Use of Chinese herbal medicine ‘meizitanc’ in pregnancy: Report of three cases Filiz Çayan 1 , Umut Dilek 1 , Esen Akbay 2 , Ramazan Gen 2 and Saffet Dilek 1 Departments of 1 Obstetrics and Gynecology and 2 Endocrinology and Metabolism, University of Mersin School of Medicine, Mersin, Turkey Abstract The Chinese herbal medicine ‘meizitanc’, known as ‘LiDa Dai Dai Hua Jiao Nang’ (Kunming Dali Industry and Trade, Kunming, Yunnan, China) has been used by many women to support weight loss, even though life-threatening side-effects and deaths have been reported. We report the outcomes of three cases of exposure to ‘meizitanc’ during early pregnancy. In the first case, the pregnancy continued after the patient stopped taking the drug and at 38 weeks of gestation, the patient delivered a healthy infant. However, in the second and third cases fetal cardiac activities were not detected on obstetric follow-up and both pregnancies were terminated due to missed abortion. To our knowledge, this is the first report of exposure to meizitanc during pregnancy. Although herbal medicines are presumed to be safe because of their natural origin, consumption of such products may be dangerous due to the content of undeclared drugs, adulteration with multiple sub- stances and contamination with toxic metals. Key words: contamination, herbal medicine, meizitanc, pregnancy, toxic metals. Introduction Herbal medicines have recently increased in popularity because of the growing use of naturally derived sub- stances throughout the world. 1 Although they are offered as pure herbal concentrates, the presence of synthetic adulterants in herbal medicines may cause serious and life-threatening consequences. 2 The Chinese herbal medicine ‘meizitanc’, known as ‘LiDa Dai Dai Hua Jiao Nang’ (LiDa) (Kunming Dali Industry and Trade, Kunming, Yunnan, China) has been used by many people for weight reduction despite its hazard to human health and life. Although serious side-effects and deaths have been reported and its sale has been banned in many countries, many people can still acquire it over the internet. 3,4 The aim of the present study was to report the outcome of pregnancy in three women who used ‘meizitanc’ for weight loss for 3 to 6 (average 4.6) months during early pregnancy. To our knowledge, this is the first study to report fetal outcomes after meizitanc use in pregnant women. Cases In the first case, a 28-year-old healthy woman, (gravida 1, parity 0) was exposed to LiDa during the first 7 weeks of her unplanned pregnancy. She had been using the drug without any medical consultation for the purpose of slimming (BMI = 25), and had been taking one capsule (350 mg) per day for 3 months. An obstetrical ultrasound showed a viable singleton intrauterine pregnancy consistent with her dates, and she continued her pregnancy after ceasing use of the drug. The fetal nuchal translucency was 1.1 mm, within the normal limits, and the double screen was normal at 12 weeks of gestation. The patient’s antenatal course was uneventful and at 38 weeks of gestation she deliv- ered by cesarean section, due to breech presentation, a newborn infant weighing 3150 g with Apgar scores of 9 Received: April 10 2008. Accepted: September 18 2008. Reprint request to: Dr Filiz Çayan, Department of Obstetrics and Gynecology, University of Mersin School of Medicine, 33079 Mersin, Turkey. Email: filizcayan@yahoo.com doi:10.1111/j.1447-0756.2008.01004.x J. Obstet. Gynaecol. Res. Vol. 35, No. 4: 801–803, August 2009 © 2009 The Authors 801 Journal compilation © 2009 Japan Society of Obstetrics and Gynecology