Cannabis (Gan-ja): Relevant Issues in Obstetrics and Gynecology

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Sumonmal Manusirivithaya Vichai Manusirivithaya


Medical benefis of cannabis have become widely accepted. In Obstetrics and
Gynecology, it was reported to be useful to alleviate nausea and vomiting from morning sickness
in pregnant women and in gynecologic cancer patients who received chemotherapy. It has also
been used as a pain killer during labor and menstruation. Some also claimed that the cannabis
may also prolong life of cancer patients or even cure cancer. Owing to the illegalization of the
cannabis in many countries for a long time, there has been no evidence-based data from clinical
study to support the use of cannabis for those aforementioned conditions except for chemotherapy
induced nausea/vomiting. Systematics reviews confimed that cannabis was signifiantly more
effective than placebo and at least as effective as various conventional antiemetics. However,
due to the availability of many potent new standard antiemetics (5-HT3 receptor antagonists,
and neurokinin-1-receptor-antagonists) without psychotropic effects, cannabis is not
recommended as a fist-line antiemetic agent. The exception is when the new standard
antiemetics cannot adequately control nausea and vomiting from chemotherapy. The cannabis
is contraindicated in pregnant women or lactating mother because of the possibility of adverse
fetal and neonatal outcomes. Once cannabis is legalized for medical use in more countries, its
efficacy in those aforementioned conditions can be tested and confimed in randomized controlled


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