UTERINE ATONY;

Abstract

Background: Uterine atony is one of the causes of postpartum hemorrhage, resulting in increased maternal morbidity and mortality. Objective: To determine the association of low serum vitamin D level with uterine atony, among women delivering in a tertiary care hospital. Subjects and Methods: Study design: Case control Study. Setting: Gynae and Obstetrics department of Sheikh Zayed Medical College, Rahim Yar Khan. Duration: 1st January to 31st December, 2013. A total of 130 patients were recruited and grouped as A (Cases) including patients with uterine atony (100 patients) and group B (Controls) patients having no uterine atony (30 patients) after cesearean section or vaginal delivery and fulfilling the inclusion or exclusion criteria. The test for 25 OH vitamin D was performed on Elecsys 2010 Roche by using electrochemiluminescence technique. Oral informed consent was taken from all subjects and approval from institutional ethical committee was obtained. Chi square test was applied to compare atony and non atony groups in terms of presence or absence of vitamin D deficiency. The data was entered and analysed on SPSS version 17. Results: It was noted that those who have uterine atony 87% were having vitamin D deficiency or insufficiency as compared to 68% in group with no uterine atony. This difference was statistically significant. (p=0.02) so uterine atony was significantly associated with vitamin D deficiency or insufficiency. In atony group mean age was 25±4 years, gravida 2.64±1.2, gestational age, 37±1.2, blood loss 1032±400, and serum vitamin D level 15.9±6, ng/ml. In non atony group, group mean age was 26±3 years, gravida 2.7±1, gestational age, 38±.8, blood loss 309±92, and serum vitamin D level 23±9 ng/ml. The mean level of serum vitamin D level was significantly low (15.9±6 ng/ml) in atony group as compared to non atony group(23±9 ng/ml). Mean blood loss was significantly high (1032ml) in atony group as compared to non atony group (309ml). Conclusion: Our results revealed that low vitamin D level is strongly associated with uterine atony and hence is a risk factor for uterine atony.