THE EFFECTS OF AQUEOUS EXTRACTS OF ANNONA MURICATA LEAVES ON PREGNANCY AND ITS OUTCOME IN RATS

ABSTRACT
Indiscriminate consumption of medicinal plants by pregnant women has been reported in Nigeria, with effects on mother and offsprings not well documented. Annona muricata is one of the plants commonly consumed by pregnant women in Nigeria. In this study, the effects of aqueous leaf extract of Annona muricata on pregnancy and its outcomein rats was studied. Pregnancy was induced in 24 female wistar rats, which were then divided into four groups receiving different concentration of the extract as follows; control, 15mg, 30mg, and 45mg/kg of body weight. The extract was administered orally and daily throughout gestation. The results of the study were expressed as mean + standard deviation (mean + SD). Results showed that there was a significant reduction in maternal weight during pregnancy, litter birth weight, litter length, placental weight and placental/birth weight ratio of the extract-treated pregnant group (p<0 .05="" alkaloid="" be="" compared="" content="" control="" due="" effects="" group.="" i="" may="" observed="" of="" rich="" the="" these="" to="">Annona muricata
. By these effects, the extract can significantly reduce the utero-placental transfer of nutrients and as a consequence impair fetal growth. There is therefore need to subject traditional medicinal plants to scientific scrutiny.
TABLE OF CONTENTS

Title page
Abstract
Table of contents
List of tables

CHAPTER ONE
1.0       Introduction
1.1    Justification
1.2   Aim of the study
1.3   Objectives

CHAPTER TWO
LITERATURE REVIEW
2.1   Description of Annona muricata
2.1.1 Nomenclature and taxonomy of Annona muricata
2.1.2  Composition of aqueous extract of Annona muricata
2.1.3 Medicinal uses of Annona muricata
2.2.0 Published pharmacological properties of Annona muricata
2.2.1  Anti-athritic activity
2.2.2  Anticancer activity
2.2.3  Anticonvulsant activity
2.2.4  Antidiabetic activity
2.2.5  Antioxidant activity
2.2.6  Hypolipidaemic activity
2.2.7 Antinflammatory activity
2.2.8 Analgesic activity
2.2.9 Antihypertensive activity
2.3.0 Antibacterial activity
2.3.1 Antiparasitic activity
2.3.2 Antiplasmodal activity
2.3.3 Hepatoprotective activity
2.3.4 Insecticidal activity
2.3.5 Gastroprotective activity
2.3.6 Wound healing activity
2.3.7 Molluscidal activity
2.4.0 Physiology of pregnancy
2.4.1 Cardiovascular
2.4.2 Haematologic
2.4.3 Metabolic
2.4.4 Renal
2.4.5 Respiratory

CHAPTER THREE
MATERIALS AND METHODOLOGY
3.0  Collection and identification of plant
3.1 Preparation of extract
3.2 Experimental animals
3.3 Induction of pregnancy
3.4 Extract administration
3.5 Monitoring of body parameters
3.6 Statistical analysis

CHAPTER FOUR
RESULTS
4.0 Phytochemical analysis of the aqueous leaf of Annona muricata
4.1 Qualitative phytochemical analysis of the aqueous leaf of Annona muricata
4.2 Quantitative phytochemical analysis of the aqueous leaf of Annona muricata
4.3 Effect of oral administration of aqueous leaf extract of Annona muricata on maternal weight during pregnancy
4.4 Effect of oral administration of aqueous leaf extract of Annona muricata on litter size at birth, litter weight and litter length
4.5 Effect of oral administration of aqueous leaf extract of Annona muricata on placental weight
4.6 Effect of oral administration of aqueous leaf extract of Annona muricata on placental birth/weight ratio

CHAPTER FIVE
DISCUSSION
5.1 Overview
5.11 Effect of extract on weight gain in pregnant rats
5.12 Effect of extract on placental weight of treated rats
5.13 Effect of extract on litter size, birth weight and length of offsprings of treated rats
5.2 Discussion
5.3 Conclusion/Recommendation
5.4 Summary of findings

