Chinese herbal medicines for the treatment of pre-eclampsia

Pre-eclampsia is a condition in pregnancy involving high blood pressure and protein in the urine (proteinuria) after 20 weeks of pregnancy. Most women with mild pre-eclampsia give birth without problems. However, severe pre-eclampsia can cause major problems with the liver, blood clotting etc, and some women go on to have fits (eclampsia). This can lead very occasionally to serious complications, and possibly to a life-threatening situation for both the mother and her baby. Chinese herbal medicines might help to protect vulnerable organs like the liver and kidneys, and so these remedies may help with pre-eclampsia. Traditional Chinese medicine (TCM) incorporates concepts of cause, diagnosis and treatment. Typical treatment in TCM is Chinese herbal remedies based on one or several herbs that come from natural plants. Their selection is often based on the individual and presence of TCM symptoms. The prescribed herbs are combined by a distinctive method to form the prescription. In recent decades, TCM has sometimes been integrated with Western medicine to incorporate its therapeutic concepts. Not all Chinese herbal medicines are free of risk, and there are concerns regarding adverse events; for example, allergic reaction and Chinese herbal nephropathy (kidney damage).

The authors searched for controlled trials that randomly assigned women with pre-eclampsia, toxaemia or pregnancy-induced hypertension to treatment with Chinese herbal medicines (or integrated Western medicine with Chinese herbal medicines) or a control treatment. The control treatment could be a placebo, no treatment or a Western medicine. The authors identified no trials that were suitable for inclusion and so the efficacy and safety of Chinese herbal medicines for treating pre-eclampsia remains unclear. Although the authors identified 45 studies, none of the trials reported adequate methodology to be classified as randomised controlled trials.

Authors' conclusions: 

The efficacy and safety of Chinese herbal medicines for treating pre-eclampsia remains unclear. There are no randomised controlled trials in this field. High-quality randomised controlled trials are urgently required.

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Background: 

Traditional Chinese medicine (TCM) considers that, when a woman is pregnant, most of the blood of the mother is directed to the placenta to provide the baby with the required nutrition, As a consequence, other maternal organs may be vulnerable to damage. These organs include the liver, the spleen and the kidneys. The use of Chinese herbal medicines is often individualised and based on the presence of TCM symptoms. The general effects of Chinese herbal medicines may be valuable in pre-eclampsia by encouraging vasodilatation, increasing blood flow and decreasing platelet aggregation.

Objectives: 

To assess the efficacy and safety of Chinese herbal medicines for treating pre-eclampsia and compare it with that of placebo, no treatment, Western medicine or other Chinese herbal medicines.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2009), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 2), MEDLINE (1950 to June 2009) and Chinese National Knowledge Infrastructure (1979 to June 2009).

Selection criteria: 

Randomised controlled trials in which Chinese herbal medicines were used for treating pre-eclampsia.

Data collection and analysis: 

Three review authors searched studies and assessed full texts independently. Another author also assessed the studies if there was any doubt about whether or not to include the trial. We did not perform analysis as there were no trials included in this review.

Main results: 

No trials were suitable for inclusion in this review.

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