How does the tone of the uterus feel during pregnancy. What is dangerous uterine tone during pregnancy

During pregnancy, a woman expects many surprises, unfortunately, and unpleasant ones too. One of them is the tone of the uterus. It has different causes, but in the absence of the necessary treatment, it can lead to pathologies such as premature birth, miscarriage, placental abruption, and fetal hypoxia.

Normally, during pregnancy, the muscles of the uterus should be relaxed. If they begin to shrink, then they say that it is in good shape. This condition is not an independent disease, but is considered a symptom or termination of pregnancy.

The tone of the uterus during pregnancy is manifested by pains of a pulling and aching nature in the abdomen and lower back. They resemble the feeling during and before menstruation. There may be bloody discharge from the vagina. In the later stages, you can even see and feel, when touched, how the uterus tenses. If such manifestations occur, it is necessary to consult a gynecologist.

The tone of the uterus occurs for the following reasons:

• somatic diseases;
• endometriosis;
• malformations (saddle,;
• increased emotionality and anxiety;
• uterine fibroids;
• immunological (for example, Rhesus conflict);
• endocrine (high content of androgens and / or prolactin);
• genetic.

The diagnosis of uterine tone is made on the basis of an examination by a gynecologist, ultrasound and patient complaints. However, a woman does not always experience any discomfort with this pathology.

But it must be treated anyway. Since the tone of the uterus leads to a deterioration in the nutrition of the placenta, as a result, the fetus receives less substances and oxygen. This can lead to developmental delays, various pathologies, and even death of the child.

In addition, the uterus shrinks, but the placenta does not, so its detachment is possible. The most terrible consequence of this pathology is a miscarriage. At a later date, premature birth is possible.

When making a diagnosis of uterine tone, they try to find out the reason that caused it. To do this, the doctor may prescribe a number of additional examinations.

In the early stages, a frequent cause of tone is a lack of progesterone, whose task is to maintain pregnancy and relax the muscles of the uterus. You can figure out if this is the case by doing a blood test for this hormone. If its concentration is below normal, then artificial gestagens are prescribed, which are allowed during pregnancy -

Regardless of the reasons that caused the tone, they usually write out:

• sedatives, as nervousness increases tone;
• magnesium preparations, they relieve spasm, preventing the penetration of calcium into cells;
• antispasmodics that reduce

Additional drugs are introduced into the treatment regimen based on the results of an examination about the causes of this condition.

• refuse flights, trips to other countries and cities;
• exclude sexual life, because during orgasm, uterine contractions occur;
• do not take a bath;
• exclude long and tiring walks (more than 3 hours);
• you can not stand for a long time and lift weights;
• limit physical activity (fitness, laundry, mopping).

If a woman experiences constant pain, there is spotting, treatment in the antenatal clinic does not give the desired result, then bed rest, complete rest and hospitalization are recommended.

The tone of the uterus, if it is short-lived and does not cause pain, may be a variant of the norm. So the body trains for the upcoming birth. This is even more common in the third trimester.

So, the tone of the uterus is a consequence of disorders in the body of a pregnant woman, which have various causes. This condition necessarily requires observation and treatment, otherwise it can lead to serious consequences. Among them are miscarriage, premature birth, placental abruption. Quite often, treatment is carried out in a hospital.

In the state of pregnancy, women often hear the diagnosis "uterus in good shape." A phrase that is common in auditory perception can become threatening and lead to irreversible consequences. You should carefully consider the medical verdict and ask the gynecologist an important question: what does this phenomenon mean and whether it is necessary to fight it.

What is uterine tone during pregnancy

The uterus is a hollow muscle, contracting is its natural state. The organ consists of layers:

• external - perimetry;
• middle (muscular) - myometrium;
• internal - endometrium.

When sneezing, coughing, medical gynecological examination or ultrasound, the uterus contracts - it comes into tone for a short time. Prolonged contraction of the muscle layer is called "hypertonicity". This is a dangerous condition for pregnancy. It is necessary to recognize the symptoms in time and eliminate the causes.

Symptoms

The growing fetus stretches the tissues, during this period the muscles relax. You can determine the tone of the uterus by a number of symptoms and during an instrumental examination by a doctor. At each stage of bearing a baby, contractions appear with varying degrees of intensity, have their own characteristics, consequences. Contractions can be local (tonus along the posterior wall of the uterus) or general. A woman can understand that the uterus is in good shape by internal sensations and some external signs.

In the early stages

At this stage, cases of tone are observed frequently. Main features:

1. Aching pain in the lower abdomen.
2. Pulling sensations.
3. Cramps like contractions, or like menstruation.
4. Discomfort, pain in the lumbar region.

Sometimes the increased tone does not manifest itself, so doctors recommend undergoing an ultrasound scan. This procedure accurately determines the condition of the muscles.

