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OB: Herbs In PregnancyFrom: art fougner, md (evsono@pipeline.com)Tue Aug 3 07:15:23 2004
>From the latest Ob-Gyn News Side Effects of Some Herbs Harmful in Pregnancy Carl Sherman Contributing Writer NEW YORK — Many herbal preparations taken during pregnancy are innocuous, but some are ineffective, and others are downright dangerous, Dr. Tieraona Low Dog said at a meeting on botanical medicine sponsored by Columbia University and the University of Arizona. Blue cohosh used to stimulate labor, should be wholly avoided in pregnancy. Blue cohosh is often combined with black cohosh and taken as a uterine tonic or partus preparator during the last 6 weeks of pregnancy, according to Dr. Low Dog of the University of New Mexico, Albuquerque. Blue cohosh was listed in the U.S. Pharmacopeia for labor induction at the end of the 19th century. It is still widely prescribed by lay midwives, and, in one survey, 90 of 174 (52%) certified nurse-midwives said they recommended labor-stimulating preparations; of these, 64% used blue cohosh, and 45% used black cohosh. Complications, which were reported by 21% of respondents who used either black or blue cohosh, included transient fetal tachycardia, meconium-stained fluid, and nausea. Blue cohosh contains compounds that exhibit cardiotoxic, vasoconstricting, and uterine-stimulating activity, Dr. Low Dog said. Cases involving stroke, cardiomegaly, and pulmonary edema have been reported in infants of mothers who took blue cohosh during pregnancy. “Leave this herb alone,” she said. Probably the herb most commonly taken by pregnant women in the United States and Europe is raspberry leaf, which is often prepared as a “pregnancy tea.” It is believed to alleviate morning sickness, prevent miscarriage, and aid in childbirth. A randomized, controlled trial of 192 women found that those who used raspberry tea from week 32 through delivery had no adverse effects. However, the herb had no perceptible effect on the timing or length of labor or on the need for analgesia, Dr. Low Dog noted during the meeting. Raspberry leaf contains several vitamins and minerals and might have provided nutritional benefits many years ago for women who had no other way of getting those benefits. “There's no reason not to take it,” she said. Ginger is often taken to alleviate morning sickness, and three clinical trials have confirmed some benefit in this regard, without finding evidence of harmful effects to the mother or infant. The German Commission E, which regulates the use of herbal remedies in that country, has stated that ginger is contraindicated during pregnancy but provided no data to support this contention. In excessive doses, ginger may affect bleeding tendencies; one study associated a significant reduction in agonist-induced platelet aggregation with the ingestion of 10 g. “To be on the safe side, women should limit ginger consumption to 1 g/day, Dr. Low Dog said. Chamomile, which is often ingested in a tea made from its flowers, is considered safe for consumption during pregnancy by the German Commission E and by the British Herbal Medicine Association, and there have been no reports of adverse effects. Questions of teratogenicity have arisen, however, in connection with animal studies using high doses of alpha-bisabolol, a volatile oil that is found in chamomile. The concentrations used in the study, however, are far in excess of what would be seen in human plasma under conditions of normal use, Dr. Low Dog said. http://www2.eobgynnews.com/scripts/om.dll/serve art
-- art fougner, md ich bin ein New Yorker
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