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Over the last decade academic interest in the prevalence and nature of herbal medicines use by pregnant women has increased significantly. Such data are usually collected by means of an administered questionnaire survey, however a key methodological limitation using this approach is the need to clearly define the scope of 'herbals' to be investigated. The majority of published studies in this area neither define 'herbals' nor provide a detailed checklist naming specific 'herbals' and CAM modalities, which limits inter-study comparison, generalisability and the potential for meta-analyses. The aim of this study was to compare the self-reported use of herbs, herbal medicines and herbal products using two different approaches implemented in succession. Cross-sectional questionnaire surveys of women attending for their mid-trimester scan or attending the postnatal unit following live birth at the Royal Aberdeen Maternity Hospital, North-East Scotland. The questionnaire utilised two approaches to collect data on 'herbals' use, a single closed yes/no answer to the question \"have you used herbs, herbal medicines and herbal products in the last three months\"; and a request to tick which of a list of 40 'herbals' they had used in the same time period. A total of 889 responses were obtained of which 4.3% (38) answered 'yes' to herbal use via the closed question. However, using the checklist 39% (350) of respondents reported the use of one or more specific 'herbals' (p<0.0001). The 312 respondents who reported 'no' to 'herbals' use via the closed question but \"yes\" via the checklist consumed a total of 20 different 'herbals' (median 1, interquartile range 1-2, range 1-6). This study demonstrates that the use of a single closed question asking about the use of 'herbals', as frequently reported in published studies, may not yield valid data resulting in a gross underestimation of actual use.

The co-occurrence of endometrial stromal sarcoma and pregnancy is a rarely documented occurrence, leading to a scarcity of comprehensive research and treatment guidelines in the current literature. This case is centred around a low-grade stromal sarcoma in a woman at 15 weeks of gestation. Initially presenting with left iliac fossa pain and elevated inflammatory markers, the diagnosis was suspected to be pyelonephritis, which prompted the initiation of intravenous antibiotics. Persistent symptoms prompted an MRI at 19 weeks’ gestation, which revealed a mass expanding into the left internal iliac and left common iliac veins, as well as compression and invasion of the left distal ureter and associated obstructive uropathy to the level of the mass. This case highlights the diagnostic challenges and multidisciplinary management of the patient as well as the justification for supporting her wishes to continue with the pregnancy.

Aims. To undertake a systematic review of the recent (2008–2013) primary literature, describing views and experiences of CAM use during pregnancy by women and healthcare professionals. Method. Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Review Library and Allied, and Complementary Medicine Database were searched. Studies reporting systemic CAM products (homeopathic preparations, herbal medicines, Vitamins and minerals, homeopathy, and special diets) alone or in combination with other nonsystemic CAM modalities (e.g., acupuncture) were included. Results. Database searches retrieved 2,549 citations. Removal of duplicates followed by review of titles and abstracts yielded 32 relevant studies. Twenty-two reported the perspectives of women and their CAM use during pregnancy, while 10 focused on healthcare professionals. The majority of studies had significant flaws in study design and reporting, including a lack of appropriate definitions of CAM and associated modalities, absence of detailed checklists provided to participants, the use of convenience sampling, and a general lack of scientific robustness in terms of data validity and reliability. Conclusion. To permit generalisability of study findings, there is an urgent need to expand the evidence base assessing CAMs use during pregnancy using appropriately designed studies.