11th NAPRECA Symposium Book of Proceedings, Antananarivo, Madagascar Pages 110-122

Ethno-pharmacological screening of Vernonia amygdalina and Cleome

gynandra traditionally used in Childbirth in Western Uganda

Maud Kamatenesi-Mugisha1*, Hannington Oryem-Origa1, Olwa-Odyek2 & Dominic W.

Makawiti3
1
Department of Botany, Makerere University, P.O Box 7062, Kampala, Uganda. Tel. 256-
41-540765; Fax. 256-41-530134
2
Department of Pharmacy, Medical School, Makerere University, P.O Box 7062, Kampala,
Uganda
3
Department of Biochemistry, College of Health Sciences, University of Nairobi, P.O Box
30197, Nairobi, Kenya
*Corresponding author: Tel: 256-77-438905; e-mail: mkamatenesi@botany.mak.ac.ug,

Abstract
Over 80% of pregnant women in Western Uganda deliver at home with the assistance of
mainly traditional birth attendants who use herbal remedies to complete the processes of child
bearing in the rural communities. In Uganda, complications resulting from reproductive health
related conditions such as maternal mortality and morbidity (20.4%) account for number one
problem among the disease burden followed by malaria (15.4%). The national maternal
mortality average is 506/100,000 and that has remained stable for over the last ten years. Despite
the wide usage of herbal remedies in childbirth, this indigenous knowledge is not well
documented and the claims not properly validated through scientific scrutiny under
conditions mimicking the indigenous methods of use. This paper will discuss the crude
aqueous herbal extracts of Vernonia amygdalina Del. and Cleome gynandra L. that were
screened for their bioactivities on the motility of the rat uterus and rabbit jejunum. The
ethnopharmacological screening results showed that the aqueous herbal extracts of V.
amygdalina and C. gynandra increased rat uterine motility. In addition, aqueous extracts
from V. amygdalina caused rabbit jejunum contraction. The aqueous plant extracts of V.
amygdalina and C. gynandra that increased the rat uterine contraction may be oxytocic. Since
the usage of herbal medicines offers a holistic approach that is lacking in western medicine,
integration and safety aspects of herbal medicine development is a concern to the developing
countries and globally.

Key words: medicinal plants, oxytocics, childbirth, western Uganda

1. Introduction
In Uganda, complications resulting from reproductive health related conditions such as
maternal mortality and morbidity account for number one problem among the disease burden
(NHP, 1999, HSSP, 2000). The perinatal and maternal related conditions (20.4%) being the
first, followed by malaria (15.4%), acute lower respiratory infections (10.5%), AIDS (9.1%) and
diarrhoea (8.4%) and these together account for over 60% of the total burden. The national
maternal mortality average is 506/100,000 (HSSP, 2000) and that has remained stable for the
last ten years and infant mortality is 89.4/1,000 (CIA, 2002), excluding home deaths that are not
recorded. The Ugandan population having access to basic health services within 5 kilometre
walking distance is 49% because most health centres are confined in urban areas. More than
60% of mothers in Uganda are not attended to by trained health personnel during child-birth.
In Uganda, there are at least 290 people for one traditional medical practitioner, compared to one
western trained medical practitioner for every 10,000 people in urban areas and 50,000 people

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in rural areas (IK Notes, 2003). This is an indicator that the health sector in Uganda is grossly
underdeveloped. The Uganda’s population of over 24 million, high population growth rates of
about 3.0 % and the fertility rate close to 7.0 is a threat to women health and make it difficult for
the proper provision of basic health facilities (UNAIDS, 2002, CIA, 2002). On average, the
number of children born to a Ugandan woman during her life time is 6.9 which is substantially
greater than Kenya’s total fertility of 3.4 and Tanzania’s rate of 5.3 (CIA, 2002; Kelley, 2003).

