Preventing severe hypocalcemia during surgery for placenta accreta spectrum

How do I manage severe postpartum hemorrhage?

“…Key equipment includes a rapid infusor device (Rapid Infusor RI‐2; Belmont Medical Technologies); arterial line and central venous pressure transducer sets; programmable infusion pumps for infusing drugs, for example, vasopressors and oxytocin; fluid‐warming devices and forced‐air warming machines; a transesophageal echocardiography machine; and a cell saver. Hypocalcemia has been reported during large blood losses requiring 4 or more RBC units in women undergoing cesarean hysterectomy for PAS . Therefore, before each scheduled cesarean hysterectomy for suspected PAS, we obtain 10 × 1 g minijets of calcium gluconate and maintain patients' ionized calcium level at >0.9 mmol/L.…”