Abstract / Summary
Abstract Background Calcium and magnesium are essential electrolytes for uterine contraction, vascular regulation, and postpartum cardiovascular adaptation. The study aimed at evaluating serum calcium and magnesium levels, hemodynamic fluctuations, and their association with postpartum hemorrhage and uterine contractility in postpartum women at Kabutare District Hospital, Rwanda. Methods Ninety-nine postpartum women participated in a cross-sectional study carried out in a hospital setting. Venous blood samples were collected within one hour after delivery for measurement of total calcium and magnesium levels. Uterine tone, quantified blood loss, blood pressure, and pulse rate were assessed during the first 24 hours postpartum. Data were analyzed using SPSS version 25. Statistical significance was set at p < 0.05. Results Hypocalcaemia was observed in 16.2% of participants, while 8.1% had both hypocalcaemia and hypomagnesemia. Women with electrolyte abnormalities had significantly higher rates of postpartum haemorrhage than those with normal electrolyte levels (37.5% vs. 4.0%; p = 0.003). Serum calcium levels were significantly lower among women with a boggy uterus ( p < 0.001). Calcium showed a negative correlation with pulse rate and a positive correlation with systolic blood pressure, whereas magnesium was positively correlated with diastolic blood pressure. Logistic regression identified hypocalcaemia (adjusted odds ratio [AOR] = 2.41), hypomagnesemia (AOR = 2.13), and boggy uterus (AOR = 8.92) as significant predictors of postpartum haemorrhage. Conclusion Reduced serum calcium and magnesium levels are significantly associated with impaired uterine contractility, altered postpartum hemodynamic parameters, and an increased risk of postpartum haemorrhage.