Intravenous Calcium to Decrease Blood Loss During Intrapartum Cesarean Delivery

(Obstet Gynecol 2024;143(1):104–112) Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide; uterine atony contributes 70% to 80% of cases to PPH. If PPH happens even after oxytocin administration, other therapies are few and ineffective, as well as unavailable in many areas of the world. One treatment that has potential for uterine atony treatment is calcium chloride (CaCl). Currently CaCl is used to treat magnesium toxicity and hypocalcemia, but increasing calcium concentration could improve the contractile ability of the uterus. This study was designed to test the hypothesis that calcium infusion would decrease quantitative blood loss at delivery in a population at risk of atonic PPH. The primary outcome was the effect of CaCl on quantitative blood loss measured at the time of intrapartum cesarean delivery.