presented by: Rm.salsabila lawan
General hospital gumel, Date:1/july/2021
Updated By: Abubakar usman
Date:2/07/2021
Hypocalcemia in pregnancy
Hypocalcemia in pregnancy
puerperium remains a major health issue, particularly in the developing world where daily calcium intakes are suboptimal. This electrolytes imbalance can lead to severe maternofetal and childhood consequences. Calcium supplementation among others contributes significantly to meeting calcium demands in pregnancy and puerperium. With ionized calcaemia as the gold standard for diagnosis, total calcaemia and albumin corrected calcaemia in other pathological states have been found to overestimate the burden of Hypocalcemia.
💥Definition.💥
A literal meaning; low level of calcium in the human blood.
It's a condition in which the circulating blood had too little amount of calcium less than body requirements.
💫Signs and symptoms.💫
- -Tingling sensation (often in lips, the tip of fingers, and feet's)
- -muscles aches.
- - muscle spasm in the throat causing difficulty breathing.
- -Stiffness and spasm of muscles.
- Abnormal heart rhythms.
- -Tetany
- -circumoral numbness
- -cramps.
Hypocalcemia in pregnancy and puerperium💥
Total serum calcium normally falls throughout pregnant, thus a healthy and balanced maternal diet is crucial since the diet need to take care of the women's usual nutritional needs as well as the need of growing fetus enabling the mother to maintain her stores of nutrients and those required for fetal health as well as for the future breastfeeding period. Many physiological changes occur during pregnancy resulting in an increase of red blood cells and plasma volume and a reduction of micronutrients and circulating nutrients binding proteins. In most developing countries, poor nutrition combined with the usual physiology, pregnancy can lead to micronutrients deficiency States, which can have detrimental effects on bone health since the bone stores most of the body's calcium and replaces extracellular flood lost. Women are at risk when they already have Hypocalcemia and have to undergo the strain in their bodies to meet the Normal maternal needs with the additional needs of calcium during pregnancy and lactation.
How it occurs in pregnancy.
Usually, hemodilution causes the serum albumin and hemoglobin to decrease while the albumin remains low until birth. This fall in albumin causes the total serum calcium to fall to levels normally associated with symptomatic Hypocalcemia. Biological resistance to PTH (parathyroid hormone ) causes inadequate Flow of calcium into intracellular fluids and deficient phosphate excretion by the kidney. Hypocalcemia is due to impaired mobilization of calcium from bone, reduced intestinal absorption of calcium, and increased urinary losses.
During early lactation breast, milk calcium obtained from increase renal calcium mobilization. After the resumption of menses, renal calcium conservation appeared to continue and spinal bone mineral was recovered.
☀️Prevention of Hypocalcemia in pregnancy.☀️
🌪️Antenatal prevention
It starts early from here, health education about calcium diet intake, early sign, and symptoms of Hypocalcemia, danger to the mother and fetus should be included in antenatal care during pregnancy for early prevention and also throughout pregnancy and puerperium.
Normal calcium level During pregnancy and puerperium
- female aged 19-50 and 14-18 yrs during pregnancy and lactation is 1000mg and 1300mg accordingly.
Pregnant and lactating women are expected to increase their daily calcium intake.
Management of Hypocalcemia in pregnancy
🌪️Mild symptoms.
In mild symptoms like prickling and tingling sensation in tip of fingers,
* Run laboratory test to rule out the level of calcium
Calcium supplements and advice on increased calcium diet.
🌪️Severe symptoms
Like tetani and spasm.
Take the measure as mentioned in mild symptoms treatment
- *Intravenous calcium gluconate in a monitored amount and According to the calcium level.
- *Close monitoring of the fetomaternal condition.
- *Calcium chloride is acute and has occurred over a short time frame.
Complications
🌪️To the baby.
- *Stillbirth.
- *IUFD(intrauterine feotus death).
- *Abortion.
- *Neonatal tetany.
- *Hernia most especially inguinal.
- *Mental and growth retardation.
🌪️To the mother.
- *High Blood pressure.
- *Preterm labor.
- *Pre eclampsia
- *Maternal mortality
Conclusion
Women are at risk when they already have Hypocalcemia and must undergo a strain in their body to meet the Normal needs with the additional needs of calcium during pregnancy and lactation. Mother adopts to this additional requirement this need could be met by increased dietary calcium intake and calcium supplementation to ensure optimal bone and extraskeletal Heath in the mother and baby as well. Throughout her life especially during pregnancy and lactation special consideration for the treatment of women with hypoparathyroidism During pregnancy and puerperium.