Hypertonicity of the uterus at different stages of pregnancy: why is it dangerous, how to remove it? What does "the uterus is in good shape" mean and is it dangerous during pregnancy

Starting from the first weeks of pregnancy, the entire body of a woman undergoes restructuring and preparation of optimal conditions for the development of a new life. And the mother is no exception. Natural stretching and its increase in size are often accompanied by specific sensations of varying severity. It is important to distinguish physiological changes and their manifestations from other, pathological conditions requiring medical control. We will talk about such a phenomenon as "the uterus is in good shape."

The tone of the uterus is involuntary contractions of its muscular layer (myometrium). Most often, this manifestation is a consequence of certain processes in the body, rather than an independent phenomenon. In the event of such spasms, it is important to control their duration and intensity. So, how is the tone of the uterus manifested and what are the methods for diagnosing this condition?

Signs of uterine tone

Depending on the degree of uterine tone, the symptoms may be more or less pronounced. Manifestations of hypertension that require a doctor's consultation are:

Pain in the lower abdomen. The nature of sensations can be either pulling, similar to menstruation, or cramping (at a later date).
Painful sensations in the sacrum, back, aching in them.
Bloody discharge from the genital tract.
Any discharge other than typical daily discharge.

In the case of such complaints, along with palpation, which the doctor will perform in the horizontal position of the pregnant woman, ultrasound monitoring is recommended. It can be performed both with the help of a vaginal probe and transabdominally. Based on the results of the study, the doctor judges the localization of the tone - along the anterior or posterior wall of the myometrium, its intensity - 1 or 2 degrees.

A woman can determine the presence of uterine tone on her own. To do this, she should lie on her back, relax, put her hand on her stomach. Gently probing it, the expectant mother should follow the sensations. If during the examination the abdomen is soft, this indicates that there are no obvious reasons for concern. A hard, dense stomach, “like a stone” is an alarm signal that requires special attention. In this case, it should be assumed that the tone of the uterus is increased. This condition can pose a serious threat to pregnancy, up to its termination.

Causes of uterine tone

An increase in the tone of the uterus is caused by causes that are not always directly related to it. Among the most common, we single out general factors that affect regardless of the gestational age, and those that are able to manifest themselves to the maximum only in a certain trimester.

General Factors

Overwork, stress.

These factors have a negative impact on the susceptible body of a pregnant woman, exposing it to additional stress.

Physical exercises.

Active sports during a "special position" can lead to unwanted muscle strain and, as a result, hypertonicity.

Inflammatory diseases of the reproductive system.

Previous interventions, chronic diseases of the uterus or its appendages create a risk of increased tone with an increase in the load on the organ (uterus).

Infectious and somatic diseases - acute respiratory infections, influenza, diseases of the heart, liver, kidneys or other organs, abnormalities in the work of the central nervous system.

Deviations in the functioning of body systems can cause a violation of the regulation of muscle contractions of the uterus.

Rhesus conflict.

A negative Rh factor of a pregnant woman can cause conflict with a positive Rh factor of a future dad. Then the mother's body perceives the fetus as a foreign body, which must be disposed of. The result is an increased contraction of the muscles of the uterus and hypertonicity.

Anatomy.

Individual structural features, the shape of the uterus (bicornuate or saddle-shaped) can serve as a predisposing factor to its excessive compression and spasms, and cause difficulties with bearing.

Trimester features

The most frequent “provocateurs” of uterine tone in early pregnancy are hormonal disorders and severe toxicosis.

The lack of progesterone in the body - a hormone that is directly responsible for the normal tone in the uterus - is a serious bell, indifference to which can lead to miscarriage.

Severe toxicosis is often accompanied by profuse and frequent vomiting. In this case, there is an intense compression of almost all abdominal muscles, including the muscles of the uterus.

In the second and third trimesters, the causes of tone are physiological in nature.

Multiple pregnancy, large fetus, polyhydramnios cause excessive stretching of the uterus and increase tension in it.

Treatment of uterine tone

If the doctor diagnosed the tone of the uterus, the treatment of this unpleasant phenomenon will be aimed at relaxing its muscle layer, eliminating spasms. Specialized therapy is prescribed exclusively by a doctor, based on an analysis of the causes that caused this condition. Drug treatment will not have the desired effect without compliance with bed rest - the first and main requirement. The most widely used are the following "relaxing" drugs:

No-shpa (injection or in the form of tablets), Papaverine and Magnesia.
3rd trimester - vitamin support (for example, Magne B-6). It is not recommended to completely eliminate contractions, because there is a gradual preparation of the body for labor.