Signs of uterine tone in the second trimester

At this stage (from 8 to 16 weeks), cases of hypertonicity are detected much less frequently. They are no less dangerous than in the first and third trimester of fetal formation. You should immediately consult a gynecologist, feeling the appearance of:

1. Pain in the lower abdomen.
2. Tactile sensations of the "fossil" of the entire abdomen.
3. Bloody secretions.

The diagnosis is confirmed by a medical examination. If the uterus is in good shape during pregnancy in the second trimester, this threatens with abnormal fetal development or premature birth.

In the 3rd trimester

The most responsible and difficult stage. The body prepares for childbirth, muscle contractions become more frequent. It is difficult to independently determine what it is: a manifestation of habitual spasms or tone. Only a doctor can diagnose a deviation from the norm. If, upon examination at the 32nd week, the uterus is open, and the ECG of the child inside the womb is unstable, the specialist will immediately understand the presence of an increased tone. To prevent the risk of miscarriage, visits to your gynecologist should be frequent. In all cases, with bloody discharge, an urgent need to call a doctor.

The reasons

The following reasons can cause a state of increased tone:

• overwork / slight malaise;
• stress / depression;
• physical pathologies (underdevelopment of the reproductive organ);
• lack of the hormone progesterone;
• Rh-conflict of systems for providing mother and child;
• severe toxicosis with vomiting;
• infectious diseases;
• age characteristics of a woman's body;
• chronic or acquired diseases;
• general psychological mood;
• the physical condition of the woman;
• loads;
• in special cases - sex with uterine tone.

When the uterus is in good shape, what does this mean for a woman who is looking forward to the appearance of a child? Clinical consequences, dangers for the woman in labor and the baby can be described by an experienced specialist. Wrong lifestyle and behavior of a pregnant woman can leave an indelible mark.

What is dangerous increased uterine tone

Increased tone negatively affects the child and mother. During the period of bearing a child, hypertonicity means the risk of abortion: in the early stages of miscarriage, in the later stages - premature birth. In the second trimester, prolonged muscle contraction leads to a deterioration in blood circulation with the placenta, insufficient oxygen is supplied to the fetus, which causes hypoxia. Placental abruption occurs as a result of the fact that it does not contract with the myometric layer.

Treat with medication when the uterus is in hypertonicity, what does this mean? The condition involves a mandatory visit to a doctor who will correctly diagnose and prescribe the necessary drugs. In the initial stages, it can be antispasmodics: "No-shpa", "Papaverine", motherwort, valerian. For prevention, pregnant women are prescribed vitamins A and E, light breathing exercises are prescribed, more walks in the fresh air.

How to remove the tone of the uterus at home

You can remove the tone of the uterus by resorting to simple methods.

In recent years, the diagnosis of "uterine tone" has become quite common. It is put by gynecologists in almost 60% of pregnant women who visited the antenatal clinic in order to diagnose pregnancy and monitor its development. What does “uterus in good shape” mean and what are the consequences of this condition if, at the time of diagnosis, a woman is often offered hospitalization in an inpatient department in order to maintain her pregnancy?

Validity of the diagnosis

The uterus is a hollow organ, the main wall thickness of which falls on the middle, muscular layer (myometrium). The latter consists of smooth muscle fibers that contract involuntarily, at will, like striated muscles, but under the influence of hormones and nerve impulses coming from the spinal cord.

"Live" muscles are never completely relaxed. They are always in a certain reduced state, tension, or tone. Thanks to this, a certain form and functioning of the organ is preserved, its normal blood circulation and other physiological processes are ensured. Therefore, one can speak of an increased or decreased tone only conditionally, that is, with respect to certain conditions and needs of the body.

For example, the degree of contraction of the myometrium depends on the age of the woman, many external and internal causes. As a physiological reaction, as a result of the release of a significant amount of catecholamines and other biologically active substances into the blood, increased uterine tone (hypertonicity) can occur with excitement, physical stress, and sexual intimacy. Before and during menstrual bleeding, after curettage of the uterine cavity or abortions, during childbirth, contraction of the myometrium also occurs as a protective response to stress, which helps to stop bleeding, give birth, etc.

From the beginning of pregnancy, tension and contractions of muscle fibers are less intense, which is a physiological manifestation of the preservation of pregnancy and the life of the fetus. As the duration of pregnancy increases, especially after 11-12 weeks, the number of contractions increases, and after 20 weeks they may be accompanied by short-term (seconds) pain, abdominal discomfort and a feeling of tightening of the uterus.

In other words, at times, sporadically, irregularly, there are individual signs of "tone" of the uterus during pregnancy. They don't pose any danger. These phenomena represent the physiological activity of the uterus, its reaction in response to fetal movements, touching the abdomen, medical examinations, irritation of the nipples, etc. and do not pose any threat to the child and mother.

At the same time, the relative weakness of the myometrium during the period of expulsion of the fetus leads to a delay in its stay in the birth canal and the threat of asphyxia, and after expulsion - to retention of the placenta and uterine bleeding.

