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To assess the feasibility, patient tolerance, pharmacokinetics, and potential effectiveness of a randomized controlled trial protocol investigating intravenous calcium chloride for the prevention of uterine atony during cesarean delivery.

Double-blind, randomized controlled pilot trial with nested population pharmacokinetic analysis.

This study was performed at Lucile Packard Children's Hospital, from August 2018 to September 2019.

Forty patients with at least two risk factors for uterine atony at the time of cesarean delivery.

One gram of intravenous calcium chloride (n = 20 patients) or a saline placebo control (n = 20 patients), in addition to standard care with oxytocin, upon umbilical cord clamping.

The primary efficacy-related outcome was the presence of uterine atony defined as the use of a second-line uterotonic medication, surgical interventions for …