In addition, medications are prescribed to eliminate the actual cause of the tone. If there is a shortage of progesterone, appropriate replacement therapy will make up for its deficiency. With a Rh conflict or an excess of male hormones, adequate treatment is also selected.

How to remove the tone of the uterus at home

Simple manipulations aimed at relieving the tone of the uterus and the pain caused by it can be performed by the pregnant woman herself, without leaving home.

Exercise "Cat"

Get on all fours, raise your head and arch your back. The deflection must be done on inspiration. Stay in this position for 3-5 seconds. Return to starting position. Repeat this several times and then rest for an hour. An important rule: perform the exercise smoothly, without sudden movements, while maintaining calm breathing.

Relaxation of facial muscles

Sit in a comfortable position and lower your head, trying to relax all the muscles of the face and neck as much as possible. Breathing is even, through the mouth. Try not to think about anything at this moment. The exercise lasts several minutes. This technique will not only relieve tension, but also teach you to feel and control your body.

aromatherapy

A warm shower with aromatic oils, a drop of oil in a medallion will calm you down, restore your mood and positive attitude. However, you should be careful both with the choice of oil (some, on the contrary, can increase tone), and with its quantity.

Prevention of uterine tone

Any disease or pathological condition is much better to prevent than to eliminate. A few simple recommendations will help, if not to avoid tone, then significantly reduce the risk of its occurrence.

Daily walks in the fresh air - a portion of oxygen and excellent exercise in one bottle.
Regular gymnastics. Feasible physical exercises normalize muscle tone, give vigor and a positive attitude.
Proper nutrition. Try to exclude from the diet not only all "harmfulness", but also products that provoke increased gas formation. It is recommended to limit the consumption of a number of spices, such as garlic, parsley, celery. Salty and smoked foods lead to increased water intake, retain it in the body, which increases the risk of edema and polyhydramnios. This can cause tone.
Taking vitamins. The doctor will tell you the drugs you need.
If discomfort occurs, limit or completely refuse sexual activity for a while.
Avoid wearing tight clothing that will put pressure on your stomach and impair blood circulation.
The most important thing is more positive emotions. Smile, enjoy your wonderful condition.

Careful attitude to your health, following the recommendations of the doctor will help you bear and give birth to a healthy baby. It is important to remember that the increased tone of the uterus during pregnancy is not a sentence, but a feature of its course, which requires closer attention.

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How to remove the increased tone of the uterus during pregnancy. Causes and symptoms in the 1st, 2nd and 3rd trimester. Sensations of pregnant women with tone. What to do and how to treat at home (mom reviews).

From a medical point of view, the uterus is a hollow internal organ. It consists of two mucous membranes (external and internal) and a muscular "layer". In a normal state, the uterus is relaxed (the so-called normal uterine tone).

During pregnancy, the muscles of the uterus contract, in medicine this phenomenon is called tone. Muscles can contract due to laughter, coughing, sneezing, and the psychological state of a woman can affect them.

A slight tension in the muscles of the uterus is considered normal if it is short-term and does not cause any inconvenience to the expectant mother.

Prolonged and painful contraction of the muscles of the uterus is called hypertonicity. This condition threatens the fetus and pregnancy. In the 1-2 trimester, the tone can cause a miscarriage, at a later date (3 trimester) it can provoke premature birth.

Reasons for the appearance

Prolonged, painful tension in the muscles of the uterus (hypertonicity) occurs from:

nervous overload, stress;
unhealthy lifestyle (bad habits);
muscle strain during significant physical exertion;
improper production of hormones at the initial stage of pregnancy (the body does not produce enough progesterone, which relaxes the muscles);
structural and inflammatory changes in the body (myoma, endometriosis);
significant stretching of the muscles of the uterus (the uterus can stretch from a large fetus, multiple pregnancy, polyhydramnios);
diseases transferred by the mother (tonsillitis, pyelonephritis, influenza);
previous abortions;
severe toxicosis;
Rh - conflict between mother and child (the body of a Rh - negative mother can reject a Rh - positive child as a foreign body, resulting in an increased tone).

Feelings in the first trimester

The tone of the uterus at the beginning of pregnancy can lead to the death of the embryo and miscarriage. The danger of hypertonicity in a short time is that it is almost impossible to “feel” it on your own (the uterus is still small in size).

