The following is a summary of “Toxicities of herbal abortifacients,” published in the June 2023 issue of Emergency Medicine by Feng, et al.

In the post-Roe era, barriers to facility-based abortions may result in a rise in self-managed abortions. While misoprostol-based medication abortions have been extensively studied and deemed safe, there was a lack of knowledge within the medical community regarding the toxicities of commonly used herbal abortifacients.

The study was based on a thorough search of the MEDLINE and HOLLIS databases, focusing on self-managed abortion methods involving herbal abortifacients and their associated toxicities.

Several herbal abortifacients have been identified with significant morbidity and mortality implications. These include pennyroyal, blue cohosh, rue, and quinine. The study also touched upon other commonly reported abortifacients with lower toxicity risks. Special considerations for hepatic, cardiac, renal, and hematologic toxicities were vital when dealing with patients who have had significant exposures to these herbal substances.

With the expected increase in the use of herbal xenobiotics for self-managed abortions, especially considering potential restrictions to standard mifepristone-misoprostol protocols, frontline healthcare providers should be knowledgeable about the associated toxicities. Special considerations were crucial when treating poisoned patients in a particular population.

Source: sciencedirect.com/science/article/abs/pii/S0735675723001201