Hypertonicity of the uterus at different stages of pregnancy: why is it dangerous, how to remove it? Increased uterine tone: pathology or special condition of pregnancy

Even those who have never carried a child under their hearts have been heard. This condition, unfortunately, occurs so often that it will not hurt both pregnant women and only those planning to conceive to know about it.

What is increased uterine tone?

To answer this question, let's first understand what kind of body it is. The uterus is a hollow, contractile, muscular organ, the basis of which is the myometrium. Naturally, during pregnancy increases. At the same time, each muscle fiber lengthens by 10-12 times and thickens by 4-5 times. Nature arranged it so that normally, for 9 months, the muscles of the uterus are in a calm (relaxed) state. This allows you to bear the child. Also, normally, the uterus sometimes slightly contracts, this happens closer to the expected date of birth. Such contractions are called training. It's like a dress rehearsal before the main event - the birth of a baby. But it happens that during a long period of pregnancy (in some cases, throughout the entire period of gestation), the muscles of the uterus are in an excited, contracted state. The muscle layer of this organ contracts (its tone increases) - the pressure in the uterine cavity rises. Unfortunately, this is a pathological condition that requires appropriate and timely treatment, since it is a symptom of a threat or

Causes of increased uterine tone during pregnancy

As a rule, fear, overexcitation or overstrain of muscle fibers caused by excessive physical exertion contribute to the occurrence of increased tone (hypertonicity) of the uterus.

If the tone occurred in the early stages of pregnancy, the cause of this may be hormonal disorders, in particular, reduced production of progesterone. As a rule, increased uterine tone in the second trimester usually appears due to overload at work or an unhealthy lifestyle. In addition, hypertonicity can occur due to inflammatory and structural changes (uterine fibroids, endometriosis). Overstretching of the muscles of the uterus, which occurs due to multiple pregnancy, or a large fetus, can lead to increased tone. Moreover, increased uterine tone can occur as a result of a previous acute respiratory disease or other disease (flu, tonsillitis, pyelonephritis), previous abortions, bad habits (smoking, etc.). In the third trimester of pregnancy, increased uterine tone can lead to premature birth.

What does a woman feel in such a state?

• unpleasant squeezing or aching pains in the lower abdomen (can be both barely noticeable and strong); often they are similar to those experienced by a woman before or during menstruation;
• tension in the abdomen (it becomes hard, as if made of stone);
• often - unpleasant or lower backs;

In some cases, pain may be accompanied by bleeding. If this happens, go to the doctor immediately. Also, urgent medical care requires a condition when a woman has cramping pains with an interval of several minutes.

What if you don't see a doctor? What could be the consequences?

Unfortunately not the best. Increased tone can lead to spontaneous abortion at any time. If this happens in the first trimester, they will talk about a miscarriage, in the later - about premature birth. In addition, increased uterine tone threatens with another complication: the risk of pregnancy fading.

Even if the tone is not so significant as to lead to such unfortunate consequences, then this will not be reflected in the best way on the health of the baby. The fact is that a frequent increase in the tone of the uterus provokes oxygen starvation, since the blood supply is disturbed.

Treatment of increased uterine tone during pregnancy

The occurrence of this condition should be reported to your obstetrician-gynecologist as soon as possible. He will tell you how to behave in order to reduce the risk of complications, and, if necessary, prescribe medication.

Fortunately, increased uterine tone responds well to treatment. The first thing the doctor will require is to ensure a calm regimen and the normalization of the psycho-emotional state of the patient. Now, more than ever, it is very important for a pregnant woman to establish a normal mode of work and rest, good sleep, sufficient exposure to fresh air, and feasible physical activity. With an increased tone of the uterus, bed rest is often prescribed and sexual activity is completely prohibited. If necessary, a woman is hospitalized and treated in a hospital. Medical treatment is also used in this condition. To relieve stress and ensure psychological comfort, sedatives are prescribed (tincture of motherwort and valerian). If these drugs are not effective in a particular case, Sibazol, Nozepam, Trioxazin, etc. are prescribed. To relax the uterine muscles, antispasmodics are used (No-shpu, Papaverine). Magne-B6 is often used. If the reason for the increase in tone is an insufficient amount of progesterone, Duphaston and Utrozhestan are used (up to 16 weeks). Drugs that relax the muscles of the uterus (for example, Ginipral) and calcium channel blockers (Nifedipine, Corinfar) have proven themselves well. To stop bleeding, hemostatic drugs are prescribed (Dicinon, Etamzilat sodium). In addition, if an increase in uterine tone is diagnosed in late pregnancy, a woman is prescribed droppers. Intravenous administration of a 25% solution of sulphate and 10% alcohol can alleviate the situation. In addition to the above options for treating increased tone, a fortified diet is used, as well as physio-, acupuncture and psychotherapy.

If spasms began suddenly and are very strong, then you can take 2 tablets of No-Shpa or put a candle with Papaverine. The next step in this case is an urgent visit to the doctor. Even if the pain has gone, do not leave this issue unattended and do not ignore the visit to the antenatal clinic.