The research findings in Chapter two reveal that over 80% of the mothers use traditional
medicine to provide health care for themselves and children. The treatments of most of the
ailments that women suffer especially in rural areas depend on herbs first and in case the
condition deteriorates, then they seek modern health facilities. Over 80% of pregnant women in
Western Uganda have childbirth at home with the assistance from traditional birth attendants
(TBAs) who use herbal remedies (Kamatenesi-Mugisha, 2004). For instance, to complete the
processes of child bearing, herbs are mainly given by the traditional birth attendants and other
knowledgeable elderly women and mothers in the rural communities (Neema, 1999;
Kamatenesi-Mugisha, 2002). The use of herbal medicines offers a holistic approach that is
lacking in western medicine (Anokbonggo, 1992) and its development is a concern to the
developing countries and on global panorama (WHO, 2002a; WHO, 2002b).

Although few studies have been carried out on the pharmacological properties of medicinal
plant species such as Phytolacca dodecandra and Solanum terminale (Anokbonggo, 1974)
with respect to reproductive health care in Uganda, the majority of plant species though
widely used, have not been well researched. This knowledge in herbal medicines used in
inducing labour and inhibiting threatened abortion is not well documented and claims
properly validated through scientific scrutiny mimicking the local knowledge. Thus, in this
study the crude aqueous extracts of the herbal drugs were screened by carrying out bioactivity
tests on the rat uterus motility and rabbit jejunum motility. The herbs used in traditional
medicine to induce uterine contractions (the oxytocics also used as abortifacients and in post-
partum haemorrhage) and the medicinal herbal drugs that inhibited pre-term labour or
threatened abortions and miscarriages (the tocolytics) were studied in vitro.

The Therapeutic Values of Oxytocics

The oxytocics are agents promoting uterine contractions. Oxytocin is the drug of choice for
the induction of labour. Oxytocin is a posterior pituitary hormone that is synthesized in the
hypothalamus, transported to the posterior pituitary gland for storage and then released into
the circulation (Katzung, 1992). Oxytocin is a petptide secreted by the posterior pituitary
gland. Oxytocin elicits milk ejection in lactating women, induces uterine contractions,
maintains and augments labour. Oxytocin can be used for the control of postpartum
haemorrhage. Oxytocin stimulates both the frequency and force of uterine contractions. The
spontaneous responsiveness of the uterus to Oxytocin roughly parallels the increase in
spontaneous activity. These Oxytocin effects are highly dependent on oestrogen and the
maturity of the uterus. Dysfunctional labour augmentation by Oxytocin is seen more
frequently in nulliporous women, where Oxytocin can be used to their advantage to facilitate
labour. Oxytocin is useful where there is very prolonged latent phase of cervical dilation,
compromised foetal oxygenation due to loss of placenta exchange, incompletely dilated
cervix and ruptured membranes. However, indications of induction of labour include
situations in which the risk of continued pregnancy to the mother or foetus is considered
greater than the risk of delivery or of pharmacological induction. Such circumstances include
premature rupture of the membranes, isoimmunisation, intrauterine growth retardation and
placental insufficiency (i.e. as in diabetes, preeclampsia or eclampsia pregnant mothers).

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However, Oxytocin has also similar potential complications like causing ruptured membranes
in case of overuse.

Oxytocin is used for induction and reinforcement of labour in women with mild pre-
eclampsia near term, uterine inertia and incomplete abortion and it cannot be used for elective
induction of labour in the absence of these indications (Katzung, 1992). During the first two
trimesters of pregnancy, the motor activity is very low, but spontaneously the motor activity
progressively increases until the sharp rise that constitutes the initiation of labour and
delivery (Hardman, et al., 2001).

After delivery of foetus or following therapeutic abortion, it is desirable to have the uterus
firm and contracted and this greatly reduces the incidence and extent of haemorrhage.
Oxytocin is usually given after delivery to help to maintain uterine contractions and tone. In
non-hypertensive patients, ergot alkaloids such as ergonovine maleate (ergotrate) or
methylergonovine maleate (Methergine) are used.

Oxytocin also plays an important physiological role in milk ejection. Stimulation of breasts
through suckling and mechanical manipulation induces Oxytocin secretion, causing
contraction of the myoepithelium that surrounds areolar channels in the mammary gland. The
action forces milk from the alveolar channels into large collecting sinuses where it is
available for the suckling infant.

