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SHAHEED ZIAUR RAHMAN MEDICAL COLLEGE

An Open Access, Double-Blind Peer-Reviewed Journal

ISSN: 1607-5854
Research Article

Association of Serum Calcium Level with Primary Postpartum Haemorrhage Observed at a Tertiary Care Hospital

Jahan N1*, Sarker S2, Sultana S3

1Dr. Nasrin Jahan, Lecturer, Department of Pathology, Rangpur Medical College, Rangpur, Bangladesh.

2Dr. Sumaiya Sarker, Medical Officer, Upozilla Health complex, Gangachara, Rangpur, Bangladesh.

3Professor Dr. Sharmin Sultana, Head of the Department of Obstetrics & Gynaecology, Rangpur Medical College and Hospital, Rangpur, Bangladesh.

*Corresponding author: jhuma926@gmail.com

Abstract

Background: Primary postpartum haemorrhage is a leading cause of maternal death worldwide and uterine atony is a major cause of primary postpartum haemorrhage. Calcium plays a major role in uterine contraction and its deficiency may cause uterine atony. This study was planned to observe the association of serum calcium level with primary postpartum haemorrhage.
Methods: This cross-sectional observational study was conducted at the Department of Obstetrics & Gynaecology of Rangpur Medical College and Hospital, Rangpur, from July 2023 to June 2024. With due consent, a total of 100 women at postpartum period were included in this study – among them 50 were postpartum women with primary PPH (Group A) and 50 were postpartum women without primary PPH (Group B). Data was collected in a predesigned case-record form and analyzed by SPSS 26 version.
Results: In Group A (with primary PPH) mean(±SD) age was 27.5(±4.9) years and in Group B (without primary PPH) mean(±SD) age was 25.6(±4.7) years. Serum calcium levels were notably lower in Group A: 60% had levels below 8 mg/dl compared to 20% in Group B (p<0.001). The mean serum calcium level was significantly lower in Group A (7.6±1.9 mg/dl) than in Group B (9.2±0.9 mg/dl) (p<0.001).
Conclusion: Lower serum calcium level was observed in patients with primary postpartum hemorrhage than in patients without primary postpartum hemorrhage.

Keywords

Lower serum calcium primary postpartum hemorrhage.

1. INTRODUCTION

Primary postpartum haemorrhage is a major cause of maternal morbidity and mortality worldwide. In Bangladesh PPH is the cause of about 31% of maternal fatalities 1. In about 3%-8% of all deliveries, postpartum haemorrhage (PPH) is a primary cause of maternal morbidity and mortality globally 2,3,4. Uterine atony is a major cause PPH and uterine muscle's ability to contract depends critically on the appropriate level of serum calcium. Reduced serum calcium level leads to impaired muscular function 5. 
Total calcium in serum typically ranges from 8.0-10.2 mg/dl or 2.2-2.5 mmol/l mmol/l 6,7. Lower serum calcium levels have potential impact on the smooth muscle of the uterus, which could lead to atonic uterus         
and thereby PPH 8. Research is going on to determine the effect of hypocalcaemia on myometrial contraction – whether normal physiological level of calcium can be optimized or increased to boost contraction, particularly in the context of augmented protracted labour which is a risk factor for uterine atony and PPH; maintaining normal serum calcium level appears to help prevent postpartum hemorrhage caused by uterine atony 7. 
And, this study was aimed at having a look into the relationship between serum calcium levels and the risk of primary postpartum haemorrhage in parturient women – the knowledge that may help us managing some of the PPH cases. 

Published: January 8, 2026

DOI: 324654-5646

ISSN: 1607-5854

Article Information
Volume 45, Issue 1 (2026)
32-35
January 8, 2026
324654-5646
31
13
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