Remember: not only the health of your unborn baby, but even his life depends on how you behave in this or that case.

Specially for- Elena Kichak

From Guest

The tone was strong from the 26th week, she lay on the preservation until the 38th week, then they were caesarean. The tone was so frequent, literally in 5-10-15 minutes. Basically lay, caloli ginepral, magnesia, saw B6 and motherwort of course. The tone is not a joke, while I was lying in the hospital I heard a lot of scary stories from girls whose tone led to premature birth. So, take care of your children, and in which case, call an ambulance and lie down for preservation !!! I wish you all the birth of healthy children!!!

Pregnancy is a time that brings a lot of joy and positive. However, in this state, a woman can expect a lot of unpleasant diagnoses. Among the most common are the tone (hypertonicity) of the uterus. What is this condition and what to expect the expectant mother?

Uterine tone: causes and danger of the condition

Normal uterine tone is when the myometrium (smooth muscle tissue) is in a relaxed state. If, during pregnancy, until the onset of childbirth, it begins to decline, then in medical practice it is customary to say that the tone of the organ is increased. Since the described muscle behavior is natural, such a condition is not always a pathology and a cause for concern. If it is not associated with other symptoms and discomfort, then most likely you should not worry. However, this does not mean that the state should be ignored. Especially if the tone of the uterus is not short-lived.

An interesting fact: more than 60% of women during pregnancy are diagnosed with increased uterine tone.

If the condition continues for a long time, then it is fraught with the most detrimental consequences. Uterine hypertonicity can lead to spontaneous miscarriage (in the first trimester) or premature birth (in the second and third trimesters). Increased tension of the uterus in the early stages can negatively affect the process of attachment of the fetal egg, provoking its rejection by the uterine organ or death. The activity of the myometrium immediately before childbirth is often not dangerous. Thus, the body of a woman prepares for childbirth.

Hypertonicity of the uterus can negatively affect the health and development of the baby. Tight muscles limit the flow of oxygen to the fetus, as they pinch the vessels of the umbilical cord. This phenomenon can lead to hypoxia (oxygen starvation) or malnutrition (growth arrest), since nutrients also cease to be supplied in sufficient quantities.

The following reasons for the development of increased tone, or hypertonicity, of the uterus can be distinguished:

• lack of progesterone (a corpus luteum steroid hormone that is formed instead of a burst follicle). He is also responsible for relaxing the muscles;
• excess male hormones and prolactin (a hormone involved in the regulation of reproductive function);
• severe toxicosis with frequent and profuse vomiting;
• anomalies of the uterine organ and pathology of the placenta;
• malfunctions of the thyroid gland;
• Rhesus conflict between the mother and father of the child. In this case, the body can reject the fetus through muscle contractions;
• certain infectious diseases of the pelvic organs and inflammatory processes;
• excessive stretching of the uterus (possibly with a high-water or multiple pregnancy);
• tumors, miscarriages, abortions and other painful conditions;
• malposition;
• violation of peristalsis (normal contraction) of the intestine;
• stress and unstable psychological state;
• increased physical activity;
• sleep disturbance;
• age after 35 years;
• sex before 12 weeks of pregnancy;
• increased gas formation and improper diet.

Please note: uterine tone is only a symptom, not an independent disease. Only after an accurate diagnosis is made, it will be possible to prescribe adequate treatment.

Norms of uterine tone by gestational age

In order for the child to develop correctly within the uterine organ, the latter must be relaxed and supple. A short tone in the early stages is relatively safe. In this case, muscle contraction:

• occurs 6 or less times a day;
• activates blood circulation and ensures the normal development of the fetus;
• most often caused by physical exertion or excessive activity.

In the second trimester, painless contractions can already be observed. They are usually called training or false. They usually happen several times a day. Thus, the body prepares for subsequent births.

At the beginning of the third trimester, contraction of the uterine muscles can be provoked by the baby himself, who begins to actively move. In recent weeks, young mothers often confuse hypertonicity with the onset of labor.

Video: why there is uterine hypertonicity during pregnancy

Symptoms of hypertension by trimester

It is possible to determine the development of pathology within each stage of pregnancy. The most terrible hypertension in the first trimester. If there is a problem:

• muscle contraction is observed;
• the uterus becomes hard due to tension;
• the condition is often accompanied by profuse vaginal discharge and pain.

Important: even if at least one of the described symptoms is present, a consultation with a doctor is mandatory.

In the II trimester, it will be more difficult to determine hypertonicity. A pregnant woman during this period has a lot of new sensations, which is why it can be difficult to single out specific ones. Fears in a woman should cause:

• pain in the lower abdomen and in the back. They are somewhat reminiscent of renal colic;
• colored highlights. Be sure to use disposable pads to quickly recognize the presence of a characteristic shade.

Important: if the nature of the pain is acute, then you must immediately call an ambulance.