Specific Objective
The specific objective of this study was to examine the biological activities of Vernonia
amygdalina and Cleome gynandra medicinal plants commonly used in traditional medicine in
reproductive health care.

2. METHODS

Ethnobotanical Data Collection Methods

The research methods used to collect the ethnobotanical information were mainly those that
promoted free sharing of information between the researchers, the herbalists and other people
in the community. Therefore, informal conversations and semi-structured interviews group
and individual focused group discussions and field visits were conducted to generate the
ethnobotanical data (Martin, 1995). To reach the traditional medical practitioners (TMPs) and
traditional birth attendants (TBAs), the local authorities (Local Council Leaders) and
herbalists associations in villages were consulted. This ethnobotanical information was
collected through visiting traditional healers to document the indigenous knowledge (IK)
regarding medicinal plants used, ailments treated, gender and socio-cultural aspects. The
medicinal plants voucher specimens were collected, documented and identified in the
Makerere University Herbarium. The main respondents during the study were traditional
healers, traditional birth attendants (midwives), women and elderly people.

Collection, Preparation and Extraction of the Plant Material

The medicinal plants studied in this paper Cleome gynandra L. (Capparaceae) and Vernonia
amygdalina Del. (Asteraceae), have been used traditionally to induce childbirth hence hasten
labour process. The plant voucher specimens for identification were collected from Kirugu
Parish in Kichwamba sub-county, Bushenyi District in western Uganda between August and
December 2000 and were identified in Makerere University Herbarium. The plant materials
for scientific validation of Cleome gynandra (roots) and Vernonia amygdalina (leaves) were

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collected from Kichwamba and Kitagata sub-counties in Bushenyi district between March
and April 2001 respectively.

The different plant parts used in folk medicine were collected and air-dried at room
temperature for at least one month. The plant parts collected were according to the traditional
healers’ prescriptions. The dried plant materials were pounded in a metallic mortar into fine
powder. Some other plant materials were grinded using an electric grinder. The pounded
plant materials were extracted with 80-95% ethanol and water extracts were prepared and
then freeze-dried using a freeze drier in the Department of Pharmaceutical Chemistry,
Faculty of Pharmacy, University of Nairobi. However, due to mechanical breakdowns, low
freeze-drier mortar capacity and great demand of the freeze-drier; it was not possible to
freeze dry all the samples. Thus, more water extracts were prepared and then oven dried at 40
0
C to 45 0C in the Malaria Pharmacognosy Laboratory in the Department of Pharmacology
and Pharmacognosy in the Faculty of Pharmacy of University of Nairobi, Kenya. To prepare
the water extracts, weighed amounts of plant material were put in conical flasks and boiled in
water for 10-15 minutes, cooled and filtered using the suction pump or a funnel and cotton-
wool. The filtrates were then stored at -20 0C and later freeze-dried or oven dried in small
portions.

For ethnopharmacological screening of the claimed tocolytic and oxytocic properties of

medicinal plants, water extracts were used. The fundamental logic behind using water as a
solvent in the extraction was because the local people (traditional medical practitioners)
administer most of their medicine in aqueous form. However, ethanol may be used as a
solvent because at times traditional healers use locally made alcohol or fermented porridge or
milk to extract and administer herbal drugs besides normal consumption of ethanol as a
beverage by humans. In addition, in terms of polarity, ethanol is the safest substitute of water
since it extracts most of the compounds that would be extracted by water.

Procedure of preparing the rat uterus

Young wistar virgin female rats weighing between 120-200g were used in the uterine motility
experiments. The rats were obtained from the University of Nairobi, Faculty of Pharmacy
animal house. The sensitivity of the uterus was increased by a subcutaneous injection of the
abdomen with stilboestrol (0.1 mg/kg) in the laboratory of Clinical Pharmacology and
Therapeutics in the Faculty of Medicine, University of Nairobi. The rats were left for 48
hours after which these young rats were sacrificed by a blow on the head. The uterus was
carefully dissected in a petri dish of De Jalon Ringer Solution at 320C. The uterine horns
separated from the animal just below the ovaries were cleaned and any extraneous fat and
connective tissues were removed. The horns were then separated at the bifurcation, yielding
two preparations. One preparation was taken and mounted in the aerated (95% O2 and 5 %
CO2) organ bath at 32 0C to 37 0C, for 30 to 45 minutes to normalize before adding the plant
crude extracts and standard drugs (oxytocin) so that the spontaneous activity could be
deduced.

