caffeine metabolite) was higher in women who had spontaneous abor-
tions than in controls [62]. Another case control study conducted on 1498 pregnant women
also showed that consumption of 375 mg or more caffeine per day during pregnancy might
increase the risk of spontaneous abortion [63]. Pregnant women who consumed high caffeine
during pregnancy have a chance to deliver low birth weight infants. This is supported by the
following studies. A prospective study conducted on 2291 pregnant women reported that
women who consumed more than 600 mg of caffeine per day are at greater risk for having
low birth weight infants [64]. A prospective study conducted on 63 women also reported that
pregnant women who consumed more than 300 mg/day of caffeine had low birth weight
newborns [65]. Studies showed consumption of high doses of caffeine had increased risk of
stillbirth. A prospective follow-up conducted on 18,478 singleton pregnancies showed that the
consumption of eight or more cups of coffee in a day doubled the risk of having stillbirth
compared with women who did not consume coffee [66].
Even though the above studies are conducted on coffee consumption, consumption of high
doses of green tea can have adverse effects on mothers and their infants. Caffeine found in
coffee and green tea is not very different. Consumption of too much caffeine (more than
300 mg per day or more than eight cups per day) can cause miscarriage as seen by the above
research findings. Consumption of too much caffeine can also cause trouble of sleeping.
2.12. Thyme (Thymus vulgaris)
It is known as common thyme, French thyme, garden thyme, oil thyme, red thyme oil, rubbed
thyme, Spanish thyme, thyme aetheroleum, thyme essential oil, thyme oil, thyme herbal, van
ajwain, vanya yavani, white thyme oil [67].
2.12.1. Benefits of thyme
A literature review conducted on herbal medicine use during pregnancy showed thyme is
used to manage bloating and stomach aches. It is also used for treatment of common cold and
urinary tract infection [2]. When used in amounts commonly found in food, thyme has a
generally recognized safe status in the US. There is insufficient reliable information available
about the safety of thyme when used in medicinal amounts during pregnancy [67]. Therefore,
pregnant women should avoid using thyme in medicinal amount.
Herbal Medicine110
2.12.2. Untoward effects of thyme
Consumption of a large dose of thyme has an emmenagogue effect. Therefore, it is better to
avoid it, especially in early pregnancy, because of concern of potential miscarriage [47].
2.13. Coconut
Countries within the Southeast Asian region are rich in coconut oil and other coconut by-
products [6769].
2.13.1. Benefits of coconut
Studies reported that coconut oil has been used to facilitate labour, delivery and prevent
congenital malformation [7072]. Coconut oil during pregnancy can be used as part of a
healthy nutrient-dense whole food diet. Coconut oil supplies rich amounts of saturated fat
with high amounts of lauric acid. The saturated fat content helps to build up adequate fat
stores in pregnancy and in preparation for breast-feeding [73].
2.13.2. Untoward effects of coconut
The study conducted to investigate the effect of virgin coconut oil on mice showed that virgin
coconut oil could affect infant growth and appearance via maternal intake. The study also
suggests the use of virgin coconut oil as herbal medicine to be treated with caution [74].
2.14. Echinacea (Echinacea spp)
Echinacea species came from North America and were traditionally used by the Indians for a
variety of diseases, including mouth sores, colds, injuries, tooth pain and insect bites [75].
2.14.1. Benefits of Echinacea
One clinical trial study shows positive association of echinacea consumption in reducing
duration and recurrence of cold and urinary tract infection [76]. The recommended dose is 5
20 ml tincture.
2.14.2. Untoward effects of Echinacea
The untoward effect of using echinacea during pregnancy needs further study.
2.15. Peppermint (Mentha piperita)
Peppermint is one of the worlds oldest medicinal herbs and is used in both Eastern and
Western traditions. Ancient Greek, Roman and Egyptian cultures used the herbs in cooking
and medicine. Peppermint is currently one of the most economically important aromatic and
medicinal crops produced in the US [77].