Strong and prolonged pain in the lower abdomen should alert (pain is stronger than that which happens during menstruation).

A pregnant woman needs to visit a doctor in order to find out exactly the cause of the pain, since it is not uncommon for an ectopic pregnancy to “manifest itself” this way. In addition to frequent and prolonged pain in the lower abdomen, you should also consult a doctor if there is bloody discharge from the vagina, the sudden disappearance of signs of pregnancy (the breast has stopped swelling, the basal temperature has decreased).

Tone in the second trimester

In the 2nd trimester, a small tummy appears, but increased uterine tone still poses a danger to pregnancy. The tension of the muscles of the uterus negatively affects the development of the child. The baby does not receive enough nutrients (tense muscles can "block" the blood vessels, provoking the development of hypoxia). In especially severe cases, this leads to a fading pregnancy or miscarriage.

It is rather difficult for most women to determine uterine tone even in the second trimester, since again the main sign of “malfunctions” is the characteristic pain in the lower abdomen, while the uterus “hardens”, shrinks (at the end of the second trimester, the expectant mother can already visually notice signs of tone when the uterus tenses, shrinks).

Tonus in the third trimester symptoms

The tone of the uterus in the third trimester is most often periodic. The uterus may contract and relax after a few seconds. This situation is considered quite normal, since the woman’s body is preparing for childbirth, such “changes” are called training contractions.

However, not all cramping pains of the third trimester should be attributed to training contractions. You can do a simple test. You need to take paper and a stopwatch and detect the frequency of pain. If the stomach tenses up every 5-10 minutes, this is a “training” of the body before childbirth (the test is informative after 30 weeks).

With severe and prolonged pain that does not go away for a long time, you should consult a doctor. Hypertonicity of the uterus in the third trimester is fraught with premature birth. The child may not yet be ready for birth (28-30 weeks), then the baby will need long-term rehabilitation and nursing.

What to do, how to treat

The answer is simple - see a doctor. Moreover, it is best to do this at the first suspicion of increased tone. The specialist will determine the severity of the tone, possible risks.

If there is no threat of termination of pregnancy, treatment is possible at home. A woman is prescribed bed rest, prescribed drugs that relieve spasm (no-shpa, papaverine), drugs containing magnesium and sedatives (sedatives).

In difficult cases, the expectant mother requires hospitalization. In the hospital, constant monitoring of doctors is provided, there are fewer “temptations” to violate the regime (the complete absence of physical activity, while at home it can be problematic to ensure peace).

Toning exercises

You can get rid of the increased tone of the uterus at home, but this does not mean that you need to forget about the medications prescribed by your doctor. You can use relaxation exercises.

The diagnosis of “uterus tone” is made for almost every second pregnant woman, both at the beginning of pregnancy and at its end. Everyone has heard about the consequences of such a state, and already from the first happy days of gestation, the future mother tries not to lose sight of the slightest deviation from the normal state. That is why many are so interested in what symptoms this ill-fated tone manifests itself.

To begin with, you still need to figure out what it is, and after that it will become obvious how it can manifest itself. So, even from the school desk, we must remember that the uterus is an organ that consists of muscle tissue. We also know that muscle fibers tend to contract. However, the pregnant body is by its very nature amazing. It is during the happy months of waiting for a new life that the brain “turns off” many functions and directs all its forces to pregnancy. Therefore, under normal circumstances, the muscles of the uterus are calm and relaxed so that the little man develops in favorable conditions. But after all, everything in our life is not always smooth and calm. Nervous stress, overstrain, overload, wrong lifestyle - all this confuses the "pregnant brain" and it can send the wrong instructions to the uterus. The fibers begin to shrink, their tone increases, and pressure “grows” in the uterus itself. Such contractions can be very dangerous, as they are able to "push out" the fetus.

With any of these symptoms, you should contact your gynecologist immediately. Only he is able to either confirm or refute the hypertonicity of the uterus. In a clinical setting, this is quite easy to do. When examining a pregnant woman with the help, the doctor clearly sees whether the muscle fibers are tense or not. By palpation (palpation), the doctor also feels tension in the abdomen and shortening of the cervix. There is a special drug that measures the force of uterine contraction during pregnancy. However, it is rarely used, since the symptoms of hypertonicity are noticeable.

