{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T23:00:32Z","timestamp":1781305232634,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T00:00:00Z","timestamp":1656288000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Unsafe abortion is a major problem in Uganda, being one of the leading causes of maternal morbidity and mortality. Abortions are performed mostly under unsafe conditions, by people without medical training. In rural areas in northern Uganda, women often resort to traditional providers, who use local herbs as abortion remedies, usually with adverse outcomes. Little is known about the biological properties of these herbs and their toxicity profile. Here, we present the case series of two women, of 31 and 24\u2009years of age, who underwent unsafe abortion for unintended pregnancy by using herbal medicines, that is, <jats:italic>Commelina Africana<\/jats:italic> (wandering jew) and <jats:italic>Vernonia amygdalina<\/jats:italic> (bitter leaf), respectively. While the first case resulted in uterine necrosis and pelvic peritonitis, which required multiple surgical interventions and the use of reserve antibiotics, the second case resulted in liver and renal failure that led to the death of the patient. This case series describes the unusual severe toxicity of two herbal medicines that are frequently used to induce abortion in northern Uganda. It highlights possible associations of <jats:italic>Commelina Africana<\/jats:italic> (wandering jew) with uterine necrosis complicated by sepsis, and of <jats:italic>Vernonia amygdalina<\/jats:italic> (bitter leaf) with acute liver and renal failure.<\/jats:p>","DOI":"10.1002\/ccr3.5975","type":"journal-article","created":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T07:29:33Z","timestamp":1656314973000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Septic shock, acute renal and liver failure following unsafe abortion using bitter leaves and wandering jew in northern Uganda: A case series"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4107-5047","authenticated-orcid":false,"given":"Gasthony","family":"Alobo","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Lira University  Lira Uganda"},{"name":"Department of Obstetrics and Gynaecology St. Mary's Hospital Lacor  Gulu Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Reverzani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology St. Mary's Hospital Lacor  Gulu Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violah","family":"Nahurira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology St. Mary's Hospital Lacor  Gulu Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sarno","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Science and Dentistry University of Naples Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.14.136333"},{"key":"e_1_2_10_4_1","volume-title":"The Annual Health Sector Performance Report 2018\/2019","author":"Ministry of Health","year":"2019"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1363\/3118305"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12190"},{"key":"e_1_2_10_7_1","volume-title":"Uganda Country Report \u2010 Country Needs Assessments on Safe Abortion Advocacy","author":"Musoke JT","year":"2018"},{"key":"e_1_2_10_8_1","volume-title":"Uganda Demographic and Health Survey 2016: Key Indicators Report","author":"Uganda Bureau of Statistcs (UBOS) and 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Harcourt, Niigeria","volume":"1","author":"Echem OG","year":"2013","journal-title":"Int J Agr Chem"},{"issue":"1","key":"e_1_2_10_18_1","first-page":"1","article-title":"Significance of bitter leaf (Vernonia Amagdalina) in tropical diseases and beyond:a review","volume":"3","author":"Clement E","year":"2014","journal-title":"Malar Chemoth Cont"}],"container-title":["Clinical Case 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