Herbal Medicine Use during Pregnancy: Benefits and Untoward Effects
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2.15.1. Benefits of peppermint
Several clinical trials have shown that peppermint essential oil, a super concentrated form of
herbs, can help relive irritable bowel syndrome [78]. Natural medicines comprehensive database
showed there are no reports in the scientific literature of peppermint being either safe or contra-
indicated during pregnancy. Peppermint leaves and oil are believed to be safe during pregnancy
when consumed in food amounts [79]. Study conducted on use of antiemetic herbs in pregnancy
indicated that peppermint is used for treatment of pregnancy-induced nausea [80].
2.15.2. Untoward effects of peppermint
The untoward effect of peppermint consumption during pregnancy needs further investigation.
3. Conclusion
The use of herbal medicine during pregnancy is a common phenomenon. Different studies have
shown that many women used one or more herbal medicines during pregnancy. Some women
used herbal medicine in first trimester while others used it in second or third trimester or
throughout pregnancy.
The common benefits of using herbal medicine during pregnancy include managing vomiting
and nausea, reducing the risk of preeclampsia, managing urinary tract infection and common
cold, and shortening of duration of labour.
The common untoward effects of using herbal medicine in pregnancy are heartburn, prema-
ture labour, miscarriage, increase blood flow, abortion and allergic reactions.
Different studies revealed that using herbal medicine during the first 12 weeks and the last
12 weeks of gestation is dangerous for the foetus. Pregnant women should consult doctors or
pharmacists before using any herbal medicines.
The untoward effects of using herbal medicine during pregnancy need further investigation
for many herbs. Thus, researches, especially a clinical trial study should be conducted to
identify untoward effect of herbal medicine use during pregnancy.
Terminologies
Antiemetic a drug that prevents or alleviates nausea and vomiting.
Astringent a substance that contracts the tissues or canals of the body, thereby
diminishing discharges, as of mucus or blood.
Emmenagogue increases blood flow.
Abortifacient cause a miscarriage from Latin: abortus miscarriageand faciens makingis
a substance that induce abortion.
Herbal Medicine112
Miscarriage a term used for a pregnancy that ends on its own, within the first 20 weeks of
gestation.
APGAR referred to as an acronym for: appearance, pulse, grimace, activity and res-
piration.
Pruritis itchy skin that makes one scratch.
Anaphylaxis serious life threatening allergic reaction.
Galactagogue milk-producing agent.
Tinctures liquid extracts made from herbs that are taken orally (by mouth).
Author details
Tariku Laelago
Address all correspondence to: tarikulalago@gmail.com
Hossana College of Health Sciences, Hossana, Ethiopia
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... Bağışıklık sistemini iyileştirmek ve bakteriyel enfeksiyonların neden olduğu solunum semptomlarını tedavi etmek için kullanılmış, antimikrobiyal ve antioksidan özellikler göstermiştir (Sharifi-Rad et.al., 2018). Ekinezya türleri Hintliler tarafından geleneksel olarak ağız yaraları, soğuk algınlığı, yaralanmalar, diş ağrısı ve böcek ısırıkları gibi çeşitli hastalıklar için kullanılmıştır (Laelago, 2018). ...
... Kan şekeri, kolesterol ve kan basıncı seviyelerini düzenlemek için önemlidir. Ayrıca vücudun metabolizma hızını artırır ve doğal kaynaklı bir enerji sağlar (Laelago, 2018). Yeşil çayın meyve ve sebzelerden daha fazla antioksidan özelliğe sahip olduğu bilinir. ...
... Yeşil çay gebelikte ruh halini dengelemeye yardımcı olur (Laelago, 2018). Türkiye'de gebelerle yapılan çalışmaya göre gebeler yeşil çayı soğuk algınlığında, konstipasyonda ve detoksikasyon amacıyla kullandıkları belirtilmiştir (Kıssal vd., 2017). ...