The increased tension of muscle fibers can be widespread (before childbirth and during childbirth) or local, local. For example, an increased local “tonus” of the uterus is observed during an ultrasound examination. This is a natural physiological reaction to irritation during manipulation of the sensor of the device in the region of the anterior abdominal wall or when using an intravaginal sensor that causes irritation of the receptors of the vagina and cervix.

At the site of the introduction of villi and implantation of the ovum into the endometrium, an aseptic (non-infectious) inflammatory reaction of tissues normally occurs, where biologically active substances that promote implantation are delivered with the bloodstream. As a result of inflammation, there is a slight limited swelling of tissues and local contraction of muscle fibers, which is perceived by insufficiently experienced doctors during ultrasound examination as local hypertonicity of the posterior wall and the threat of miscarriage.

In addition, the diagnosis of “tone” of the uterus in early pregnancy, regardless of its nature (common or local), as a rule, indicates only an erroneous interpretation of some subjective sensations of a pregnant woman and ultrasound data, an insufficient understanding of the processes and causes of the dynamics of muscle fibers.

Thus, such a formulation of the diagnosis during pregnancy is erroneous, and it is generally absent in the generally accepted classification of diseases. Of the 60% of women who received it, only 5% needed treatment. Therefore, we can only talk about the physiological or pathological variant of muscle hypertonicity.

In this case, how to understand the presence of a pathological condition, how it manifests itself and how to distinguish it from a physiological one?

Causes of uterine tone during pregnancy

Some of the reasons for the physiological contraction of the muscle layer are mentioned above. What is the danger of pathological hypertonicity? Its result is an increase in pressure in the uterine cavity and a displacement of its walls in relation to the child's place. This can lead to a violation of the blood supply to the fetus, a deterioration in the conditions of its life, to a missed pregnancy, to or to a premature termination of pregnancy - to a spontaneous abortion or to premature birth.

Pathological hypertonicity can be caused by many reasons, among which the main ones are:

1. Hormonal deficiency or imbalance of sex hormones. So, progesterone not only prepares the mucous membrane (endometrium) for the implantation of a fertilized egg, but also reduces the tone of the myometrium, reduces the number of contractions of muscle fibers, and therefore contributes to the preservation and development of pregnancy, especially in the early stages. Its absolute or relative deficiency occurs in various diseases or dysfunctions of the endocrine glands, in which hyperandrogenism (increased synthesis of androgens by the adrenal glands or ovaries) or hyperprolactinemia (increased blood levels of prolactin produced by the pituitary gland) can develop.
2. Increased or decreased thyroid function, diabetes mellitus.
3. Congenital malformations of the uterus.
4. , chronic inflammatory processes of the internal genital organs, isthmic-cervical insufficiency.
5. Rhesus conflict and autoimmune processes.
6. Pronounced.
7. Large fetus, multiple pregnancy, polyhydramnios, oligohydramnios, preeclampsia, dysfunction of the autonomic nervous system. A particularly negative role of these factors affects the late stages of pregnancy.
8. Inadequate sleep, prolonged negative psycho-emotional stress, stressful conditions, heavy physical exertion, smoking.
9. Magnesium deficiency in the body. Magnesium is a calcium antagonist at the level of cell membranes, thus it plays an important role in muscle relaxation and promotes the accumulation and preservation of calcium in bone tissue, preventing osteoporosis. Its deficiency in the second trimester may be associated with an increased need for a woman's body and fetal growth, stressful situations, excessive sweating, a lack of food, bowel dysfunction, and the use of alcoholic beverages.
10. Age under 18 or over 30, especially in first pregnancy.
11. Acute infectious diseases (influenza, acute respiratory viral infections, tonsillitis, etc.), especially accompanied by elevated body temperature, and chronic foci of inflammation (chronic tonsillitis, rhinosinusitis, pyelonephritis).

How to determine the tone of the uterus during pregnancy

Its physiological contractions are manifested by more or less pronounced soreness in the abdomen, sometimes resembling contractions and passing within a few minutes.

The main symptoms of uterine tone during pregnancy:

1 trimester

Pain in the lower abdomen, above the pubis, sometimes radiating to the groin, sacrum, lumbar region, a feeling of discomfort in the lateral parts of the abdomen and lumbar region, a feeling of fatigue in the back, a feeling of abdominal tightness, unusual discharge (with an admixture of blood, even a slight one) from genital tract. Subjective sensations persist for a relatively long time (more than a few minutes).

2 trimester

During this period, the pains and discomforts described above, especially in the lumbar region and spine, are not uncommon even in a normal state, and therefore many women do not cause concern and can be misleading. With an increased tone of the uterus, they are more intense and prolonged. An alarming symptom, the appearance of which requires an immediate appeal to a gynecologist, are unusual in nature and volume of discharge from the genital tract, especially bloody.

