Even though women are concerned about the impact of medication on fetal growth and development during pregnancy, many still take various medications while pregnant. However, in terms of medication during pregnancy, some drugs that were previously considered safe to use during pregnancy, or even had a protective effect on the fetus, can cause fetal malformation when used in high doses. So how can we safely use traditional Chinese medicine during pregnancy?
1. The Chinese herb "Mayweed" has an anti-pregnancy effect and is used by some as a contraceptive. It should be used with caution.
2. Chinese herbs with hormonal effects, such as ginseng and American ginseng, have effects on the sex glands. The plant hormones they contain can relieve menopausal symptoms and restore sexual desire, so they should be avoided.
3. Medicinal wines, such as wine extracts, tinctures, and ointments, should be avoided. Examples include ginseng and gastrodia elata wine, ginseng medicinal wine, Eucommia ulmoides wine, Polygala tenuifolia tincture (50%～58%), licorice ointment (20%～25%), and Chinese angelica ointment (45%～50%). If a pregnant woman consumes 30-60ml of ethanol daily, it can cause chronic ethanol poisoning in the fetus. Excessive intake at once can cause fetal ethanol poisoning syndrome (intellectual disability, delayed intrauterine development, abnormalities in the eyes, heart, joints, etc.). If the weekly amount of ethanol consumed in the first three months of pregnancy exceeds 70g, the rate of cleft palate in infants will significantly increase.
4. Chinese herbs that have contraindications during pregnancy according to traditional Chinese medicine theory.
The main contraindications are herbs that "dispel stasis, disperse qi, scatter, extreme cold, extreme heat, downward movement, slippery, and toxic". "Dispelling stasis" can cause miscarriage, such as blood-activating and stasis-removing herbs; "dispersing qi and scatter" can cause qi disorder and blood overflow, such as qi-moving and stagnation-resolving herbs; "extreme cold" can cause uterine cold and fetal withering, such as heat-clearing herbs; "extreme heat" can cause blood boiling and erratic movement, such as warming and yang-tonifying herbs; "downward movement and slippery" can cause fetal qi to descend, such as purgatives and dampness-resolving herbs; "toxicity can be toxic to the fetus". These herbs can cause vaginal bleeding, abortion, and miscarriage. It is forbidden to use herbs that promote blood circulation and regulate menstruation (san leng, e zhu, leech, blister beetle, liu ji nu, ling xiao hua, gan qi, dung beetle, and earthworm), herbs that open the orifices and scatter (musk, toad venom, pangolin, centipede, and soap pod), diuretic herbs (gan sui, da ji, yuan hua, shang lu, and morning glory), emetic herbs (melon rind and quinoa), and cathartic herbs (croton seed, aloe, and senna leaf). Be cautious with herbs that disperse qi and blood, activate blood circulation and remove stasis, have warm and hot properties, act as laxatives, and have sinking properties, such as polygonum cuspidatum, rhubarb, mirabilite, fructus aurantii immaturus, peach kernel, agarwood, frankincense, myrrh, cinnamon, cortex moutan, radix quinquefolii, radix rehmanniae, radix dipsaci, radix rhapontici, radix notoginseng, radix aconiti preparata, and magnetite.
5. Chinese herbs that have a strong uterine stimulating effect should be avoided, such as datura, musk, motherwort, san leng, e zhu, safflower, achyranthes, and Chinese skullcap, to prevent miscarriage. Peach kernel, fructus aurantii immaturus, fructus aurantii, chuanxiong, rhubarb, cortex mori, lithospermum, evodia, hawthorn, and others also have a certain uterine stimulating effect and should be used with caution (should be avoided in women with a history of miscarriage).
6. Anti-cancer traditional Chinese medicine preparations have a strong teratogenic effect, as both embryonic cells and tumor cells have rapid proliferation and division functions and are sensitive to anti-cancer drugs. Therefore, these drugs should be prohibited in pregnant or potentially pregnant women.
Preparations made from arsenic (realgar, orpiment), which induce differentiation, apoptosis, and killing of leukemia cells. Chuanxiong, its extracts chuanxin new alkaloid and chuanxin alkaloid, interfere with cell mitosis and cause cell division to stop at the metaphase. In addition, chuanxin new alkaloid has neurotoxicity. The oil-in-water emulsion injection made from Tripterygium wilfordii has inhibitory and killing effects on cancer cells. Therefore, preparations made from bezoar, datura, datura, aconitum carmichaelii, croton tiglium, safflower, autumn crocus, Lijiangshan agaric, Taxus chinensis, gingko biloba (ginkgolides), Taxus chinensis var. mairei (taxanes), Nux vomica (brucine), indigo naturalis (indigo red), lily (colchicine), e zhu, toad skin (bufotenine), Radix dracocephali (dracocephalum), Codonopsis pilosula, and others should also be prohibited. Coix seed, lingzhi, poria, poria cocos, cordyceps, wolfberry, tremella, and shiitake, whether used alone or in combination, mainly use polysaccharides to improve the host's immune function and only have an adjuvant therapeutic effect, so they are not contraindicated.
7. According to the "Chinese Pharmacopoeia," contraindications for traditional Chinese medicine during pregnancy are divided into three categories: prohibited, discouraged, and cautious. Prohibited: the strictest warning against medication, which means it is forbidden to use. The use of the medication may or is likely to cause harm or significant harm to the fetus, and the medication may not significantly improve the pregnant woman's condition, or there are other safe and effective drugs available as an alternative; Discouraged: not suitable for use or should be avoided. The use of the medication has a high possibility of causing harm or significant harm to the fetus, but the pregnant woman's condition is urgent, and the medication may significantly improve the condition, and there are no other safe and effective drugs available as an alternative; Cautious: medication should be used with caution. The medication may or is likely to cause some harm to the fetus, but the medication may significantly improve the pregnant woman's condition.
When using medication, it is necessary to consider the impact of the disease itself on the fetus as well as the impact of the medication on the fetus. Both doctors and patients should consider which is the lesser of two evils when weighing the risks of treatment versus the risks of non-treatment. There are no absolutely safe drugs available for pregnant women and fetuses. For example, if a pregnant woman develops a fever (due to an infectious disease, for example), an increase in body temperature of 1.5 °C can cause fetal malformation. The location and severity of malformation are related to the duration and temperature of maternal fever and gestational age, so timely medication is necessary.
