*Article* **The Hematopoietic Effect of Ninjinyoeito (TJ-108), a Traditional Japanese Herbal Medicine, in Pregnant Women Preparing for Autologous Blood Storage**

**Eriko Fukuda, Takuya Misugi \*, Kohei Kitada, Megumi Fudaba, Yasushi Kurihara, Mie Tahara, Akihiro Hamuro , Akemi Nakano, Masayasu Koyama and Daisuke Tachibana**

> Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka 545-8585, Japan

**\*** Correspondence: t-misugi@omu.ac.jp; Tel.: +81-6-6645-3862

**Abstract:** *Background and Objectives:* There are no reports showing the hematopoietic effect of TJ-108 on pregnant women. The aim of this study was to investigate the effect of TJ-108 on the hemoglobin and hematocrit levels, and white blood cell and platelet counts of pregnant women complicated with placenta previa who were managed with autologous blood storage for cesarean section. *Materials and Methods:* We studied two groups of patients who were complicated with placenta previa and who underwent cesarean delivery. Group A consisted of women who were treated with oral iron medication (100 mg/day), and Group B consisted of women who were treated with TJ-108 at a dose of 9.0 g per day, in addition to oral iron medication, from the first day of blood storage until the day before cesarean delivery. To evaluate the effect of TJ-108, the patients' red blood cell (RBC); Hb; hematocrit (Ht); white blood cell (WBC); and platelet count (PLT) levels were measured 7 days after storage and at postoperative days (POD) 1 and 5. *Results:* The study included 65 individuals, 38 in group A and 27 in group B. At the initial storage, a 0.2 g/dL reduction in Hb levels was observed, as compared to the initial Hb levels, in the TJ-108 treated patients, whereas a 0.6 g/dL reduction in Hb levels was observed in the non-TJ-108 treated group. On the other hand, regarding the second and subsequent storages, no significant difference was found in the decrease in the Hb levels of both groups. *Conclusions:* This study is the first report showing the effect of TJ-108 on improving anemia in pregnant women, presumably by its boosting effect on myelohematopoiesis. Therefore, the combined administration of both iron and TJ-108 is effective as a strategy for pregnant women at a high risk of PPH due to complications such as placenta previa.

**Keywords:** Ninjinyoeito; autologous blood storage; postpartum hemorrhage; hematopoiesis; pregnancy; placenta previa