3rd trimester

It is quite difficult for a pregnant woman to determine the signs of hypertonicity on her own, since during this period frequent uterine contractions occur, similar to contractions (). They are preparatory (for the fetus and the woman's body) for childbirth in nature. However, they differ from pathological hypertonicity in their short duration, irregularity, the absence of severe pain in the abdomen, spine and lumbar region, as well as the absence of discharge mixed with blood.

With local hypertonicity, others may be added to the listed symptoms. For example, the tone of the posterior wall of the uterus can lead to a feeling of heaviness in the perineum, to constipation or, conversely, to the appearance of loose stools, frequent urge to defecate in the absence or small amount of feces (“false urges”). However, in many cases, increased myometrial contractility in the region of the posterior wall proceeds without severe symptoms.

The tone of the anterior wall of the uterus is also characterized by the main symptoms of hypertonicity, to which a feeling of pressure over the womb, soreness and a feeling of pressure in the inguinal regions, frequent urination and false urge to urinate can be added.

Accurate diagnosis of the pathological syndrome is carried out through examination by a gynecologist, ultrasound and tonusometry using a special apparatus.

How to determine the pathology yourself?

This is not difficult to do, given that this pathology is extremely rare in early pregnancy, knowing about its general clinical manifestations and using a simple technique. To do this, you need to calm down in a horizontal position on your back, achieve maximum relaxation, bend your legs at the hip and knee joints, and then probe the surface of the abdomen with neat, gentle movements. If its high density is felt, especially if the density of the stomach seems to be "stone", this will indicate a very high tone of the myometrium.

In addition, in the later stages, in the second and third trimesters, you can additionally navigate by other subjective sensations - an increase or, conversely, a decrease in the intensity of fetal movements, an increase or decrease in its activity, that is, by the number of movements (compared to previous days or weeks), discomfort that was not previously noted during fetal movements.

How to reduce the tone of the uterus

In a hospital, physical rest is recommended, up to bed rest. In relatively mild cases, oral hormonal drugs are prescribed, if necessary (Dufaston, Utrozhestan), antispasmodic drugs (No-shpa, Papaverine) and vitamin “B 6”, magnesium preparations - Panangin, especially “MAGNE B 6”.

Psychological peace is achieved by the appointment of light sedatives - tinctures of motherwort, hawthorn, valerian, or a combination of them, infusions of these plants with a decoction of valerian rhizomes. With their inefficiency, Sibazon, Nozepam are prescribed. Vitamins, trace elements, especially magnesium (magnesium sulphate) and sedatives are given by drip into a vein in more severe cases. If necessary, Corinfar or Nifedipine are prescribed inside, blocking calcium channels in cells, as well as tocolytics, which reduce the contractility of the myometrium and reduce the degree of its tension (Ginipral).

What to do if there are signs of hypertonicity and how to remove the tone of the uterus at home?

If pathological symptoms occur, it is necessary to call an ambulance, and before the doctor arrives, stop mental and physical work, even light work, go to bed and try to relax all the muscles of the body. You can also take No-shpu, Papaverine or Drotaverine and motherwort tincture, drink weak warm tea with lemon balm or mint.

How to lie in these cases? It is necessary to choose a position in which the pressure in the abdominal cavity decreases, for example, on the side or in the knee-elbow position (“on all fours”).

In the absence of severe pain, you can try to perform light exercises to relieve the tone of the uterus. To this end, you must carefully kneel down and rest your palms of outstretched hands on the floor, take a deep breath, gently raise your head and bend slightly at the same time in the lumbar region, exhaling. In this position, you need to linger for 5 seconds. Then slowly lower your head while arching your spine and exhaling. These exercises should be performed calmly and without tension.

Another exercise, simpler - just lie on your side, bend your legs slightly and breathe deeply, but not very intensively, and in the early stages of pregnancy - in the supine position with bent legs, put a pillow under the pelvis.

Most often, with the correct information of a pregnant woman and her timely seeking medical help, the phenomenon of pathological hypertonicity can be successfully stopped and maintained pregnancy without negative consequences for the unborn child.

The tone should pass imperceptibly for the woman. If a pregnant woman feels pulling pains, heaviness and discharge mixed with blood, she should immediately contact her doctor. Hypertonicity backfires in every trimester.

• Pregnancy is not always smooth and trouble free. It is not uncommon for women to make a decision about the existence of tone in all trimesters - this is muscle tone. The uterus is also a muscle and it tends to contract under the influence of various factors. Ideally, during pregnancy be calm. But if it periodically decreases before conception and after, this is not always bad and problematic.
• This phenomenon can be safely regarded as a normal physiological process, if it is not pursued by any other symptoms and diseases. Muscle contraction should not cause confusion, because it is observed even when a woman simply sneezes. Stress, anxiety and nervousness remain unchanged factors affecting contractions.
• When making such a diagnosis, you need to ask the doctor in detail about how dangerous it is for you. The consequences of not normal tone can be very deplorable. In the early stages, the tone can provoke a miscarriage, and in the rest - premature birth

Most often, uterine tone is diagnosed in the early stages of pregnancy (in the first trimester) according to the results of an ultrasound examination.