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Günümüzde kimyasal ürünlerin kullanımından uzaklaşılıp doğal ürünlerin kullanımının yaygınlaşmasıyla birlikte gebelik döneminde karşılaşılan fizyolojik ve psikolojik sorunların semptomlarının azaltılması ve bu sorunların tedavisinde bitki kaynaklı ürünlere yönelimin arttığı gözlenmektedir.
... [8][9][10] Today, researchers are looking for ways to reduce the side effects of drug treatment for miscarriage or introduce new drugs with fewer side effects. Among these, medicinal plants that have been used by humans for a long time have been considered and the efficiency of some of them such as saffron, 11 borage, 12 common rue and marjoram 13 [7] has been proven. ...
... These results indicated an improvement in the excretion of uterine products following the use of Nigella sativa oil.A review of the literature revealed that so far, there has been no study to evaluate the effectiveness of Nigella sativa on abortion and the outcome of missed abortion, whether in animal models or clinical trials and in the present study for the first time its effectiveness in improving the outcomes of missed abortion and better excretion of uterine contents was observed. In an ethnobotanical study of the use of herbs to induce abortion, 70% of participants recommended the use of Nigella sativa (two doses of 30 g).13 In the study of Keshri et al, the contraceptive effects of Nigella sativa were evaluated and it was observed that the administration of a hexagonal extract of Nigella sativa at a dose of 2 gr/kg daily for 1-10 days after intercourse prevented pregnancy in Sprague Dovli mice.25 ...
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Background and Aim Due to the concern about the side effects of chemical drugs and their ineffectiveness, the use of natural compounds as alternatives or complementary therapies has received increasing attention. The purpose of this study was to investigate the effect of Nigella sativa oil on the outcome of missed abortion. Methods In this double‐blind clinical trial, 70 nulliparous pregnant women referred to Hajar Hospital and Imam Ali clinics of Shahrekord and had missed abortion before the 12‐week gestational age were selected and randomly divided into two interventions and control groups. The intervention group received 5 g of Nigella sativa oil alone daily for up to 3 days and the control group received a placebo. In case of nonresponse, 3 days after the last dose of medication or placebo, 800 μg of misoprostol (vaginal) were used. Data were analyzed by SPSS software. The chi‐square test, Fisher's exact test, independent t‐test and paired t‐test were used for analytical statistics. Results According to the results, 18 cases (51.4%) in the intervention group and seven cases (20%) in the control group showed complete evacuation of uterine contents which had a significant difference (p < 0.05). The frequency of vagina physical examination and type of hemorrhage did not show any significant difference between the two groups before and after the intervention. After the intervention, human chorionic gonadotropin (HCG) was significantly decreased in the intervention group but did not change in the control group (p < 0.05). The frequency of adverse events in the intervention group was three (8.6%) and in the control group was one (2.9%) which had no significant difference. Conclusion Nigella sativa improves the outcome of missed abortion by reducing HCG and facilitating cervix dilatation and delivery of uterine contents.
... 178 179 Furthermore, garlic has shown preventive properties against pre-eclampsia. 174 Based on these perceived benefits, cultural beliefs and available scientific evidence, more than one-third of the women included in this review reported using at least one type of HM during pregnancy. Nevertheless, despite the perceived safety and expectations associated with HM as a treatment option for pregnancy-related conditions, certain remedies were found to cause adverse effects and poor delivery outcomes when used inappropriately. ...
... The consequences of inappropriate HM use are particularly profound during the first and third trimesters of pregnancy, as these stages are critical for fetal development and final maturation. 174 184 185 To prevent inappropriate HM use, scholars have advocated the need for physicians to be aware of patients' HM use and engage in open communication about self-care practices. 27 73 186 Previous studies have shown that open communication regarding patients' selfmedication through medication reconciliation helped to reduce the risk of adverse drug interactions and medication errors. ...
