Motherwort extract
Also known as: Motherwort, Chinese motherwort, Leonurus japonicus Hoult, Leonurus japonicus
Overview
Motherwort extract is derived from the aerial parts of *Leonurus japonicus*, a plant traditionally used in Chinese medicine. It is available in oral formulations and, notably, as an injectable form (motherwort injection) used clinically. Its primary application is for its uterotonic properties, stimulating uterine contractions to prevent or reduce uterine bleeding, particularly postpartum hemorrhage and bleeding after abortion. While traditional uses also include cardiovascular and menopausal symptom relief, these lack robust clinical support. Research on motherwort injection for obstetric bleeding is relatively mature, with multiple randomized controlled trials (RCTs) and meta-analyses, though the evidence quality is often rated as low to moderate, indicating a need for further high-quality studies.
Benefits
The primary evidence-based benefit of motherwort injection is the reduction in uterine hemorrhage risk following abortion, vaginal delivery, and cesarean section. Meta-analyses indicate that prophylactic administration significantly lowers the incidence of uterine bleeding compared to controls or oxytocin alone. This benefit is most pronounced in women undergoing induced abortion or delivery, where it serves as an adjunct to reduce bleeding complications. While preclinical studies suggest secondary benefits like anti-inflammatory and antioxidant effects, these lack strong clinical confirmation. The benefits are observed when motherwort injection is administered prophylactically immediately after the procedure. Pooled analyses report statistically significant relative risk reductions for uterine hemorrhage post-abortion, though exact effect sizes vary and require cautious interpretation due to study heterogeneity and quality.
How it works
Motherwort contains active compounds, primarily alkaloids and flavonoids, which stimulate uterine smooth muscle contraction. This action promotes uterine tone, effectively reducing and preventing bleeding. It is believed to act synergistically with oxytocin, enhancing its uterotonic effects. Additionally, the extract exhibits antioxidant and anti-inflammatory properties, which may contribute to tissue healing and further reduce bleeding. The injectable form is optimized for rapid bioavailability and pharmacokinetics, ensuring quick action on the uterus.
Side effects
Motherwort injection is generally considered relatively safe when used clinically for preventing uterine bleeding. Oral motherwort may cause mild gastrointestinal symptoms such as diarrhea and upset stomach. Serious adverse events are rare, but comprehensive data are limited, especially for the injectable form, which requires monitoring. Drug interactions have not been extensively studied; caution is advised when co-administering with other uterotonics or anticoagulants due to potential additive effects. Contraindications include known hypersensitivity to motherwort. Caution is also recommended for patients with bleeding disorders or cardiovascular instability. For pregnant individuals, safety is supported only in the context of controlled clinical use for bleeding prevention; it is not recommended for general use without medical supervision.
Dosage
Clinical studies primarily utilize motherwort injection, administered intramuscularly or intravenously, immediately after abortion or delivery. Typical doses range from 2 to 4 mL of motherwort injection, though the exact concentration can vary by preparation. The timing of administration is crucial, with prophylactic use immediately post-procedure being most effective. Oral dosing is less standardized and lacks robust clinical trial support for bleeding prevention. There is no established maximum safe dose beyond the parameters observed in clinical trials, and the risks associated with overdosing are not well characterized.
FAQs
Is motherwort effective for general bleeding disorders?
No, strong evidence does not support the use of motherwort beyond obstetric bleeding contexts like postpartum hemorrhage or post-abortion bleeding.
Can motherwort be used orally for uterine bleeding?
Oral motherwort lacks robust evidence for preventing uterine bleeding; the injectable form is clinically preferred and better supported by research for this purpose.
Are there risks of uterine hyperstimulation with motherwort?
While a potential for uterine hyperstimulation exists, it is not commonly reported in clinical settings, and monitoring is standard practice during its use.
How soon are effects seen after motherwort administration?
When administered via injection, the uterotonic effects of motherwort typically occur rapidly, often within minutes to hours post-injection.
Research Sources
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.916665/full – This systematic review and meta-analysis of RCTs found that prophylactic motherwort injection significantly reduces the risk of uterine hemorrhage after abortion, demonstrating an acceptable safety profile. However, the study noted moderate heterogeneity and some low-quality trials, suggesting a need for larger, high-quality RCTs to confirm findings.
- https://onlinelibrary.wiley.com/doi/abs/10.1111/jebm.12300 – This systematic review and meta-analysis indicated that motherwort injection, when combined with oxytocin, reduces the incidence of postpartum hemorrhage in women undergoing cesarean section. The authors highlighted limitations including small sample sizes in some trials and a risk of bias, leading to low to moderate quality evidence.
- https://pubmed.ncbi.nlm.nih.gov/31354850/ – This systematic review and meta-analysis suggested that motherwort injection, used as an adjunct to oxytocin, may improve outcomes in preventing postpartum hemorrhage after vaginal delivery. However, the evidence was not definitive and was considered low quality, underscoring the need for more rigorous RCTs.