It is because of uterine contractions that many women cannot become pregnant. The fertilized egg is simply not able to attach to the wall of the uterus.

Tonus until the twenty-eighth week is considered a real threat of miscarriage, and only when more than 28 weeks have passed can one talk about it as a risk of preterm labor.

Unfortunately, uterine tone is diagnosed in 60% of pregnant women, but doctors are trying to do everything possible to exclude all possible causes of its manifestation:

• replenish the hormone progesterone
• prescribe sedatives
• appoint "preservation" and recommend a calm, inactive lifestyle
• eliminate or alleviate toxicosis
• eliminate increased flatulence in the intestines
• cure inflammatory and infectious diseases

How to determine the tone of the uterus during pregnancy on your own?

Determining the presence of tone is not difficult. This will be indicated by very eloquent symptoms that accompany the problem at all stages of pregnancy. When a woman's belly is not yet bulging forward, she may feel:

• severe heaviness in the groin and lower abdomen
• pain and cramps, similar to those that accompany a woman during menstruation
• lumbar pain
• pain similar to intestinal spasms
• spotting discharge with blood impurities

To these symptoms in the second and third trimester, you can add:

• feeling of a tight and heavy abdomen
• visual petrification
• belly hard to the touch

A pregnant woman experiencing such symptoms should immediately seek medical advice so that this phenomenon does not provoke a miscarriage or unplanned premature birth. The doctor prescribes a number of medications that have an antispasmodic and mild sedative effect.

How to reduce the tone of the uterus during pregnancy?

• Involuntary uterine contractions may be present at all stages of pregnancy. Most often, the tone appears due to a hormonal failure in the body and a lack of progesterone - the female "pregnant" hormone.
• Starting from the sixteenth week, it may appear as a result of placental growth and fetal enlargement. In this case, it does not require intervention, in others - it is simply necessary to reduce the tone in order to avoid consequences.
• In most cases, in order to reduce uterine tone, doctors prescribe antispasmodics - drugs that relax muscle organs.
• The most common medicine is No-shpa, proven over the years. It has a fairly mild and safe effect. In more severe cases, you can use fresh "papaverine" or "viburkol"

The tone caused by the growth of the placenta can be alleviated by wearing a special bandage for pregnant women. The principle of his work is that he is able to distribute the weight of a woman and facilitate her movement, as well as relieve the load from her back.

Yes, and the very physical activity, movement and carrying weights - must be excluded from your life.

A pregnant woman suffering from tonus needs more sleep, walk in parks and breathe the air. It is worth completely reviewing your diet to eliminate fixing foods:

• sweet foods: candy, chocolate and others
• bakery products
• rice groats

It is very useful for women to increase the amount of vitamin E consumed from food, to eat royal jelly and wheat germ.

Uterine tone in the first trimester of pregnancy

The muscles enveloping the uterus are three-layered, intertwined very tightly. This interlacing allows the muscle to hold the uterus tightly in case of overstrain.

The tone indicates the presence of problems in the body, since the fetus is very small and can hardly somehow stretch the walls of the uterus.

In the early stages of pregnancy, namely in the first trimester, the tone of the uterus can appear from the smallest experiences and worries. Stress is not the only reason.

Physical activity, even the smallest, provokes tone. Not infrequently, simple abstinence and the inability to go to the toilet also provoke muscle contractions.

If you still relaxed, went to the toilet, did not burden yourself with loads, and the tone and pulling sensations do not go away, it is possible that your symptoms are related to something else:

• hormonal disorders in the body
• toxicosis
• lack of progesterone
• underdevelopment of the uterus
• the presence of cancer in the uterus
• diseases of the genital organs
• infectious disease
• different Rh factor in the blood of mother and baby

If the tone is provoked by external factors, it is eliminated very quickly. If internal - you need to look for the cause with the help of specialists.

Uterine tone in the second trimester of pregnancy

We can say that the second trimester of pregnancy for a woman is the most favorable. In the second trimester, toxicosis goes away and the pregnant woman feels much better. All that can disturb a woman in the fourth, fifth and sixth months is the tone of the uterus.

The tone in this period is provoked by various factors, both external and internal. External factors include:

Internal factors:

• hormonal disorders
• uterine mime
• the threat of a breakdown (underdevelopment of the child, different Rh blood factors in mother and baby, congenital anomalies)
• rapid fetal growth

Unfortunately, the tone can lead to poor blood flow in a woman's body. This phenomenon can have very unpleasant consequences and inhibit the development of the child in utero.

The worst thing that can happen to a woman experiencing tone is detachment of the fetal placenta from the uterine wall, since it, unlike a muscle, does not contract.

Uterine tone in the third trimester of pregnancy

Minor contractions of muscle fibers are normal for a pregnant woman. Not infrequently, hypertonicity is a consequence of multiple pregnancy ( several children in the womb) or too large a fetus.

