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Toxicities of herbal abortifacients
Chris Feng1, Kathryn E Fay2, Michele M Burns1
1Harvard Medical Toxicology, Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA.
The American Journal of Emergency Medicine
|March 16, 2023
Summary
As access to facility-based abortions decreases, herbal abortifacients may be increasingly used for self-managed abortions. This review details the significant toxicities associated with common herbal abortifacients, crucial for medical providers to recognize.
Area of Science:
- Toxicology
- Herbal Medicine
- Reproductive Health
Background:
- Post-Roe v. Wade, increased barriers to facility-based abortions may drive a rise in self-managed abortions.
- While medication abortion (mifepristone-misoprostol) is well-studied, medical community knowledge gaps exist regarding herbal abortifacient toxicities.
- Herbal abortifacients pose potential risks, necessitating greater awareness among healthcare providers.
Purpose of the Study:
- To review self-managed abortion methods utilizing herbal abortifacients.
- To identify and discuss the toxicities associated with commonly used herbal abortifacients.
- To inform healthcare providers about potential risks and management considerations.
Main Methods:
- A narrative review of existing literature.
- Searches conducted in MEDLINE and HOLLIS databases.
- Focused on herbal abortifacients and their associated toxicities.
Main Results:
- Pennyroyal, blue cohosh, rue, and quinine are identified as herbal abortifacients with significant morbidity and mortality risks.
- Other less toxic herbal abortifacients are also discussed.
- Key toxicities include hepatic, cardiac, renal, and hematologic effects, requiring specialized patient management.
Conclusions:
- Anticipated increase in herbal xenobiotic use for self-managed abortions due to restricted access to standard protocols.
- Healthcare providers must be aware of herbal abortifacient toxicities.
- Specialized considerations are vital for treating patients with significant exposures to these substances.
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