| For more than 3,000 years of history, Traditional Chinese Medicine has been used in pregnant women. Nowadays, it is principally applied in Mainland China but has become more and more widely used worldwide to promote both mothers ' and fetuses ' health and treat common pregnancy disorders.;To date, no data are available to provide an overview of Chinese medicines in pregnancy. In the first part of this study, the clinical applications, and therapeutic effects and safety of Chinese medicines for pregnancy were reviewed and studied. In the second part of this study, the safety of most commonly used Chinese medicine during pregnancy was studied in pregnancy animal models, in vivo and in vitro.;Over 3,000 publications were identified and selected to assess Chinese medicines for pregnancy, including their indications, contraindications, formulae, individual medicines, regimes, effectiveness, efficacy, safety, adverse effects and toxicity. Amongst all clinical applications, threatened miscarriage was the most common clinical indication. Shou Tai Pill, containing 4 major herbal medicines Chinese Dodder Seed, Chinese Taxillus Twig, Donkey-hide Glue, and Himalayan Teasel Root, was the most commonly used formula in preventing miscarriage and promoting pregnancy. The top 10 most frequently prescribed single herbal medicines in wide variety of formulas were identified. The average clinical dose for each medicine ranged from 6g to 28g daily, however the dosage of Chinese medicines was not significantly correlated with its overall efficacy. Randomized controlled trials evaluating the effectiveness of the medicines were selected for meta-analysis. The results showed Chinese medicines in combination with other pharmaceuticals were more effective to improve the clinical outcomes of threatened miscarriages than other pharmaceuticals. No specific safety problem was reported, but potential adverse and toxic effects on reproductive system by certain medicines were identified from other publications.;A safety study was then carried out in VIVO III normal pregnant mice. The most commonly used single herb, Largehead Atractylodes Rhizome, at relevant clinical doses was administered orally to the pregnant animals at different or throughout gestational periods, beneficial and adverse effects on both mothers and offspring were studied. At higher clinical dosage, significant decreased maternal weight, fetal/neonatal growth and weight; and significant increased incidences of fetal resorption, congenital caudal regression and hip dysplasia were recorded. Bone CT examination and skeleton staining confirmed congenital skeleton abnormality, including shoulder joint dislocation, congenital absence of ulna and distal digits, oligodactyly, long bone shortening, congenital hip dislocation and caudal regression In vitro whole embryo culture confirmed that Largehead Atractylodes Rhizome induced abnormal limb development during early development. Molecular study suggested the effects of Largehead Atractylodes Rhizome on Tbx suppression for early limb development. |
