SAFETY AND EFFICACY OF BLUE COHOSH (Caulophyllum Thalictroides) DURING PREGNANCY AND LACTATION

Main Article Content

Jean-Jacques Dugoua
Daniel Perri
Dugald Seely
Edward Mills
Gideon Koren

Keywords

Blue cohosh, caulophyllum thalictroides, pregnancy, lactation, breastfeeding, systematic review

Abstract

Background


There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and  safety  of  herbal  medicines  in  pregnancy  and  lactation.  This  is  one  article  in  a  series  that systematically reviews the evidence for commonly used herbs during pregnancy and lactation.


 Objectives


To systematically review the literature for evidence on the use, safety and pharmacology of blue cohosh, focusing on issues pertaining to pregnancy and lactation.


 Methods


We searched 7 electronic databases and compiled data according to the grade of evidence found.


 Results


According to a survey of midwives in the United States, approximately 64% of midwives reported using blue cohosh as a labour-inducing aid. There are three case reports in the scientific literature that blue cohosh taken at the time of delivery may cause; 1) perinatal stroke, 2) acute myocardial infarction, profound congestive heart failure and shock and 3) severe multi-organ hypoxic injury. There is one case report that blue cohosh possesses abortifacient properties. There is in vitro evidence that blue cohosh may have teratogenic, embryotoxic and oxytoxic effects. In lactation, the safety of blue cohosh is unknown.


 Conclusions


Based on the available scientific information, blue cohosh should; 1) be used with extreme caution during pregnancy, 2) be used only under medical professional supervision and 3) not be available to the public as an over-the-counter product. There is an urgent need to conduct a retrospective or prospective cohort study of midwifes using blue cohosh in order to determine its safety

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