The fetus in the uterus is already large enough, it stretches the uterus and gives discomfort. If the tone is increased, this may well cause premature birth.

Also, the causes of tone in the third trimester can be:

• nervous irritation, regular stress
• carrying weights
• intestinal gases

Why is uterine hypertonicity dangerous during pregnancy?

The tone of the uterus can have different consequences at different stages of pregnancy. In any case, the tone is dangerous for abortion. In the early stages, muscle contractions make it impossible to fix the fetal egg to the wall of the uterus.

Hypertonicity is the cause of constriction of blood vessels, which are the main link between mother and child. It is for this reason that the fetus may not receive development in the womb. It is through the blood vessels that the child receives the necessary amount of nutrients and oxygen.

In all three trimesters, hypertonicity causes involuntary abortion. Not infrequently, the tone itself can be confused with the onset of contractions.

How to treat uterine tone during pregnancy?

The tone of the uterus, depending on the causes, requires proper treatment. It can be simple manipulations, or it can be a full-fledged drug treatment.

Try to start treatment with simple exercises, and only if folk methods cannot cope with the sensations, consult a doctor for help:

• take a horizontal position
• master breathing relaxing gymnastics in order to successfully apply it at the right time
• raise your legs above your head, put them on a pillow
• drink soothing tea with chamomile and lemon balm
• stroke the belly with gentle circular motions
• try not to burden yourself with heavy bags and physical exercises during the day and not be nervous

The tone of the uterus requires regular use of medications. In the arsenal of every pregnant woman should be sedatives, antispasmodics and vitamins prescribed by the attending physician.

Exercises to relieve uterine tone during pregnancy

A number of simple exercises are aimed at eliminating the tone and relaxing the muscular system of the body of a pregnant woman:

• Exercise "Cat". This is a simple exercise that every woman can do, and it is especially useful for those who are already in the third trimester of pregnancy. It requires the support of a woman on all limbs. Standing on all fours, the back and abdominal muscles relax. It is necessary to stand in a calm state for five minutes, after which bending and raising the back should be performed. You need to fix each position up to five seconds. Blood circulation increases, condition becomes better
• Exercise "Free position". For this, it is not necessary to perform any special movements. It is enough to take a position in which the uterus remains as relaxed as possible. Take a chair, lean on it with your forearms, put your knees on the floor and sit in this state for a while

What to do with uterine tone during pregnancy: tips and reviews

The tone of the uterus pursues almost every woman at different stages of pregnancy. In any case, strong sensations of pain, stretching, spotting are always not normal. The tone requires elimination in any case, since it should always pass asymptomatically and imperceptibly.

At the slightest health disorder, try to contact your doctor, limit your workload and be in a horizontal mood. Stress is the easiest way to cause muscles to contract, so try not to be nervous, relax and avoid any stress.

Video: “The tone of the uterus. What to do?"

We will start talking about the tone of the uterus with a brief summary of the anatomical foundations. The uterus is an unpaired muscular hollow organ of the female reproductive system, in which the embryo is born, and then the fetus. Despite the sounded name “muscular”, the structure of this organ is not so simple, the wall of the uterus consists of three layers: endometrium (mucous membrane, the innermost layer), myometrium (muscular, the most massive membrane) and serous (peritoneal) membrane or perimetrium.

The myometrium has a complex structure, and in turn, consists of three layers, each of which is a smooth muscle fiber:

1. longitudinal layer includes circular and longitudinal muscle fibers
2. circular layer (or vascular), it includes many vessels
3. The submucosal layer consists of longitudinal fibers and is the most vulnerable of all layers.

Muscle tone, and in particular, the tone of smooth uterine muscles (uterine hypertonicity) is a state of contractile activity, increased muscle tension.

Like any structure that has muscle tissue in its structure, the uterus "has the right" to be in good shape. Outside of pregnancy, the uterus is in increased tone during menstruation, thus, blood and sloughing parts of the endometrium (uterine lining) are expelled from the cavity. If the uterus does not contract enough, then there may be problems with insufficiently complete excretion of secretions from the body. Therefore, menstruation is often accompanied by a feeling of sipping in the lower back and lower abdomen. This is a normal condition, but during pregnancy, everything is completely different.

The uterus during pregnancy is a fetal place, and it should maximally contribute to ensuring that the embryo is first safely implanted (attached to the wall of the uterus and begins to receive nutrition), and then grows and develops until the due date of delivery. To accomplish these tasks, with the onset of pregnancy, a significant hormonal restructuring occurs in the woman's body. Most often, when it comes to hormones, pregnant women hear the word “progesterone” and rightly so.

