الفهرس 
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Abstract
Herbal medicines are preparations derived from naturally occurring plants with medicinal or preventive properties.
The increase in the use of natural health products, particularly herbal products, is noticed all over the world.
There is substantial evidence, indicating that up to 50% of the general population has tried at least one herbal product. The safety of herbal drugs becomes particularly important in some subpopulations of patients such as pregnant women and children, who are more vulnerable to the effects of drugs as well as of natural products for their physiological characteristics.
Herbal remedies which are in popular use amongst pregnant women are:
Ginger (Zingiber officinale):
It is a well-known remedy for gestational sickness.Its antiemetic effects probably being due to local gastrointestinal anticholinergic and antihistaminic actions.
Garlic (Allium sativum):
Garlic’s antibacterial and antifungal characteristics make it an ideal nutrient to consume, particularly during pregnancy. Garlic will enhance the mothers immune system which in turn will enhance her odds on having a healthy pregnancy and most importantly a healthy baby.
Green Tea (Camellia sinensis):
This substance contributes to regulation of blood sugar, cholesterol and blood pressure levels. This product also helps to speed up the body’s metabolic rate and provides a natural source of energy. It could possibly help to stabilize a pregnant woman’s moods, which is the best advantage.
Peppermint (Mentha piperita):
Peppermint has been used since antiquity to treat a variety conditions, including gastrointestinal (GI) disorders, common cold and respiratory conditions, muscle pain, headaches, and neuralgia during pregnancy.
Fenugreek (Trigonella foenum-graecum, T. foenugraecum):
Fenugreek stimulates uterine contractions and fastens labor process. It is also helpful in inducing childbirth. The natural herb is also said to increase the production of milk in lactating women.
We aimed in this study to spot light on this topic and to explore patterns of herbal medications use including dietary supplements in pregnant women in Alexandria.
To accomplish this aim, a cross sectional study of pregnant females was conducted in a family health center in Alexandria as it was appropriate for gathering data and reflecting what actually prevailed. The estimated sample size was approximated to 300 pregnant women. A specially designed questionnaire was used to collect the data by interviewing the pregnant females in the study sample.
About (27%) of the studied sample of pregnant females reported that they use herbal medicines while higher percentage of pregnant females were using dietary supplements (89%).
Out of the total number of studied pregnant women, 77% of them had secondary education or higher while 19% had basic education and only 4% were illiterate. No statistically significant difference was found between educational level of pregnant female and use of herbal medicines while there was a significant relationship between educational level of pregnant females and usage of dietary supplement.
The mean age of the studied pregnant females was 26.9 ± 4.9 years with a minimum of 17years and a maximum of 45 years. A significant relationship between age of pregnant female and usage of both herbal medicines and dietary supplements was detected. The median age of users of herbal medicines and dietary supplements was significantly older than that of non-users.
The mean number of gravidity of the studied pregnant females was 2.3 ± 1.2 pregnancies with a minimum of 1 pregnancy and a maximum of 8 pregnancies. A significant relationship was found between the number of pregnancies and the use of herbal medicines while no significant relationship between the number of pregnancies and the use of dietary supplements was found. The users of herbs had a significantly higher gravidity status than non-users.
The mean number of parity of the studied pregnant females was 1.2 ± 1.0 child with a minimum of no child (primi) and a maximum of 7 children. There was a significant relationship between the number of children and the use of herbal medicines while there was no significant difference between users and non users of dietary supplements as regard parity of pregnant women. The users of herbs had a significantly higher mean number of children than non-users.
The mean body mass index of the studied pregnant women was 28.1 ± 2.3 with a minimum of 24.6 and a maximum of 36.2. A significant relation between BMI of the studied pregnant women and the use of both herbal medicines and dietary supplements was also reported. Median body mass index was higher in users of both herbal and dietary supplements than non-users.
Regarding the person who recommended the use of herbs, it was found that 18.3% of female users themselves made the decision to use herbal medicines, whereas 28% of them were recommended to use herbs by friends, less than half of subjects (42.7%) were advised by family while physician was rarely cited as the person recommending herbal usage as stated by only 11% of subjects. However, physicians had the upper hand in recommending dietary supplements where 76% of pregnant female users reported that physicians advised them about the use of dietary supplements, 2.2% took them by themselves, while 14.3%, 7.5 % reported that family and friends recommended dietary supplements respectively.
Out of the total number of studied pregnant female non-users, 49.5% of them did not trust effect of herbs, meanwhile 30.3% were afraid of side effects of herbs during pregnancy, and 20.2% did not believe in herbs
The most common herbs used by pregnant women were Aniseed (40.2%), fenugreek (31.7%), ginger (29.3%), garlic (22%), green tea (19.5%) and peppermint (11%).
Concerning the result of using herbs, 64.6 % reported that herbal medicines were effective in relieving their complaints while 35.4 % stated that herbs were not effective.
Regarding the indications for use of herbs, 47.6 % used them to relief abdominal colic during pregnancy, while 28% used herbal medicines for nausea and vomiting and 9,7 % used them for relieving dysurea, while 2.4 % used them to relief headache, and 18.2% used them without any indication.
There was no statistically significant relationship between use of dietary supplement among the studied pregnant females and use of herbal medicines.
As regards types of herbs used by studied pregnant females, there was no significant relationship between the different pregnancy trimesters and the use of peppermint, green tea, garlic and aniseed while there was a significant relationship between trimesters and usage of ginger and fenugreek.
Ginger was found to be used by significantly higher percentage of pregnant women in the first trimester than in the second or third trimesters (52.4%, 20% and 22.6% respectively).
On the other hand, Fenugreek was used by a significantly higher percentage of pregnant women in the third trimester (51.6%) than in the first (19%) or second (20%) trimesters.
About one fifth( 20.7%) of the studied pregnant female believed that herbal medicines are used for reduction of weight while 4.9% believed that it is used as antibiotic , and 15.9%believed that it facilitates deliveries while 25.6% believed that it improves lactation and 6.1% believed that it controls diabetes.