The most dangerous tone of the uterus in the first trimester of pregnancy (up to 12 weeks). Its untimely diagnosis or ignoring it can cause an arbitrary miscarriage. Any pain and incomprehensible sensations in the uterus should be a good reason to see a doctor. It is necessary to treat the tone of the uterus during this period.

Very often, hypertonicity is observed in the second trimester of pregnancy. However, during this period, the uterus begins to "train", and the woman feels tension and relaxation, but without pain and rarely. They maintain a normal state with a familiar medicine - Magne B6.

But in the last weeks of pregnancy, the tone of the uterus is becoming increasingly difficult to determine. Now it is difficult to distinguish it from preparatory contractions, and the baby himself shoves his mother, because he becomes cramped in his tummy. If, nevertheless, uterine contractions are painful, and even more so regular, then urgently consult a doctor. Hypertonicity in the last trimester provokes.

Listen to your "pregnant body", but do not panic for any reason. Otherwise, you will only make things worse for yourself and your baby. Although the diagnosis of “uterine tone” is common, it almost always has a favorable outcome if the expectant mother is attentive to herself and remembers that pregnancy is a pleasure!

Take care of yourself!

Specially for- Tanya Kivezhdiy

Increased uterine tone during pregnancy is a problem that threatens to interrupt it. Pathology occurs quite often, but with the right approach, serious consequences can be avoided.

An increase in the tone of the uterus is an excess tension of the cells that form the muscle layer in the wall of the organ. The uterus is able to stretch very much with the growth of the fetus. At the same time, it must retain a biologically expedient shape and size.

The elasticity of the uterine wall gives the muscle layer. Due to it, the expulsion of the fetus occurs during childbirth. In certain situations, the tone of the uterus increases, and this creates certain difficulties in the course of pregnancy.

Physiology of uterine tone

The uterus always has some tone. It is sufficient so that there is no overstretching of its walls, but at the same time it does not violate the physiological processes associated with the growth and development of the fetus.

The tone of the uterus has a complex regulation. On the cells of the myometrium (the muscle layer in the wall of the uterus) there are receptors for female sex hormones (estrogen, progesterone, oxytocin) and various biologically active substances (prostaglandins, adrenaline, norepinephrine and others). They are influenced by impulses transmitted through nerve fibers. Moreover, some factors have a stimulating effect, while others have a relaxing effect.

All this is necessary to maintain pregnancy with its favorable course. In this case, certain mechanisms are involved, a sufficient level of progesterone is one of them. If the embryo is not viable, it is rejected and expelled.

During childbirth, the functions of the uterus are especially important. A full-fledged labor activity is necessary - rhythmic contractions, increasing in duration and frequency, sufficient to expel the fetus. At the same time, relaxation of the cervix is required for its disclosure. In addition, after childbirth, the uterus must contract quickly so that blood loss does not develop.

Of course, other structures are also involved in the described processes - the endometrium, ovaries, pelvis, muscles of the abdominal wall, and the whole organism as a whole. But the role of the myometrium is very large.

Why does the tone increase during pregnancy?

For all these processes to be carried out, the body must work "like a clock". However, the high complexity and subtlety of the regulation of uterine tone also determines the very high sensitivity of the myometrium to various factors.

There are several groups of reasons leading to a change: more often - to an increase, less often - to a decrease in uterine tone.

Hormonal. Outside of pregnancy, the uterus is small. In order for it to increase, giving room for the growth of the fetus, a change in the hormonal background is necessary. The main hormone that determines the continuation of pregnancy is progesterone, produced by the corpus luteum of the ovary. It is he who signals to all other organs that a pregnancy is being carried. If its amount is not enough, the uterus tends to contract, as if there is no pregnancy, and comes into increased tone. It is also affected by an excess of male sex hormones, prolactin and other hormonal changes.
Neuropsychic. With fluctuations in the emotional background in the blood of a woman, the content of "stress hormones" - cortisol, adrenaline and others - may change. This entails an increase in the tone of the uterus.
Anatomical features, pathology of the reproductive sphere. Uterine immaturity, fibromyoma, structural anomalies () can also disrupt the normal course of pregnancy, including leading to an increase in myometrial tone.
Causes related to the fetus. It can be polyhydramnios, multiple pregnancy, large fruit. Leading to mechanical overstretching of the walls of the organ, they are able to provoke a compensatory overstrain of muscle cells.
Somatic pathology of the body. In acute or severe decompensated chronic diseases, disturbances in the functioning of organs and systems often lead to pathology of pregnancy, hypertonicity and the threat of miscarriage.

