title: Safety and efficacy of ginkgo (Ginkgo biloba) during pregnancy and lactation.
abstract: BACKGROUND
  There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and safety of herbal medicines used in pregnancy and lactation. This is one article in a series that systematically reviews the evidence for commonly used herbs during pregnancy and lactation.
  
  
  OBJECTIVE
  To systematically review the literature for evidence on the use, safety, and pharmacology of ginkgo focusing on issues pertaining to pregnancy and lactation.
  
  
  METHODS
  We searched 7 electronic databases and compiled data according to the grade of evidence found.
  
  
  RESULTS
  There is some very weak scientific evidence from animal and in vitro studies that ginkgo leaf has antiplatelet activity, which may be of concern during labour as ginkgo use could prolong bleeding time. Low-level evidence based on expert opinion shows that ginkgo leaf may be an emmenagogue and have hormonal properties. The safety of ginkgo leaf during lactation is unknown. Patients and clinicians should be aware of past reports of ginkgo products being adulterated with colchicine.
  
  
  CONCLUSIONS
  Ginkgo should be used with caution during pregnancy, particularly around labour where its anti-platelet properties could prolong bleeding time. During lactation the safety of ginkgo leaf is unknown and should be avoided until high quality human studies are conducted to prove its safety.
authors.affiliation: Department of Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada. jeanjacques.dugoua@utoronto.ca
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Dugoua
authors.forename: Edward
authors.initials: E
authors.lastname: Mills
authors.forename: Daniel
authors.initials: D
authors.lastname: Perri
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
mesh_terms: D000818:Animals; D005260:Female; D020441:Ginkgo biloba; D041743:Herb-Drug Interactions; D006801:Humans; D007774:Lactation; D007928:Lethal Dose 50; D018515:Plant Leaves; D028321:Plant Preparations / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use / Q000633:toxicity; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use / Q000633:toxicity; D006473:Postpartum Hemorrhage / Q000139:chemically induced; D011247:Pregnancy; D018570:Risk Assessment; D012639:Seeds
chemical_list: D028321:Plant Preparations; D010975:Platelet Aggregation Inhibitors