To minimise the experimental errors of dilution, the known weighed drugs were transferred
into the test tubes and dissolved in de Jalons solution since they were water extracts. In each
consecutive experiment, new de Jalons solution and crude plant drug were freshly made.

The plant drug or standard drug (for control) was then injected into the organ bath with the
tissue and the 7050 Microdynamometer Recording Machine, connected to the transducer and
writing lever that was translating the tissue movements on the 7050 Microdynamometer

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recording graph paper (Fig.1). The tissue was always washed with De Jalon Ringer solution
after every injected drug (or set of drugs) and recording was done before another drug (or set
of drugs) was introduced. The time of tissue washing varied based on the behaviour of the
drug on the tissue. The washed tissue in the organ bath was left to normalise before addition
of another drug. The temperature of the organ bath containing the tissue was always
maintained between 32-370C.

Procedure of preparing the Rabbit Jejunum

A rabbit was sacrificed, the abdomen opened, the caecum was lifted forwards, and the ileum
was found joined at the back of it. The duodenum was cut at a point 5 to 10 cm below the
stomach and the length taken from here downwards to the caecum and placed in a dish
containing Tyrode’s solution. The tissue did not require intensive washing because the rabbit
intestines are wider than guinea-pig intestine and partly because of the Jejunum spontaneous
activity that causes it to clear itself even after cutting it. Great care was taken to avoid
damaging the gut muscle. It was handled with fingers rather than being gripped with forceps.
The mesentery was trimmed away and pieces were cut from the length of jejunum, as
required starting above Peyer’s patch. A portion of 2-3 cm in length, free from mesenteric
attachments, was cut and tied with thread at each end, taking care to see the jejunum is left
open and then the threads did not close the lumen. Each piece was then mounted in an organ
bath and aerated with a mixture of 95% oxygen and 5% carbon dioxide. Once mounted, the
piece of the rabbit jejunum was contracting rhythmically and regularly. After normalizing the
tissue for about 30 minutes, the herbal drugs were introduced as well as standard drugs to act
as controls and the pendular movements of the rabbit jejunum were translated by the
transducer attached to the 7050 Microdynamometer Recording Machine on the 7050
Microdynamometer recording paper (Fig. 1.). The crude plant extracts of C. gynandra and V.
amygdalina wer3 screened for both oxytocic and tocolytic effects on the isolated rat uterus
and rabbit jejunum and the motility of the tissue and time were recorded.

Figure 1. The 7050 Microdynamometer Recording Machine, recording of the

uterine or jejunum motility

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Procedure of preparing the aqueous herbal drugs

100 mg of aqueous crude plant sample were weighted using a weighing machine of up to 4
decimal places. The stock aqueous extracts for the bioassay were prepared by dissolving 100
mg of the crude extract in 5 ml of De Jalons solution for rat uterus or Tyrode’s solution for
the rabbit jejunum experiments. The serial dilutions were further made from the stock
solution where necessary. To draw the specified amount of the herbal drug to introduce to the
organ bath, one ml new disposable syringes were used. The tissues were mounted in the
bathing solution of approximately 7 ml of De Jalons and Tyrode’s solutions for the uterus and
jejunum tissues respectively. Therefore, the actual concentration of the herbal extract is that
particular concentration drawn using the syringe plus the organ bath dilution effect. The
concentration of the stock solution for all crude extracts was prepared by dissolving 100 mg
in 5 ml of either De Jalons or Tyrode’s solution to obtain 20 mg/ml. Thus, 20 mg/ml is
divided by 7 ml of the organ bathing solution to obtain the actual concentration used (Table
1).

