This research study is being done to learn what effect a single dose of calcium gluconate will have on blood loss at the time of cesarean delivery in pregnancy patients at high risk for uterine atony.
English speaking
Viable Intrauterine Pregnancy, Gestational Age ≥24 weeks
Labor Converted to Cesarean Delivery at High Risk for Atonic Bleeding Defined as: Any exposure to oxytocin infusion for labor augmentation or induction prior to cesarean delivery
> 4 Prior deliveries
Non-English speaking
Antenatal suspicion for placenta accreta spectrum
History of allergic reaction to Calcium Gluconate
Patients with hypertensive disorder of pregnancy receiving Magnesium Sulfate for seizure prophylaxis
Parallel
Calcium Gluconate
Drugslow push intravenous administration of 2g calcium gluconate- 20 mL of 10% Calcium Gluconate in 55mL of IV fluid diluent, Normal Saline CaGluc concentration 26.7 mg/mL
Saline
Other interventionslow push intravenous administration of 75 mL of IV
Quantitative Blood Loss (QBL) (continuous variable) administered at Delivery
Standardized volumetric assessment of blood loss during cesarean section
Quantitative Blood Loss (QBL) (continuous variable) Total
Standardized volumetric/gravimetric assessment of blood loss during cesarean section
Postpartum hemorrhage
Quantitative blood loss ≥1000mL
Number of patients with a transfusion requirement
Any transfusion prior to discharge
Change in Hematocrit (HCT)
Preoperative HCT and Post operative HCT measured though blood sample
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