The work of the body can be compared with the performance of a melody by an orchestra. Harmony is achieved only with the coordinated action of all organs and systems. During pregnancy, the requirements are especially high. When a woman is carrying a fetus, the so-called “pregnancy dominant” is formed in her brain at a conscious and subconscious level. All organs and systems in their work are subject to this dominant. All the forces of the body are aimed at making the child endure.

If any adverse event occurs in the life or health of a pregnant woman that has a strong impact on her, then forces can be redirected to combat the problem that has arisen. At the same time, the “dominant of pregnancy” ceases to be a dominant, and there may not be enough strength and internal resources to fully preserve the child. As a result, there is a threat of interruption.

Symptoms of uterine tone during pregnancy

All manifestations of tone can be divided into those that a woman feels (complaints), and those that are determined during examination and additional examination. In addition, the symptoms are divided into those affecting the mother and the fetus. Symptoms of increased tone are somewhat different in early and late pregnancy.

The main manifestations that bother a woman are as follows:

Pain in the lower abdomen of a pulling or spastic nature. In the early stages, when the uterus is slightly enlarged, it is pain that most often worries. In the later stages, when a woman already feels the uterus, an increase in her tone is perceived as a spasm - something like a cramp in the abdomen.
Discharge from the genital tract. They can be bloody, with early endometrial rejection and late placental abruption (a very alarming symptom that requires immediate attention). Also, the discharge can be mucous - when the “plug” leaves the cervix.
Weakening or disappearance of fetal movements. This may be due to the fact that he suffers from hypoxia, as well as the fact that movements are less felt when the uterine wall is tense.

If the uterus is small, then the sensations resemble the sensation during menstruation. At this time, the uterus also contracts, expelling the remnants of the torn endometrium from itself.

If the period is long, then the tension of the walls of the uterus leads to the fact that the woman begins to feel it as a hard ball in the stomach, which can be felt through the abdominal wall. If, with a normal tone, the belly of a pregnant woman changes shape when the position of the body changes - in the supine position, it seems to “flatten”, then with an increase in tone, the stomach continues to remain dense and protruding in any position.

The degree of severity of hypertension can be different. It is constant insignificant, a woman feels it as heaviness in the stomach, mild pulling pains. Sometimes the contraction of the walls of the uterus develops quickly and resembles a contraction in strength. In addition, hypertonicity can be total or cover only a portion of the endometrium. In any case, this condition is threatening for pregnancy.

Why is uterine hypertonicity dangerous?

The most unfavorable thing about uterine hypertonicity is that it increases the risk of abortion. If the term is short, the fetal egg with membranes and exfoliated endometrium can be "pushed" out of the uterine cavity. The likelihood of a miscarriage is especially high when bleeding occurs.

For a long time - this is a threat of premature birth. In addition, with hypertonicity, there is a risk of outflow of amniotic fluid, as well as the development of prolapse (omission) of the presenting part of the fetal bladder into the vagina.

A more formidable complication is placental abruption. Normally, the placenta is, as it were, “spread out” on the inner surface of the uterus. The contact between the endometrium and the placenta is very tight. If the uterus contracts, then the area that is located under the placenta decreases in size. Although the tissues are highly elastic, this resulting discrepancy can cause part of the placenta to detach.

Detachment of part of the placenta leads to uterine bleeding. In addition, the exfoliated area “drops out” of gas exchange and the fetus begins to suffer from oxygen deficiency. Placental abruption can also occur for other reasons, hypertonicity is just one of them.

But if placental abruption does not occur, with increased uterine tone, the fetus still suffers from hypoxia. Due to the contraction of the muscle layer, the blood vessels in the uterus and placenta are compressed. This also leads to disruption of uteroplacental blood flow and gas exchange. Signs of fetal hypoxia are determined subjectively (by weakening the movement) and objectively (according to survey data).

At-risk groups

Previously, the causes leading to the development of uterine hypertonicity were considered in terms of changes occurring in the body. Based on these reasons, a list of conditions and situations in which the risk of developing pathology is very high has been compiled. These include:

a history of miscarriage (when a woman has already had miscarriages or premature births);
young (up to 18 years old) and late for childbirth (over 35 years old) age;
unfavorable life situation (single mother, low income, conflict relations in the family);
difficult working conditions;
chronic diseases, especially of the endocrine system;
bad habits;
diseases of the reproductive organs (endometritis, and others);
acute diseases during pregnancy (flu, acute respiratory infections);
severe stress (loss of a loved one, job, housing);
previous induced abortions.