Table 1. The actual dilutions of the aqueous herbal drugs

Concentration of the stock Concentration, (mg/ml) Final concentration in

solution, (in ml) organ bathe (mg/ml)
0.1 2.0 0.286
0.2 4.0 0.571
0.3 6.0 0.857
0.5 10.0 1.429
1.0 20.0 2.857
2.0 40.0 5.714

3. RESULTS

Ethnobotanical uses

The roots and leaves decoction of Vernonia amygdalina are traditionally used in western
Uganda to treat various ailments such as treatment of painful uterus, inducing uterine
contractions, management of retained placenta and post partum bleeding, malaria, induced
abortion, antimicrobes (bacterial and fungal infections), infertility, colic pains and treatment
of irregular and painful menstruation (Kamatenesi-Mugisha 2004).

The roots of Cleome gynandra are chewed to induce uterine contractions and removal of
retained placenta and control post partum bleeding in childbirth process. The roots, leaves
and flowers of Cleome gynandra are used in the prevention of miscarriages and treatment of
colic pains when boiled or cooked as food. The leaves, roots and flowers of Cleome gynandra
are chewed, cooked or are sun-dried and drank in tea to treat sexual impotence or erectile
dysfunctions in men (Kamatenesi-Mugisha, 2004; Kamatenesi-Mugisha & Oryem-Origa
2005).

V. amygdalina is mainly growing as a wild plant although in Cameroon is eaten as vegetable.

C. gynandra is home grown and is widely used as an edible food and vegetable in most parts
of Uganda and East Africa.

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The effects of V. amygdalina on the uterine motility

The aqueous extract of V. amygdalina dissolved completely in the De Jalons solution. V.
amygdalina extract, at 0.29 mg/ml, 1.43 mg/ml, 1.71 mg/ml and 2.86 mg/ml, showed
increased rat uterine motility (Fig. 2 i, ii, iii). The extract of V. amygdalina displayed similar
uterine motility as Oxytocin (Fig. 2, iii). With the increased concentration of V. amygdalina,
uterine motility increased. Thus, the aqueous herbal extract of V. amygdalina causes uterine
contractions.

Vernonia amygdalina
V. amygdalina

(i) V. amygdalina (0.29, 1.71 mg/ml) (ii) V. amygdalina (1.43, 2.86 mg/ml)

Vernonia
amygdalina

(iii) V. amygdalina (2.86 mg/ml) and Oxytocin (1 µg /ml)

Figure 2. The effects of Vernonia amygdalina on the uterine motility

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The effects of C. gynandra on the uterine motility.

The aqueous root extract of C. gynandra (2.86.mg/ml) showed weak uterine motility (Fig. 3i)
in comparison to the uterine motility caused by Oxytocin (Fig. 3ii). However, on combining
C. gynandra (2.86 mg/ml) with Oxytocin (1.0 µg/ml) (Fig. 3 iii), the uterine motility
increased slightly higher than Oxytocin alone but went down after 5 minutes. Cleome
gynandra had weak uterine stimulating effects and might be acting to facilitate the activity of
Oxytocin at childbirth.

Cleome gynandra
Cleome gynandra

(i) C. gynandra (2.86.mg/ml) (ii) Oxytocin (1.0 µg/ml)

Cleome gynandra

(iii) C. gynandra (2.86 mg/ml) + Ocytocin (1.0 µg/ml)

Figure 3. The effects of Cleome gynandra on the uterine motility

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The effects of V. amygdalina on the jejunum motility

The different concentrations of Vernonia amygdalina (0.86, 1.43, 2.86 mg/ml) increased the
jejunum motility (Fig. 4 i, ii). The stimulating effects of V. amygdalina (Fig. 4 ii) and the
standard drug, Carbachol (Fig. 4 iii), showed similar behaviour by shifting the baseline and
increased jejunum motility. The aqueous extract of Vernonia amygdalina contracted the
smooth muscle of the rabbit jejunum and shifted the baseline upwards. The V. amygdalina
(0.86 mg/ml) extract is able to cause effective jejunum contractions.

