A newborn infant whose mother ingested an herbal medication, blue cohosh, to promote uterine contractions presented with acute myocardial infarction associated with profound congestive heart failure and shock. The infant remained critically ill for several weeks, although he eventually recovered. Other causes of myocardial infarction were carefully excluded. Blue cohosh, Caulophyllum thalictroides, contains vasoactive glycosides and an alkaloid known to produce toxic effects on the myocardium of laboratory animals. We believe this represents the first described case of deleterious human fetal effects from maternal consumption of blue cohosh.

– Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. — J Pediatr 1998 Mar;132(3 Pt 1):550-2 — Jones TK, Lawson BM.

Numerous natural products have been used as traditional abortifacients, each with their own efficacy and adverse effects. With the continued growth of the natural products industry, clinicians are more likely to see adverse effects from attempted abortions using these agents. A 21-y-old female developed tachycardia, diaphoresis, abdominal pain, vomiting and muscle weakness and fasciculations after using blue cohosh (Caulophyllum thalictroides) in an attempt to induce an abortion. These symptoms are consistent with nicotinic toxicity and probably resulted from methylcytisine known present in blue cohosh. The patient’s symptoms resolved over 24 h and she was discharged. Whether successful or not, the use of natural agents to induce abortion is frequently associated with adverse effects in the mother or fetus. Clinicians should recognize the potential toxicity of these agents.
– Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. — Vet Hum Toxicol 2002 Aug;44(4):221-2 — Rao RB, Hoffman RS.