Re: caulophyllum thalictroides tablets+ IOL
From: Sue Smith (midwifesue@charter.net)
Fri Aug 19 11:58:23 2005
I have the 2005 version, and both cimicifuga racemosa and caulophyllum
thalictroides are listed. Respectfully, I would be surprised to learn that
caulophyllum is known as squaw vine, as it is an upright plant and not a
vine. Perhaps you meant squaw root? The vine Mitchella repens is commonly
known as squaw vine, or partridge berry.
Both of the cohoshes are listed as contraindicated in pregnancy, black
because of the "increased risk of spontaneous abortion", blue is silent on
the reason.
The PDR reports uterine stimulant effects of blue "similar to oxytocin" in
infusions in concentrations of 500:1 or 1000:1.
Let us not forget, to put things in perspective, that many of the meds used
on L&D are also listed as contraindicated in pregnancy.
I have used both homeopathic and tincture forms, and not been particularly
impressed with either. If she was taking the homeopathic form, it would be
instructive to know what potency it was.
Since the patient whose labor initiated this thread was using 3 modalities
that are known to be effective at producing contractions, it would be
difficult to assign blame for a precipitous labor to caulophyllum alone,
though certainly the gastrointestinal symptoms could well be a "proving" of
the remedy, usually caused by taking it too frequently over too long a
period.
--
Sue Smith, CPM
"Well-behaved women seldom make history"
L. Ulrich
_____
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of fran
wilson
Sent: Friday, August 19, 2005 3:40 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: caulophyllum thalictroides tablets+ IOL
Lenore
I mentioned the herbal PDR in a previous post. The first version (the one I
own) has both cimicifuega and caulophyllum, there is german research sited
for various anti spasmodic and estrogenic effects but I did not see actual
research re: labor induction. It did mention that it has been used for
centuries (hence blue cohosh nickname squaw vine) as a labor enhancer as
well as an abortifactant. I could fine neither of the cohoshes in the
online table of contents for the 2005 version.
Fran Wilson CNM
Kennewick, WA
_____
From: Len2976@aol.com
Reply-To: ob-gyn-l@obgyn.net
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
Subject: Re: caulophyllum thalictroides tablets+ IOL
Date: Tue, 16 Aug 2005 07:24:50 -0500
I have a question for the group, particularly MWs and others who are
familiar with herbal therapy, an area which I am not familiar with.
Sunday afternoon I had a patient (32 y/o G1 at 38+ weeks) present to L&D
with what appeared to be symptoms of aacute gastroenteritis--severe nausea,
vomiting, and diarhea for about 18 hours. The woman was doubled over in
pain at times screaming as though she was in transition.
Her sister, who is a message therapist, had given her caulophyllum
thalictroides tablets to induce labor. She had taken 2 tablets every 3
hours the evening before and yesterday morning (6 doses for a total of 12
tablets). I learned that caulophyllum thalictroides tabs are blue cohash.
In addition to the blue cohash, she had also done both accupressure and
nipple stimulation (for 15 minute periods per hour) to try to induce labor.
She had not consulted either the MD nor any of the CNMs with our practice
for advice regarding this.
After assessing her and deciding she was not in active labor on admission,
but was dehydrated and exhausted from the vomiting and diarhea, I admitted
her, started an IV, and sedated her so she could get some rest. Her cervix
was long, thick, and closed, and the FHTs were reassuring.
About 4 hours later, I was called by the nurse that she was contracting
regularly, her cervix was about 2-3 cms dilated, and that she wanted an
epidural. When I got to L&D she had had a SROM with thick meconium stained
AF. Her labor progressed steadily and I anticipated a NSVD. I usually try
to encourage patients with an epidural NOT to push when the cervix is fully
dilated, but to rest and wait till they either have a strong urge or the
head is at a +2 station. This patient, however, had an urge to push at
about 9 cms and insisted on pushing when her cervix was fully dilated and
the head was at a +1 station.
Unfortunately when she began pushing there were severe variable
decelerations (down to 40-50's x 1 minute with slow recovery) and after a
few of these I stopped her from pushing (which helped somewhat), called the
obstetrician in, and she ended up a C/S. There was no nuchal cord present
or other explanation for the thick mec.
My questions involve the appropriate use of the blue cohash. I'm aware that
some MWs use blue cohash for cervical ripening particularly with post-dates
patients, but I always thought it was used in a tincture form. I could not
find out anything regarding usual dosage, side effects, etc. Obviously it
was as effective in inducing labor as I have sometimes seen cytotec to
be--in fact it was almost a precipitous labor. Comments would be
appreciated.
Lenora McCall, CNM