Progesterone is a female sex steroid hormone, the concentration of which increases significantly during pregnancy. Progesterone has a relaxing effect on all the smooth muscles of the body. Under the action of progesterone, the smooth muscles of the uterus are in a relaxed state, it is soft, the volume of the cavity is normal, and the fetus is not threatened with premature expulsion from the uterine cavity. In addition to the smooth muscles of the myometrium, progesterone also relaxes the muscles of the esophagus and stomach (possible heartburn), intestines (constipation), muscles that make up the vessels, primarily veins (varicose veins of the lower extremities and small pelvis, the appearance of hemorrhoids). As we can see, the action of progesterone is very powerful, but not selective. However, all these problems are temporary and solvable, and the main thing for a woman is to safely endure the desired pregnancy. By the way, here too progesterone plays a favorable role, acting on the central nervous system, the hormone creates a “protective inhibition” and does not allow the pregnant woman to worry too much.

Norms of uterine tone by gestational age

Normally, the uterus is in a normal tone (that is, in a relaxed state) up to the term of a full-term pregnancy, that is, up to 37 weeks.

As already mentioned, the uterus is a muscular organ and it can respond with increased tone to many stimuli (laughter, coughing, sneezing, a sharp rise from bed, sexual contact, rapid breathing, fear, gynecological examination on the chair, fetal movements). It is perfectly normal if the uterus in response to these irritants comes into tone, BUT (!) The key points here are SHORT-TERM and PAINLESS.

That is, the tone for several seconds - minutes, which does not cause pain (primarily pain in the lower abdomen and lower back), is not accompanied by pathological secretions (read more about this in the article "Discharge during pregnancy"), which does not change the nature of the movements fetus (if we are talking about tone after 16-20 weeks), passing at rest, should not cause panic in a pregnant woman.

The episodes of hypertonicity should be reported at the next appointment with the doctor, depending on the ultrasound findings, obstetric examination data, as well as on the basis of the anamnesis data (missed pregnancies, spontaneous miscarriages, premature births, abortions and operations on the uterus, gynecological and endocrinological diseases), management of your pregnancy will be chosen.

Periodic increased tone in the period of full-term pregnancy is a normal phenomenon, most often manifested in the form of irregular, short-term, painless, weak contractions. Such fights are often called "training", this definition, in fact, is correct. Thus, the uterus is rebuilt to a new mode and is preparing for intensive work on the expulsion of the fetus (that is, for childbirth).

Causes of violation of the tone of the uterus during pregnancy:

1. Hormonal

As mentioned above, progesterone is the main hormone that preserves pregnancy. And most of the cases of uterine hypertonicity are due precisely to hormonal causes. Progesterone deficiency directly affects the tone of the uterus, smooth muscles become much more excitable, react to less powerful pathogens, and the tone persists for a longer time.

There are several diseases of the female genital area, one of the symptoms of which is a deficiency of progesterone.

Hyperandrogenism syndrome is a symptom complex that includes an increased level of androgens (male sex hormones), a relatively low level of female sex hormones, including progesterone. Manifestations of this syndrome are detected even during the collection of anamnestic data. In women, menstrual irregularities, excessive hair growth on atypical locations for women (stomach, chest, back, face), problematic skin (excessive greasiness of the skin, acne), the condition of which worsens before the next menstruation, increased greasiness of hair are revealed.

Often, women with this problem cannot become pregnant for a long time, and then from the early stages there are signs of a threatened abortion (uterine hypertonicity, pulling pains in the lower abdomen, spotting). Most often, hyperandrogenism is due to PCOS (polycystic ovary syndrome) or diseases of the adrenal glands. The diagnosis is established on the basis of blood tests for sex hormones, ultrasound of the pelvic organs and adrenal glands, and other highly specialized studies.

There is evidence that pregnancy, accompanied by a Rh conflict, often occurs against the background of uterine hypertonicity. If the mother is Rh-negative and the father is Rh-positive, then it is likely that the fetus will have Rh-positive blood. In this case, the child is perceived by the mother's body as a foreign body and it is rejected at the immunological level. A manifestation of this process is the hypertonicity of the uterus.

5. infectious process

Acute inflammatory diseases of the female genital area or exacerbation of chronic inflammation are accompanied by the production of inflammatory mediators (substances that regulate the course of the inflammatory process). The inflammatory process changes the local metabolism and may be accompanied by an increased tone of the uterus.

Acute infectious diseases (ARVI, food poisoning) can also be complicated by uterine hypertonicity, as the body experiences stress, body temperature rises, and general intoxication increases. Timely treatment helps to prevent complications of pregnancy.

6. Overstretching of the walls of the uterus (polyhydramnios, multiple pregnancy)

Overstretching of the walls of the uterus is a mechanical factor that provokes the contractile activity of the uterus.

7. Secondary causes (increased intestinal motility, constipation with excessive accumulation of feces, acute urinary retention with overdistension of the bladder and compression of the uterus)

8. Mechanical impact (rough sexual contact, abdominal trauma, fall).

9. Stress. During stress, the level of adrenaline and cortisol rises, which indirectly provokes an increase in the tone of the smooth muscles of the uterus.