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Introduction Lack of transparent communication between patients and physicians regarding the use of herbal medicine (HM) presents a major public health challenge, as inappropriate HM use poses health risks. Considering the widespread use of HM and the risk of adverse events, it is crucial for pregnant women to openly discuss their HM use with healthcare providers. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence of pregnant women’s HM use and disclosure to healthcare providers and to examine the relationship between HM disclosure and various maternal and child health (MCH) measures. Methods A systematic search of five databases was conducted for cross-sectional studies on HM use during pregnancy published from 2000 to 2023. Data extraction followed a standardised approach, and Stata V.16.0 was used for data analysis. Also, Spearman’s correlation coefficient was calculated to examine the association between use and disclosure of HM and various MCH indicators. Results This review included 111 studies across 51 countries on the use of HM among pregnant women. Our findings showed that 34.4% of women used HM during pregnancy, driven by the perception that HM is presumably safer and more natural than conventional medical therapies. However, only 27.9% of the HM users disclosed their use to healthcare providers because they considered HM as harmless and were not prompted by the healthcare providers to discuss their self-care practices. Furthermore, a significant correlation was observed between HM disclosure and improved MCH outcomes. Conclusion Inadequate communication between pregnant women and physicians on HM use highlights a deficiency in the quality of care that may be associated with unfavourable maternal outcomes. Thus, physician engagement in effective and unbiased communication about HM during antenatal care, along with evidence-based guidance on HM use, can help mitigate the potential risks associated with inappropriate HM use.
... 1 20 23-25 For instance, IHM use could result in heartburn, increased blood flow, miscarriage, premature labour and allergic reactions. 27 They also have herb-drug interactions, 28 are associated with induced liver injury 29 , and complicate the care of pregnant women who have pre-existing conditions such as epilepsy or asthma. 21 Moreover, intrauterine death and intrauterine growth restriction, uterine rupture, stillbirth, birth defects of the eye, ear and heart, and other risks have also been linked to the use of IHMs by pregnant women. ...
... 1 20 23-25 For instance, IHM use could result in heartburn, increased blood flow, miscarriage, premature labour and allergic reactions. 27 They also have herb-drug interactions, 28 are associated with induced liver injury 29 , and complicate the care of pregnant women who have pre-existing conditions such as epilepsy or asthma. 21 Moreover, intrauterine death and intrauterine growth restriction, uterine rupture, stillbirth, birth defects of the eye, ear and heart, and other risks have also been linked to the use of IHMs by pregnant women. ...
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Objective The aim of this study was to investigate the prevalence of indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care (ANC) at public health facilities in Dire Dawa, Ethiopia. Design A facility-based cross-sectional study design. Setting The study was conducted in seven public health facilities (one referral hospital, three urban and three rural health centres) in Dire Dawa, Ethiopia, from October to November 2022. Participants 628 pregnant women of any gestational age who had been on ANC follow-up at selected public health facilities were included. Main outcome measures Prevalence of indigenous herbal medicine (users vs non-users) and associated factors. Results The study revealed that 47.8% (95% CI 43.8% to 51.6%) of pregnant women used herbal medicines. Lack of formal education (adjusted OR, AOR 5.47, 95% CI 2.40 to 12.46), primary level (AOR 4.74, 95% CI 2.15 to 10.44), housewives (AOR 4.15, 95% CI 1.83 to 9.37), number of ANC visits (AOR 2.58, 95% CI 1.27 to 5.25), insufficient knowledge (AOR 4.58, 95% CI 3.02 to 6.77) and favourable perception (AOR 2.54, 95% CI 1.71 to 3.77) were factors significantly associated with herbal medicine use. The most commonly used herbs were garden cress ( Lepidium sativum ) (32%), bitter leaf ( Vernonia amygdalina ) (25.2%), moringa ( Moringa oleifera ) (24. 5 %). Common indications were related to gastrointestinal problems, blood pressure and sugar. Conclusion The prevalence of herbal medicine use is high (one in two pregnant women) and significantly associated with education level, occupation, ANC visits, knowledge and perceptions. The study’s findings are helpful in advancing comprehension of herbal medicines using status, types and enforcing factors. It is essential that health facilities provide herbal counselling during ANC visits, and health regulatory bodies ought to raise awareness and implement interventions to lower the risks from over-the-counter herbal medicine use by pregnant women.