If these risk factors are identified during registration, then measures to correct the situation may be taken. To do this, a woman is transferred to easier work, sent to a family psychologist, she is prescribed adequate treatment for comorbidities. Other measures are being taken. A pregnant woman is prescribed more frequent examinations to monitor her condition, so that if a pathology is detected, treatment can be started in a timely manner.

Treatment of pathology

In fairness, it should be noted that uterine hypertonicity, especially in the second half of pregnancy, is most often caused by neuropsychic overstrain (progesterone deficiency is more common in the early stages). If a woman is initially healthy, stress is almost the only cause of spasm. Therefore, the main recommendation is to monitor your emotional state, treat it consciously.

To do this, it is worth reconsidering your attitude to annoying factors, as well as consciously creating conditions for maintaining a good mood - walking in the fresh air, striving for positive emotions, not getting involved in conflicts, not watching "heavy" films and TV shows. There are relaxation techniques based on yoga, meditation and breathing techniques.

If uterine hypertonicity does not go away from non-drug measures or has “organic” causes (caused by pathology of internal organs, genitals or endocrine system), appropriate treatment is prescribed for correction. The following groups of drugs are used:

Antispasmodics - drugs that relax smooth muscles (participating in the construction of the walls of organs, including the uterus). This is No-shpa, papaverine, drotaverine.
Magnesium preparations with B vitamins. They also help to relax smooth muscle cells, and also have a beneficial effect on the nervous system.
Herbal sedatives. They should not be treated superficially. These are also drugs that have indications and contraindications.
Progesterone in various dosage forms. It is prescribed for functional insufficiency of the corpus luteum.
Calcium channel blockers. Since muscle contraction occurs due to the redistribution of calcium in the cell and intercellular substance, these drugs eliminate spasms.

There are other drugs prescribed in a hospital setting. These are beta-agonists, oxytocin antagonists, prostaglandin synthesis inhibitors and other tocolytics (drugs that relax the uterus).

The use of all means should be carried out only on the prescription of a doctor and under his supervision. Taking drugs that relax smooth muscles, especially in the last trimester, can lead to the development of weakness of labor during childbirth, when they are due. In addition, some drugs have severe side effects, and their use is a last resort.

If the severity of uterine hypertonicity is very high, hospitalization is indicated due to the threat of abortion. A woman is prescribed a complex treatment: bed rest, sedatives, physiotherapy, drugs that reduce the tone of the myometrium. If there is a high risk of preterm birth, the doctor may prescribe therapy that accelerates the maturation of the fetus to increase the chance of survival for the child if he is born prematurely.

When bleeding due to placental abruption, an emergency delivery is often required to save the life of the mother and child. If bleeding develops for a short period, then if it is impossible to maintain the pregnancy, the removal of the remaining parts of the ovum and endometrium is indicated (curettage of the uterine cavity).

In conclusion, it should be said that although pregnancy is not a pathological condition, it requires a special attitude from a woman. Maximum attention and efforts should be directed to saving yourself and the child. Examinations should be carried out in a timely manner, the prescribed drugs should be taken regularly, lifestyle recommendations should be followed carefully. All this will allow you to bear the child healthy and give birth without complications.

Increased uterine tone is observed in 60% of pregnant women, but only in 5% this phenomenon requires special treatment. In other cases, uterine hypertonicity is not considered a dangerous condition during gestation. The only thing that is required from the expectant mother is to observe bed rest, sexual rest and adhere to the daily routine.

Pulling pain in the lower abdomen with uterine hypertonicity

What is uterine hypertonicity during pregnancy?

The female uterus is a muscular hollow organ that can contract like any other muscle in the human body. The contraction of the muscle fibers of the uterus leads it to the so-called tone. This means that the uterus, as it were, “tightened up” and remained in this state.

Normally, during pregnancy, the uterus is completely relaxed, but sometimes there is an increased tone when the muscular layer of the uterus contracts, thereby increasing pressure in the uterine cavity. This condition of the uterus has a bad effect on the course of pregnancy and the development of the fetus, this condition is called uterine hypertonicity.

Symptoms and consequences of increased uterine tone

The main symptom of uterine hypertonicity in the early stages is a pulling pain in the lower abdomen (as during menstruation), pain in the lower back and in the sacrum. In the second trimester and later, these are cramping pains and hardening of the abdomen, which is well felt when it is palpated (palpated).

