From the FDA Drug Label
Clinical Considerations Disease-associated maternal risk Maternal hypocalcemia can result in an increased rate of spontaneous abortion, premature and dysfunctional labor, and possibly preeclampsia
- Calcium gluconate (IV) may be used to treat hypocalcemia, which can cause dysfunctional labor.
- The use of calcium gluconate (IV) in pregnant women is supported by the fact that maternal hypocalcemia can lead to dysfunctional labor.
- Therefore, calcium gluconate (IV) can be used to prevent or treat dysfunctional labor caused by hypocalcemia 1.
From the Research
Calcium supplementation, specifically in the form of calcium gluconate, may be beneficial when used in conjunction with oxytocin for the induction of labor in women with term premature rupture of membranes, as it has been shown to increase the rate of vaginal delivery within 24 hours and reduce blood loss. However, this does not directly address the use of calcium for dysfunctional labor. The most recent and highest quality study on the topic of labor induction, 2, suggests that the coadministration of calcium and oxytocin may offer significant advantages during the process of labor induction, resulting in better outcomes such as a higher rate of vaginal delivery within 24 hours and reduced hemorrhage. Key points to consider in the management of dysfunctional labor include:
- Careful monitoring of both the mother and the fetus
- Adequate hydration
- Position changes to help progress labor
- Oxytocin augmentation when appropriate, starting at a low dose (1-2 mU/min) and titrating up as needed
- Consideration of cesarean delivery depending on the status of the mother and the fetus While calcium plays a crucial role in uterine muscle contractility, the evidence supporting its use specifically for dysfunctional labor is not strong, and management should focus on identifying and addressing the underlying cause of the labor dysfunction, such as cephalopelvic disproportion, malpresentation, or inadequate uterine contractions, as noted in studies like 3 and 4. Additionally, a narrative review, 5, discusses the potential of calcium carbonate as an intervention to prevent labor dystocia, highlighting the need for further research in this area. In clinical practice, the decision to use calcium supplementation should be based on the most current and high-quality evidence available, and its use should be considered on a case-by-case basis, taking into account the specific circumstances of the labor and the health of the mother and fetus, as informed by studies such as 2 and reviews like 5.