Condition: Elective Cesarean Delivery · Sponsor: Rambam Health Care Campus
Postpartum hemorrhage (PPH) is the leading cause of death related to pregnancy. PPH can lead to blood transfusion, disseminated intravascular coagulation (DIC), hysterectomy, or death. The prophylactic administration of uterotonic agents as part of an active management of the third stage of labor has been proven to reduce rates of PPH. However, even with these treatments, PPH rate is still relatively high, and puts women at risk of heavy bleeding and death. Calcium is a key component in the coagulation cascade and known as factor IV. It has a role in platelet activation, and it is an important co-factor for the activation of factors II and There is a concentration-dependent effect of hypocalcemia on in vitro clot strength in patients at risk of bleeding. Calcium gluconate is the calcium salt of gluconic acid, and it has a relatively strong safety profile. Hypocalcemia is a poor prognostic factor in actively bleeding patients. Calcium has a positive inotropic effect both on skeletal muscle and smooth muscle. The inotropic effect doesn't skip the myometrium, and it is well-established that hypocalcemia can impair myometrial contractility. As so, calcium channel blockers are prescribed as a tocolytic drug and calcium gluconate should be considered as adjuvant therapy for treating PPH duo to atony, in case of prolonged tocolytic or magnesium sulfate use prior to delivery. Studies have already shown an association between low ionized calcium levels and the risk for severe bleedi…
This description comes directly from the study's public registry record.
Gili Buchnik Fater, MD · +972-54-6738628 · gili.buchnik@gmail.com
Always discuss trial participation with your own doctor first.
| Soroka Medical Center | Beersheba, Israel | Recruiting |
| Shamir Medical Center | Be’er Ya‘aqov, Israel | Recruiting |
| Rambam Medical Center | Haifa, Israel | Recruiting |
| Edith Wolfson Medical Center | Holon, Israel | Recruiting |
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Source record: clinicaltrials.gov/study/NCT06235749