Miscarriage or spontaneous abortion is the loss of a pregnancy without medical or mechanical means before completion of the 20th week of gestation. The fetus is not sufficiently developed to have been able to survive outside the mother’s womb. Threatened miscarriage is a very common in early pregnancy. Most threatened miscarriages occur in the first 12 weeks of pregnancy and become evident as vaginal bleeding, abdominal and low back pain that persist for days or weeks. So far, therapies have limited effectiveness in preventing early pregnancy loss due to threatened miscarriage. Chinese herbal medicines are a part of Traditional Chinese Medicines and are made up of products from plants and some animal and mineral substances. They have become very popular and are commonly used as an alternative treatment for threatened miscarriage.
This review compared the therapeutic effects of Chinese herbal medicines with other pharmaceutical agents. Among the 44 included randomised trials involving 5100 participants, all from China, no trial used placebo or bed rest as a control intervention. Twenty trials used a common prescription of Shou Tai Pill as a basic formula, while the other 24 trials used other formulae. The Western medicines included tocolytic drugs such as salbutamol and magnesium sulfate, hormonal supplementation with human chorionic gonadotrophin or progesterone and supportive supplements including vitamin E and folic acid. Five trials followed 550 women until after 28 weeks of gestation and delivery and showed that combined Chinese herbal and Western medicines were more effective than Western medicines alone in the treatment of threatened miscarriage. The remaining studies looked at the immediate effects of treatment. Combined treatment was more effective than Western medicines in preventing inevitable miscarriage so that the pregnancy continued. Many of the trials did not report on side effects during treatment or throughout continuing pregnancy and birth. Chinese medicine practitioners slightly modify the classical prescriptions depending on the individual women’s clinical presentations. All the trials had poor methodological quality. In conclusion, there is a lack of evidence from randomised controlled trials on the effectiveness of Chinese herbal medicines for the treatment of threatened miscarriage and to determine if Chinese herbal medicines alone are more beneficial than Western medicines alone for threatened miscarriage.