V. amygdalina
V.amygdalina

(i) V. amygdalina (0.86, 1.43, 2.86 mg/ml) (ii) V. amygdalina (2.86 mg/ml)

V. amygdalina

(iii) Carbachol (2.0µg/ml)

Figure 4. The effects of Vernonia amygdalina on the jejunum motility

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4. DISCUSSION
The rat uterus tissue was used in ethnopharmacological screening because Vernonia
amygdalina and Cleome gynandra herbal remedies are used in stimulating childbirth
traditionally. The smooth muscle of the rat uterus was the point of contact for these herbal
drugs experimentation due to its high sensitivity among other laboratory animals. The
aqueous extracts of Vernonia amygdalina and Cleome gynandra contracted and increased the
uterine motility.

The aqueous herbal extract of Vernonia amygdalina of that showed marked rat uterine
stimulation (oxytocic) was further re-screened using the smooth muscle of the rabbit jejunum
to confirm the findings. The rabbit jejunum was used because of being a smooth muscle like
the uterus and the pronounced pendular movements due to its high sensitivity. Vernonia
amygdalina contracted the jejunum motility.

In the interpretation of the results, normal motility is the baseline for that particular tissue.
Standard drugs were used as the controls of the set up. The medicinal plants selected for
ethnopharmacological tests were based on the ethnobotanical indigenous knowledge. The fact
that traditional healers have been using these plants for ages is a worthwhile reason to
investigate their efficacy in the claimed use and matching preparations in the laboratory with
indigenous knowledge.

The aqueous herbal extract of V. amygdalina is a strong oxytocic plant. The herbal extract
was found to be long acting and when introduced to the rat uterus, it caused contractions that
were sustained over 30 minutes. The decoction of V. amygdalina is used for treating malaria
irrespective of age, gender, sex and pregnancy in western Uganda, yet the plant is oxytocic as
displayed in (Figs. 2 and 4). The use of V. amygdalina extract to treat malaria in pregnancy is
scientifically dangerous since it increased uterine motility. According to the findings in this
work, the plant drug is oxytocic and may cause abortion when used in preterm pregnancy.
The aqueous extract of V. amygdalina can cause uterine contractions at lower doses of less
than 300 µg/ml. The usage of V. amygdalina to induce labour can, if due care is not taken;
can cause uterine rupture or other complications to the mother and foetus. The aqueous herbal
extract of Vernonia amygdalina caused the contraction of the smooth muscle of the rat uterus
and rabbit jejunum. This is an indication that V. amygdalina can hasten childbirth or cause
abortion if used in preterm pregnancy.

Ethnobotanical uses elsewhere show that the plant is widely used in Africa. In Malawi, the
dried bark of V. amygdalina is used to improve uterine contractions during labour in pregnant
women (Bullough, & Leary, 1982). However, the aqueous extract was found inactive on the
guinea pig uterus (Bullough, & Leary, 1982). Lactating women who want to increase milk
flow (Vasileva, 1969) drink hot water extract decoction. In Guinea-Bissau and Nigeria, the
infusion of leaves of V. amygdalina is used as an abortifacient in women (Viera, 1959; Awe,
et al., 1999). In Rwanda, the methanolic extract of V. amygdalina showed weak relaxant
activity on the smooth muscle of the guinea pig ileum, but caused neither relaxation nor
stimulation of the guinea pig uterine muscle (Chagnon, 1984). Although the
ethnopharmacological experiments else where never proved more effective, it could have
been due to the choice of the test animals used since the rat uterus in more sensitive than the
pig uterine muscle.

The aqueous extract of Cleome gynandra showed weak stimulating effects on the uterus. On
combining C. gynandra extract with Oxytocin, the motility increased slightly higher. The C.

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gynandra facilitated the activity of Oxytocin. The medicinal plants like Cleome gynandra,
which is used all over Uganda to hasten childbirth, might be augmenting endogenous
Oxytocin and may be useful in hastening the process of childbirth. Cleome gynandra is
widely used in hastening childbirth (Oryem-Origa, et al., 2003).

Although herbal drugs are used in hastening childbirth, the doses used at term for initiating,
sustaining, and augmentation of labour to hasten childbirth are very low. Childbirth being an
emergency, only a few leaves are squeezed or a single root is chewed in traditional medicine.
Thus, the usage of V. amygdalina in hastening childbirth is potentially safe particularly when
administered by the traditional birth attendants with long standing experience in child births.