Symptoms of increased uterine tone during pregnancy

In the I and II trimesters, you should worry about uterine hypertonicity if there are complaints of pulling pains in the lower abdomen and lower back, sacral region. At the end of the II and III trimester, the nature of pain with hypertonicity is approximately the same, and you can also visually determine the increase in the tone of the uterus, the stomach seems to “shrink”, it becomes hard to the touch, in thin pregnant women you can observe how the uterus contours (its contour becomes clearer and highlighted).

There is no decreased tone during pregnancy, since the norm (normal tone) is a relaxed state. Reduced tone may be of further importance if there is a tendency to overwear (pregnancy lasts more than 41 weeks, but spontaneous labor is not observed), during childbirth (weak labor). Management tactics in all cases is determined individually, after examination and history taking, and is carried out in an obstetric hospital.

Diagnostics

1. Medical examination. An obstetrician-gynecologist examines a pregnant woman, performs an external obstetric examination (4 receptions according to Leopold), "by touch" determines the tone of the uterus and, if necessary, counts contractions, their strength, duration and regularity.

According to the indications, an internal obstetric examination is performed on the chair, which determines the length of the cervix, the condition of the external uterine os and other parameters indicating the threat of interruption in combination with uterine hypertonicity.

2. Ultrasound examination of the uterus with dopplerometry. Ultrasound is performed to determine the degree and prevalence of uterine tone, to identify possible detachment of the fetal egg and the formation of a retrochorial hematoma (sometimes local hypertonicity is due to a hematoma starting to form). Doppler is performed to determine the state of blood flow in the uterine vessels and fetal vessels, which allows you to more accurately determine the prognosis of the fetus.

3. Cardiotocography. In a period of more than 30 - 32 weeks, a tensometric sensor of the CTG apparatus is used to determine uterine hypertonicity (read more about this research method in the article “Cardiotocography (CTG) during pregnancy”). The sensor is superimposed on the right corner of the uterus and reflects the contractile activity of the muscles of the uterus, the presence, number, duration and regularity of contractions.

Complications of increased uterine tone during pregnancy

In a period of more than 22 weeks, uterine hypertonicity is dangerous for the onset of premature birth. The shorter the gestation period, the less chance of a successful outcome in nursing a premature baby. There is also an increased risk of obstetric bleeding.

Prolonged, frequent uterine hypertonicity contributes to periodic circulatory disorders, and hence the nutrition of the fetus. The baby does not receive oxygen and nutrients, the risk of malnutrition (malnutrition) of the fetus increases.

Treatment of uterine hypertonicity during pregnancy

1. Hormonal preparations.

The main treatment for uterine hypertonicity, as a manifestation of a threatened abortion, is currently progesterone preparations.

Dufaston (dydrogesterone) is available in 10 mg tablets, the maximum daily dose is up to 30 mg, taken orally. The drug is taken under the supervision of a doctor up to 20 - 22 weeks. The start of taking the drug can be with pre-gravid preparation, if infertility is being treated.

Utrozhestan (natural micronized progesterone) is available in capsules with a dosage of 100 mg and 200 mg, oral or vaginal. The maximum daily dose is up to 600 mg, divided into 3 doses. The drug is taken starting from preconception preparation (if infertility treatment is being carried out) and up to a maximum of 34 weeks of pregnancy with dose adjustment. At different stages of pregnancy, the daily dose varies. Therefore, the drug should be taken under the supervision of an obstetrician-gynecologist.

Utrozhestan is an original drug, generics (analogues) are Prajisan and Iprozhin in the same dosages.

2. Sympathomimetics.

To stop the increased tone of the uterus, the drug Ginepral (hexoprenaline) is used. It is administered intravenously in an individual dosage, the drug is administered very slowly (the standard dose is administered in about 4 to 6 hours) and only in a hospital setting. After stopping an acute situation, it is possible to prescribe ginepral in tablets.

3. Osmotic therapy(magnesium sulfate intravenously, magnesium tablets)

Magnesia therapy (intravenous administration of magnesium sulfate 25%) is performed during pregnancy up to 37 weeks, in a day or round-the-clock hospital. The dose of the drug is selected individually.

Magnesium preparations in tablets (magneB6-forte, magnelis B6, magnistad) 1 tablet 2 times a day, taken from 1 month, then the duration is regulated by the attending physician, are used from early pregnancy, are well tolerated and show good results in the prevention of uterine hypertonicity. For the relief of an acute condition, these drugs are not used.

4. There are also recommendations on observing the regime of work and rest, optimal stay in the fresh air, rational nutrition (especially the exclusion of excessively hot and spicy foods), taking herbal sedatives (valerian 1 tablet 3 times a day for a long time).

Forecast

Situations that provoke uterine hypertonicity are very diverse. But most of them are quite manageable situations that are subject to successful treatment under the supervision of a doctor. Comprehensive treatment always increases the chances of a successful course and completion of pregnancy.

Your task is timely registration (up to 12 weeks), regular monitoring and compliance with the recommendations of your obstetrician-gynecologist. Look after yourself and be healthy!

Obstetrician-gynecologist Petrova A.V.