What is known about the use of camphor during pregnancy?/nA 30-year-old woman at 32-weeks of pregna

Fråga: What is known about the use of camphor during pregnancy? A 30-year-old woman at 32-weeks of pregnancy wants to use Tigerbalsam (camphor).

Sammanfattning: Camphor is not teratogenic in animals (rats and rabbits) and available data do not indicate any increased risk of teratogenicity in humans. However, due to its absorption through the skin, passage into the fetus and doubtful efficacy, its use during pregnancy should be discouraged.

Svar: Tigerbalsam containes camphor (0.11 percent), menthol (0.08 percent), clove oil

(0.015 percent), oil of peppermint (0.06 percent), oil of cajuput tree (0.13 percent), paraffin and vaseline.

Camphor is readily absorbed from all sites of administration, including topical application to the skin and it crosses the placenta (1). In reproductive studies in rats and rabbits given oral doses, no evidence of embryo toxicity or teratogenicity was observed even at maternally toxic doses (2). In man, we found no reports linking the use of either topical or systemic use of camphor with congenital defects. Topical use of camphor during pregnancy was reported in 763 cases of which 168 occurred during the first trimester (3). No association to defects was noted for use anytime during pregnancy.

In the literature there are hundreds of reports of intoxications due to camphor including four women who took camphor during pregnancy. These four cases have been summarised in a textbook on maternal and fetal toxicology (4). The first case concerned a 26-year-old woman who ingested 60 ml of camphor oil by mistake. She had two seizures but delivered a normal child, who had the obvious odour of camphor. The second one was a 40-year-old woman at term, who ingested 60 ml of camphor oil and also developed seizures. Thirty-six hours later, she delivered a girl in poor condition, who died within 30 minutes. Since the course was complicated by preeclampsia, abruptio placentae with haemorrhage, and breech presentation, the contribution of camphor to the fetal death is uncertain. The third case concerns a 32-year-old woman in her third month pregnancy with threatened abortion who drank 45 ml of camphorated oil by mistake. Although the patient had four seizures, she carried to term, delivering a normal baby. The last case was a 17-year-old girl who drank 60 ml of camphorated oil to induce an abortion. The girl recovered and her conceptus remained vital, but further details are missing.