References



CHAPTER ONE
1.0   INTRODUCTION
Pregnancy is defined as the period from conception to birth(Dorland’s medical dictionary, 2012). It is also referred to as gestation period, during which there is an embryo developing in the uterus and it could be a single embryo or multiple embryo(Abman, 2011). In humans, it usually lasts around 40weeks from the last menstrual period and ends in childbirth(ACOG, 2013).
Pregnancy begins with conception, the process of fertilization of the female egg by the male spermatozoa. The fertilized egg starts dividing fast into many cells. It keeps dividing as it moves slowly through the fallopian tube to the uterus where it gets attached to the endometrial lining where it begins to form thefetus and placenta. This attachment to the endometrial linningis known as implantation(Sadler, 2011).
Pregnancy is divided into three trimesters(Moore and Persaud,2003);
First trimester; This period spans from 0-12wks(Sohaey et al., 1996). During this period, hormone levels change significantly, placenta and fetus growth is supported by the uterus, heart rate and blood supply increases to meet the needs of the growing fetus(Demianczuck and Van, 2003). These changes accompany many of the pregnancy symptoms such as fatigue, morning sickness, nausea, vomiting, headache and constipation(Festin, 2014).
The first trimester is very crucial to the development of the baby. The fetus will develop all its organs by the end of the third month(Rosenblatt et al., 1996).  Adequate nutrition and food supplementation is necessary(Kaiser et al., 2008). Alcohol abuse, cigarette smoking, undue ingestion of drugs and abusive substances have all been related to serious complications and birth defects(Aaranson and Macnee, 1989, Ness et al., 1999).
In rats, the gestation period is about 21days and the first trimester corresponds to day 1-7(Karen, 2006).
Second trimester; This period spans from13-28wks(Ecker and Green, 2006). During this period, uterus increases in size, maternal weight gain, fetus increases in size, fetal movement starts. Screening tests are usually done at this time(Hurt, 2011).
This period corresponds to days 8-13 in rats(Karen, 2006).
Third trimester;This trimester lasts about 29-40wks. At this time, final weight gain takes place, fetal engagement with reduction in bladder capacity and increase in pressure on the pelvic floor and the rectum(Seeds, 1996).
In rats, the third week corresponds to the third trimester. During this period, the mammary gland develops maximally with the uterus developing a lot of blood vessels (Lindsey, 2004).
Each year, an estimated 123million women get pregnant worldwide, about 46million get terminated(WHO, 2004).
Complications that can arise in pregnancy include the following; abortion, maternal bleeding, maternal sepsis, anemia, ectopic pregnancy, fetal intrauterine growth retardation, intrauterine fetal death(ACOG, 2011).
WHO estimates that 4billion people, i.e 80% of the world population, use herbal medicine for some aspect of primary health care (Farnsworth et al, 1985). It also suggested in improving the technologies for cultivation of medicinal plants.
Investigations across the world confirm dramatic increment in the use of complementary and alternative medicine in pregnant women. Most pregnant women believe that these medicines are natural and safe compared to modern drugs. Besides, traditional medicine is believed to treat medical problems and improve health status during pregnancy, birth and postpartum care in many rural areas of the world. There are few researches performed on their safety, purity and adverse consequences during pregnancy(Khadivzadeh and Ghabel, 2012).Data on medicinal plants for women’s reproductive health is in general limited and a traditionally ignored subject(de Boer et al., 2014).

1.1 JUSTIFICATION
Women in Nigeria have been using different medicinal plants to cure various ailments associated with maternal health since time immemorial. However, the use of such plants was never documented (Sulaiman et al., 2015).Patients who are likely to be at risk from adverse effects of herbal medicines includes those who are already prone to difficulties from regularly prescribed medications namely; fetus, infants and older children, the elderly, as well as pregnant and lactating women (Drew, 1997; Gold and Cates, 1980; Roulet et al., 1988; Saxe, 1987).
It is a fact that knowledge of potential side effects of many herbal medicines in pregnancy is limited, its use may lead to fetal distress as indicated by the high frequency of meconium-stained liquor and high caesarian section rates in this group of women presenting in labour(Mabina et al, 1997).Many plants either wholly or their extracts are consumed by pregnant women with unknown effects on mother and child.Some herbal products may be teratogenic in human and animal models(Goel et al, 2006),data on the extent of women’s use of herbal medicines during pregnancy is scanty especially in sub-Saharan Africa, where the legislation for distribution and purchase of herbal medicines is not as stringent as it is for conventional medicines(Adisa and fakeye2006).
There is scarcity of reports on the effects of the extractof this plant on pregnancy outcome. The present study was designed to investigate this.

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