The increased tone of the uterus is aggravated in the early stages by spotting bloody discharge from the genital tract. Then there is a risk of spontaneous miscarriage, since it is difficult for a fertilized egg to attach to the wall of the uterus due to the increased tone of the muscular layer of the uterus.

In the second trimester of pregnancy, when the placenta is already fully formed, there is a risk of its exfoliation due to increased uterine tone.

In late pregnancy, uterine hypertonicity can lead to premature birth, because such uterine contraction occurs during labor to help the baby be born.

Also, a negative consequence of uterine hypertonicity is fetal hypoxia, when uteroplacental blood flow is disturbed due to the tone of the muscular layer of the uterus. Thus, the fetus receives an insufficient amount of oxygen and nutrients necessary for its normal development. Usually, such a fetus lags behind in weight and size, its development is also slowed down, and with untimely treatment, the development of malformations of the fetal organs can be observed, or even this can lead to a missed pregnancy, i.e. to fetal death.

Causes and methods for diagnosing uterine hypertonicity

There are a lot of reasons for the appearance of increased uterine tone during pregnancy:

hormonal deficiency;
diseases of the uterus (inflammatory processes of the appendages and the uterus itself, endometriosis, uterine fibroids, etc.) and disruption of the central nervous system;
exacerbation of chronic diseases and the occurrence of colds (ARI, SARS and other ailments, which are characterized by an increase in body temperature);
constant stress and increased physical activity, insufficient sleep and / or rest, as well as the presence of bad habits in a pregnant woman;
polyhydramnios, multiple pregnancy or large fruit.

It is possible to determine the local hypertonicity of the uterus along the posterior or anterior wall using ultrasound. At the same time, the ultrasound shows a change in the wall of the uterus in the place of its tone, it bends inward.

There is also a special sensor for determining the tone of the uterus. But, unfortunately, tonusometry is not carried out in all antenatal clinics.

Treatment of uterine hypertonicity

At any stage of pregnancy, No-shpa or Papaverine suppositories will help relieve pain during uterine tone. These drugs can be taken at home at the first symptoms of tone.

In the first trimester of pregnancy, with uterine tone caused by a deficiency of the hormone progesterone, Utrozhestan or Duphaston is prescribed to maintain the pregnancy. The main rule of taking hormonal drugs is that they cannot be abruptly canceled. If the tone has ceased to disturb the pregnant woman, then we reduce the hormonal preparations in dosage and only then stop drinking them altogether.

With detachment of the placenta, there is a tone of the uterus and aching dull pain that radiates to the thigh or perineum. Then the pregnant woman is hospitalized and she is prescribed treatment at the hospital. Typically, such treatment includes an antispasmodic "plus" a drug containing magnesium (for example, Magne-B6 or magnesium sulfate), which can reduce the activity of the uterus, "plus" vitamins and herbal sedatives (for example, valerian or motherwort).

From the second trimester, you can use a more effective drug for the treatment of uterine hypertonicity - Ginipral, but in the presence of placental abruption, it cannot be used.

In the third trimester, if the baby is mature enough and there is a risk of losing the baby due to excessive placental abruption or opening of the cervix, doctors may decide to induce labor or perform a caesarean section in order to save the life of both the child and the expectant mother.

But usually modern pregnant women suffer from hypertonicity due to psycho-emotional stress: blockages at work, the need for housekeeping, active pastime with children, etc. All this causes stress and fatigue, to which the central nervous system of the pregnant woman reacts with the manifestation of uterine hypertonicity.

Myometrial hypertonicity caused by an active lifestyle is usually not treated by doctors as such, but simply prescribed vitamins, they recommend avoiding stressful situations, keeping calm (including sexual) and daily routine (sleep for at least 8 hours). During the period of exacerbation, take a day off for at least a couple of days and try not to get out of bed for a day (you should lie on your left side).

If it is not possible to take a day off, then you can do relaxing exercises directly at the workplace (if you have your own office or you are surrounded by good female co-workers).

Kneel on a chair in an all-fours position and slowly arch your back while lifting your head up. Stay in this position for a few seconds. So the tummy will be in a “suspended” comfortable state. Then slowly arch up (like a cat), pulling your chin to your chest, and linger again. Do this exercise several times and try to sit quietly for the next hour, leaning on the back of a chair and slightly stretching your legs forward.