Prevalence of Traditional Medicine Use during Pregnancy, at Labour and for Postpartum Care in a Rural Area in Zimbabwe.

OBJECTIVES: The aim of this study was to determine the prevalence and types of traditional medicine used during pregnancy, at labour and for postpartum care by women in rural Zimbabwe. RESEARCH DESIGN: A cross-sectional survey was conducted on 398 women from two rural districts in Zimbabwe. Data on socio-demography, pregnancy related information as well as traditional medicine use patterns was collected using a structured interviewer administered questionnaire. Convenient sampling was used to recruit women of childbearing age who were either pregnant at the time of the study, or had previously given birth. RESULTS: The prevalence of traditional medicine used during pregnancy and at labour was 69.9% and only 17.3% used these medicines for postpartum care. During pregnancy, 27.7% used soil from a mole hill, 21.6% used elephant dung, and 13.3% used Fadogia ancylantha. These medicines were mainly used to facilitate labour (43.5%), avoid tears/stitches (19.7%), make delivery easy and safe (18.3%) and to avoid prolonged labour (5%). Only 9% of the participants however reported to have experienced adverse effects from using traditional medicines. CONCLUSION: The use of traditional remedies in different forms during pregnancy and at labour was very common as confirmed by the high prevalence rate of 69.9%. Some of the women however used more than one type of traditional medicine during pregnancy, labour and for postpartum care. The exact effects of some of these medicines on both the mother and infant however, are not known, and there is therefore a need for them to be studied in greater detail.

Spasmogenic effects of Sclerocarya birrea stem bark aqueous extract on rat isolated uterine horns.

ETHNOPHARMACOLOGICAL RELEVANCE: Sclerocarya birrea (Anacardiaceae), popularly known as "marula", is used as a traditional remedy for allegedly treating dysmenorrhoea and a host of other ailments such as malaria, fever, diarrhoea, dysentery, stomach disorders, headaches and to facilitate childbirth. This study investigated the pharmacological effects of S. birrea extract (SBE) on isolated, spontaneously-contracting uterine horns of healthy, young adult, female Wistar rats. MATERIALS AND METHODS: One kilogramme of S. birrea fresh stem bark was identified and authenticated. The bark was air-dried at room temperature (26 ± 1°C) for two weeks. The dried stem bark was milled and macerated in 2.5l of distilled water for 48 h and filtered. A rotary evaporator was used to concentrate the aqueous extract by drying it at 60 ± 1°C. Freeze-drying gave 61.3g/kg (i.e., 6.13% yield) of a dark-brown, powdery, crude extract. Rat isolated uterine horns were mounted in 25-ml Iworx tissue organ-baths containing De Jalon׳s physiological solution, and exposed to graded concentrations of SBE (25, 50, 100, 200, 300, 400mg/ml/kg). The effects of SBE and atropine, oxytocin, verapamil, indomethacin, acetylcholine, serotonin, cimetidine and histamine on the isolated uterine muscles, were recorded using LabScribe2 software. RESULTS: The aqueous stem bark extract of S. birrea produced significant (p<0.05) concentration-dependent contractions of the uterine horn muscle preparation reaching a maximum at the 300 mg/ml dose. SBE mimicked and potentiated uterine muscle contractile effects of oxytocin (0.5-5 µU/ml) and acetylcholine (0.1-3 µg/ml). Pre-incubation of tissues with atropine (1-3 µg/ml), non-significantly (p>0.05) inhibited SBE-induced contractions on uterine muscles. Verapamil (2 µg/ml), indomethacin and -p-tosyl-l-phenylalanine-chloromethyl-ketone (TPCK) inhibited the contractile effects of SBE (25-400mg/ml/kg), suggesting possible calcium-mediated mechanism of action for SBE and possible COX-enzyme inhibition. Pre-incubating tissues with histamine (10(-8)-10(-5)M) resulted in relaxation of the uterus, while cimetidine potentiated the contractile effects of SBE. Serotonin potentiated the contractile effects of SBE. CONCLUSION: These results indicate that SBE causes contraction on uterine smooth muscles possibly through its effects on oxytocin, acetylcholine and serotonin receptors. As a result SBE should not be used by patients suffering from dysmenorrhoea as it can worsen it or pregnant patients as it can result in miscarriage/abortion.

Sclerocarya birrea (A. Rich) Hochst. ['Marula'] (Anacardiaceae): a review of its phytochemistry, pharmacology and toxicology and its ethnomedicinal uses.

A plethora of ethnotherapeutic properties and pharmacological actions have been attributed to Sclerocarya birrea (family: Anacardiaceae). It is one of the most highly valued indigenous trees of southern Africa. Reports in biomedical literature have indicated the presence of medicinally-important chemical constituents in the plant, notably: polyphenols, tannins, coumarins, flavonoids, triterpenoids, phytosterols, and so forth. Pharmacological studies by various groups of investigators have shown that S. birrea possesses antidiarrhoeal, antidiabetic, anti-inflammatory, antimicrobial, antiplasmodial, antihypertensive, anticonvulsant, antinociceptive and antioxidant properties, thus lending pharmacological support to the plant's folkloric, ethnotherapeutic uses in South African traditional medicine. In view of the immense medicinal importance of the plant, this review aimed at compiling all currently available information on S. birrea's chemical constituents, as well as its ethnomedicinal, pharmacological and toxicological properties.