Unlike in the stimulation of abortion, the pregnant women consume large amounts of the
plant extracts for some days either intentionally or while treating other diseases such as
malaria to cause adverse effects. This would imply that the plant that has shown properties of
contracting the uterus is hinged on the dose dependent ratio.

The plants that may cause mild effects when consumed such as Cleome gynandra to hasten
labour and may not pose much serious threat in rupturing the uterine membranes. The plant
species that have shown to augment Oxytocin such as Cleome gynandra on the isolated rat
uterus could as well imply that they can augment the endogenous Oxytocin by sustaining the
force and amplitude of contractions hence hastening childbirth.

The oxytocic plants such as V. amygdalina have the ability of hastening parturition.
Exogenous oxytocin can initiate or enhance rhythmic contractions at anyone time. The
uterine stimulating agents used most frequently to induce or augment labour in selectively
pregnant woman (Dudley, 1997) is common in hospitals, as plants used by traditional birth
attendants to hasten childbirth is also a common practice. However, considerable higher
doses are required in early pregnancy for exogenous oxytocin to have action (Katzung, 1992;
Dudley, 1997; Hardman, et al., 2001). This may also imply that use of oxytocic medicinal
plant species such as V. amygdalina that double as antimalarial herbs in pregnancy may be
safe depending on the dosage used, the stage of pregnancy and the vitality of the pregnant
woman. Katzung (1992) reported that an eight-fold increase in uterine sensitivity to oxytocin
occurs in the last half of pregnancy, although the use of exogenous oxytocin at any stage may
facilitate labour progression. The use of exogenous oxytocics like plants in rural areas is
important in cases where there is a significant arrest of dilation or descent though great care is
required.

On comparison, the plant species such as Cleome gynandra with weak uterine motility when
consumed in small quantities may help to hasten childbirth at the onset of labour and they
may be less fatal than the definite oxytocic herbs where the dosage is not standardised as the
case of conventional Oxytocin. However, further pharmacological tests to determine dosage
are recommended for V. amygdalina and C. gynandra medicinal plants to warrant their
safety.

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5. Acknowledgements
We extend our thanks to the sponsors of this research namely, Third World Organization for
Women in Sciences (TWOWS), African Institute of Capacity Development (AICAD), NUFU
medicinal Plants project and World health Organization-Uganda. The Faculties of Pharmacy
(Department of Pharmacology and Pharmacognosy) and Medicine (Department of Clinical
Pharmacology and Therapeutics), University of Nairobi where this laboratory research
experiments were done in the Laboratories is highly appreciated. Prof. J.O. Midiwo, Prof. I.
Kibwagi, Prof. Ndele, Mr. J. Nganga, Dr. Gatuma and Prof. Mwangi, all from University of
Nairobi, Kenya are thanked for their professional advice and guidance during the study. Our
regards to all the Laboratory Technologists, Research Assistants, Traditional Healers,
Traditional Birth Attendants, Opinion Leaders for providing technical laboratory expertise
and Mr. Mungai for supplying the laboratory animals. A credit to Ms. Beatrice Owur for her
ever availability, secretarial services and supply of equipment during the laboratory
experiments. We are indebted to Dr. Hellen Rabah and Prof. Guntai for providing a good
laboratory working space, consumables and equipment supplies during the research.
Makerere University is thanked for providing some research materials and good working
atmosphere that enabled the researchers to conduct this study particularly fieldwork. In
addition, we thank DAAD-NAPRECA, IPCS for funding the trip and upkeep to Antananarivo
Madagascar to present this paper. Finally we appreciate God's providence in completing this
study.

6. References

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plants; Genera Phytolacca dodecandra and Solanum terminale. Ph.D. Thesis, Makerere
University.
Anokbonggo, W. W (1992). The role of African traditional medicine in health care delivery
alongside modern medicine. In: Sue Edwards and Zemede Asfaw (eds.), Plants used in
African Traditional medicine as practised in Ethiopia and Uganda. Botany 2000: East
and Central Africa. NAPRECA monograph series No.5. Published by NAPRECA,
Addis Ababa University, Addis Ababa.
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