SERUM CALCIUM AND MAGNESIUM LEVELS RATIO IN PATIENTS WITH AND WITHOUT HYPOTONIC UTERINE INERTIA
Anita Deborah Anwar
Benny Hasan Purwara
Tita Husnitawati Madjid
Jusuf Sulaeman Effendi
American Journal of Research Communicatio, 2015, 3(2): 1-11
Hypotonic uterine inertia is defined as contractions of uterine when an active phase of labor begins, measured less than 180 Montevideo units beyond the expected time of labor. Another contributing factor to its mechanism is the imbalance of the extracellular calcium level.When extracellular calcium level is inadequate, the myometrium response to oxytocin decreases and the calcium influx inter-cell membranes are suppressed, thus inhibit uterine contractions.
Magnesium can also inhibit intracellular and/or extracellular muscle contractions by restricting the calcium intake freely accessible on extracellular; hindering the channeldependent influx on the extracellular calcium, as well as competing with calcium on sarcoplasmic reticulum that leads to the decrease in the level of calcium used during interactions of actin, myosin and myometrium repolarization. This is a comparative analytical study with cross sectional design, examining the level of calcium and magnesium of the serum in normal deliveries and in those with hypotonic uterine inertia. The normal group consists of 57 patients, and 63 patients with hypotonic uterine inertia who were treated in RSUP Dr. Hasan Sadikin and its satellite hospitals from March to September 2014 and met the inclusion criteria. The level of calcium was measured using ion-selective electrode technique while the optical photometry method was used to measure the level of magnesium.The ratio value of calcium and magnesium level in labor with hypotonic uterine inertia is 4.45. The cut-off value of the predictor point for hypotonic uterine inertia is a calcium channel < 8.5 mg/dl, increasing the chance for hypotonic uterine inertia by 4.17% . With the magnesium level > 1.84mg/dl, the risk for uterine inertia increases by 2.90%. We draw conclusions that the calcium level in labor with hypotonic uterine inertia is lower than in normal labor whereas the magnesium level in labor with hypotonic uterine inertia is higher. There is a significant correlation between low calcium level and high level of magnesium in for hypotonic uterine inertia.
Keywords: Calcium, Hypotonic uterine inertia, Magnesium