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Since the human body has a very complex anatomical structure, there are many parameters when it comes to disease and health. Among the parameters in question, many parameters such as the individual’s current immune system, fatigue, depression, and the structure of the body’s blood vessels are eff ective. Th e way to these eff ective parame ters is through learning the human anatomical structure. For this reason, from the existence of humanity until today, eff orts regarding human disease and health have been realized thanks to the science of anatomy. Th e science of anatomy began with the existence of humanity. Since all anatomical studies and eff orts from ancient times to the present day aim to improve the quality of human life, anatomy is a branch of science that paves the way for complementary medicine. Anatomy is a complex and dynamic fi eld that is constantly evolving as new discoveries are made. In recent years, there has been a signifi cant increase in the use of advanced imaging techniques such as MRI and CT scans, which provide more detailed and accurate imag ing of body anatomical structures, making signifi cant contributions to both anatomical science and complementary medicine. Learning the anatomical structure of the human body provides the individual with the ability to interpret 85-90% of all diseases. Prof. Dr. Vatan KAVAK
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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.
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Background Improving maternal and child health is one of the public health priorities in several African countries including Ethiopia. However, research on herbal medicine use during pregnancy is scarce in Ethiopia. The present study aimed at assessing the prevalence and correlates of herbal medicine use among pregnant women on antenatal care (ANC) follow-up at Gondar university referral hospital, Ethiopia Methods An institutional-based cross sectional study was conducted on 364 pregnant women attending ANC clinic from March to May 2016 at University of Gondar referral and teaching hospital, northwest Ethiopia. Data on socio-demography, pregnancy related information as well as herbal medicine use was collected through an interviewer-administered questionnaire. Descriptive statistics, univariate and multivariate logistic regression analysis were performed to determine prevalence and associated factors of herbal medicine use. ResultsFrom 364 respondents, 48.6% used herbal medicine during current pregnancy. ginger (40.7%) and garlic (19%) were the two most commonly used herbs in pregnancy. Common cold (66%) and inflammation (31.6%) were the most common reasons for herbal use. Majority of herbal medicine users (89.8%) had not consulted their doctors about their herbal medicine use. Rural residency (Adjusted odds ratio (AOR): 3.15, Confidence interval (CI): 1.17–6.14), illiteracy (AOR: 4.05, CI: 2.47–6.62) and average monthly income less than 100 USD (AOR: 3.08CI: 1.221–7.77) were found to be strong predictors of herbal medicine use. Conclusions The use of herbal medicine during pregnancy is a common practice and associated with residency, level of education and average monthly income. From the stand point of high prevalence and low disclosure rate, the health care providers should often consult pregnant women regarding herbal medicine use.
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Background Coconut oil is commonly used as herbal medicine worldwide. There is limited information regarding its effects on the developing embryo and infant growth. Methods We investigated the effect of virgin coconut oil post-natally and until 6 weeks old in mice (age of maturity). Females were fed with either standard, virgin olive oil or virgin coconut oil diets 1 month prior to copulation, during gestation and continued until weaning of pups. Subsequently, groups of pups borne of the respective diets were continuously fed the same diet as its mother from weaning until 6 weeks old. Profiles of the standard and coconut oil diets were analysed by gas chromatography flame ionization detector (GCFID). ResultsAnalysis of the mean of the total weight gained/ loss over 6 weeks revealed that in the first 3 weeks, pups whose mothers were fed virgin coconut oil and virgin olive oil have a significantly lower body weight than that of standard diet pups. At 6 weeks of age, only virgin coconut oil fed pups exhibited significantly lower body weight. We report that virgin coconut oil modifies the fatty acid profiles of the standard diet by inducing high levels of medium chain fatty acids with low levels of essential fatty acids. Furthermore, pups borne by females fed with virgin coconut oil developed spiky fur. Conclusion Our study has demonstrated that virgin coconut oil could affect infant growth and appearance via maternal intake; we suggest the use of virgin coconut oil as herbal medicine to be treated with caution.
