SERUM CALCIUM IN PRIMARY POSTPARTUM HAEMORRHAGE

Oguaka V. N., Adinma J. I. B.*, Okafor C. I., Udigwe G. O., Adinma Obiajulu-ND and Edet M. M.

ABSTRACT

Background: Postpartum haemorrhage may cause maternal mortality. Uterine atony is a major cause of primary post-partum haemorrhage (PPH). Calcium plays a role in uterine contraction and may contribute to the causation of uterine atony. Objective: To determine the serum calcium levels in parturient women and its relationship to primary PPH. Subject and Method: A cohort study of 140 consecutive parturient women at Nnamdi Azikiwe University Teaching Hospital, Nigeria, involving intrapertum estimation of serum calcium levels and relating it to primary PPH. Data analysis was done using SPSS version 21.0. Comparison of variables employed student’s t-test, with p-values of <0.05 at 95% confidence interval considered to be statistically significant. Results: of the 140 parturient, 97 (69.3%) had Spontaneous Vertex Delivery (SVD); 25 (17.9%), assisted delivery, and 18 (12.9%), caesarean section. Sixteen (11.4%) women (all with SVD) had primary PPH, 10 (62.5%) of which were due to uterine atony. The mean serum ionized calcium level of participants without primary PPH was higher (1.11±0.25 mmol/L) than that of participants who had primary PPH from uterine atony (1.0±0.35 mmol/L), (P = 0.037). Conclusion: This study shows that hypocalcaemia occurred in parturient women with primary PPH from uterine atony. Suggesting the role of adequate calcium in preventing obstetrics haemorrhage. The relationship between serum calcium and primary PPH could be explored in the development of predictive, preventive and therapeutic strategies for primary PPH and ultimate reduction of maternal morbidity and mortality from PPH.

Keywords: Serum calcium, uterine atony, primary post-partum haemorrhage, parturient women.