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Background According to World Health Organization (WHO) estimates, 80 % of the population living in rural areas in developing countries depends on traditional medicine for their health needs, including use during pregnancy. Despite the fact that knowledge of potential side effects of many herbal medicines in pregnancy is limited and that some herbal products may be teratogenic, data on the extent of use of herbal medicines by women during pregnancy in the study setting is largely unknown. We determined the prevalence and factors associated with herbal medicine use during pregnancy among women attending postnatal clinics in Gulu district, Northern Uganda. Methods This was a descriptive cross-sectional study which involved 383 women attending postnatal care across four sites in Gulu district using quantitative and qualitative methods of data collection. A structured questionnaire was used to collect quantitative data while qualitative data were obtained using focus group discussions and key informant interviews. The selection of the study participants was by systematic sampling and the main outcome variable was the proportion of mothers who used herbal medicine. Quantitative data was coded and entered into a computerized database using Epidata 3.1. Analysis was done using Statistical Package for Social Scientists version 13, while thematic analysis was used for qualitative data. Results The prevalence of herbal medicines use during the current pregnancy was 20 % (78/383), and was commonly used in the second 23 % (18/78) and third 21 % (16/78) trimesters. The factors significantly associated with use of herbal medicines during pregnancy were perception (OR 2.18, CI 1.02-4.66), and having ever used herbal medicines during previous pregnancy (OR 2.51, CI 1.21-5.19) and for other reasons (OR 3.87, CI 1.46-10.25). Conclusions The use of herbal medicines during pregnancy among women in Gulu district is common, which may be an indicator for poor access to conventional western healthcare. Perception that herbal medicines are effective and having ever used herbal medicines during previous pregnancy were associated with use of herbal medicines during current pregnancy. This therefore calls for community sensitization drives on the dangers of indiscriminate use of herbal medicine in pregnancy, as well as integration of trained traditional herbalists and all those community persons who influence the process in addressing the varied health needs of pregnant women.
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Background The use of herbal medicines for health prevention and ailments is an increasing trend worldwide. Women in pregnancy are no exception; the reported prevalence of herbal medicine use in pregnancy ranges from 1 to 60 %. Despite a common perception of safety, herbal medicines may have potent pharmacological actions, and historically, have been used for this reason. MethodsA multinational, cross-sectional study on how women treat disease and pregnancy-related health ailments was conducted between October 2011 and February 2012 in Europe, North America, and Australia. This study’s primary aim was to evaluate and classify the herbal medicines used according to their safety in pregnancy and, secondly, to investigate risk factors associated with the use of contraindicated herbal medicines during pregnancy. ResultsIn total, 29.3 % of the women (n = 2673) reported the use of herbal medicines in pregnancy; of which we were able to identify 126 specific herbal medicines used by 2379 women (89.0 %). Twenty seven out of 126 herbal medicines were classified as contraindicated in pregnancy, and were used by 476 women (20.0 %). Twenty-eight were classified as safe for use in pregnancy and used by the largest number of women (n = 1128, 47.4 %). The greatest number was classified as requiring caution in pregnancy; these sixty herbal medicines were used by 751 women (31.6 %). Maternal factors associated with the use of contraindicated herbal medicines in pregnancy were found to be working in the home, having a university education, not using folic acid, and consuming alcohol. Interestingly, the recommendation to take a contraindicated herbal medicine was three times more likely to be from a healthcare practitioner (HCP) than an informal source. Conclusion Based on the current literature the majority of women in this study used an herbal medicine that was classified as safe for use in pregnancy. Women who reported taking a contraindicated herb were more likely to have been recommended it use by an HCP rather than informal source(s), indicating an urgent need for more education among HCPs. The paucity of human studies on herbal medicines safety in pregnancy stands in stark contrast to the widespread use of these products among pregnant women.
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