The third trimester is marked by the active preparation of the mother's body for future childbirth. At this time, a periodic short contraction of the uterine muscle is the norm. Usually training contractions appear at 7-8 months. Hypertonicity becomes incredibly difficult to recognize. In this period, it poses a great danger, since it can cause premature birth. Therefore, it is important to carefully listen to the signals that come from the body. The following features will help distinguish training contractions from hypertonicity:

• training bouts do not differ in regularity and significant duration;
• pain during the preparation of the body for childbirth is excluded;
• bleeding is not observed.

In the II and III trimesters in a state of hypertonicity, every movement of the fetus gives off soreness. His activity is decreasing. Sometimes the opposite happens: the child begins to behave excessively smartly. If this has not been observed before, then attention should be paid to this phenomenon. If discomfort persists for a long time, then you should immediately consult a doctor.

Condition Diagnostics

Hypertonicity of the uterus can lead to detrimental consequences. The life and health of the fetus may depend on the timeliness and correctness of diagnosis, as well as well-chosen therapy. A gynecologist can determine hypertonicity with the help of a routine examination on an armchair. On palpation (palpation) of the abdomen, a characteristic tension of the myometrium will be observed. Its intensity may vary. Usually during the examination, the patient experiences discomfort or even pain.

Ultrasound scanning is one of the additional diagnostic methods. Thanks to ultrasound, it will be possible to determine the degree of contraction of the muscles of the uterine organ and the localization of the problem:

• the first degree of hypertonicity is characterized by a thickening of the muscle layer on only one side of the organ. If such a phenomenon is observed in the area of ​​attachment of the placenta, then there is a high probability of its detachment;
• the second degree of uterine hypertonicity is characterized by thickening of the myometrium around the entire perimeter of the organ. In this case, accompanying clinical symptoms must be present.

To determine the degree of uterine contractility, tonusometry can also be used. This diagnostic method involves measuring the indicator using a special sensor. It is placed in the area of ​​the anterior abdominal wall, after which the device records the level of tension in the muscles of the uterus.

Photo gallery: diagnosis of increased uterine tone

With the help of ultrasound diagnostics, it will be possible to determine the degree of localization of contraction of the muscles of the uterus. The gynecologist can determine the hypertonicity of the uterus by palpation (palpation) of the anterior abdominal wall. You can measure the tone of the uterus using a special sensor that is placed in the anterior abdominal wall

Self-determination of uterine tone

The appearance of uterine tone can be determined independently only based on the symptoms described above. Often it is blurry, so it is hardly acceptable to talk about accuracy. In some cases, hypertension is asymptomatic. Then it is almost impossible to determine its presence, as well as the reasons that led to the pathology. The first sign that you should pay attention to is the “stone” stomach. He seems to freeze and get heavy for a few seconds.

All other diagnostic methods are associated with the availability of medical knowledge or special equipment.

Treatment

Drug therapy or special exercises will help alleviate the condition and reduce the tone of the uterus.

Important: it is strictly forbidden to self-medicate or practice folk methods without consulting a specialist. Not all the methods of therapy encountered are medically justified and can boast of effectiveness.

When a physical examination or ultrasound indicates that the fetus is developing normally with mild tone with irregular contractions of the myometrium, then the pregnant woman is allowed to stay at home if she does not feel discomfort.

Medical treatment

Usually, in the first trimester, pregnant women are prescribed No-shpu. The drug relieves spasms. With severe hypertonicity, it is better to give preference to injections.
No-shpa is able to relieve spasms with uterine hypertonicity

In the second trimester, a pregnant woman may be prescribed other antispasmodics: Magnesia or Papaverine. For better tolerance, drugs are administered using a dropper. In this case, they are added to saline.

In the third trimester, the uterus is actively preparing for childbirth, so it is not recommended to completely eliminate the symptoms. Special vitamin complexes will help to regulate contractions with hypertonicity. Experts give preference to Magne B6.
Magne B6 will help regulate uterine contractions with hypertonicity

In addition, during the period of therapy, a woman needs to give up heavy loads and excessive activity, bed rest is recommended. She is prescribed to take sedative (soothing) drugs, such as:

• Persen;
• Sedavit;
• Novo-Passit;
• valerian infusion.

It will be possible to eliminate specific problems (Rh-conflict, hormonal failure) only with the help of well-chosen individually medical treatment.

Exercises

Simple exercises can help relieve tension. However, before using them in practice, it is necessary to consult a doctor.

Muscle relaxation

If you completely relax all the muscles, especially the face, then you can positively influence the uterine contractions in the direction of reducing their intensity. At the first signs of hypertonicity, you need to take a comfortable position, lower your head slightly and try to completely relax, breathing through your mouth.
At the first signs of hypertonicity, you need to take a comfortable position, lower your head slightly and try to completely relax, breathing through your mouth

Exercise "cat"

Effective exercise "cat". Execution sequence:

1. Get on all fours.
2. Lower your head, then slowly raise it, while bending your back down and taking a deep, even breath. You need to completely relax.
3. Maintain the pose for 5-7 seconds.

The uterus is in good shape - about 30% of pregnant women make such a diagnosis, stress, overwork, bad habits, hormonal imbalance can provoke the development of pathology. Special exercises, antispasmodics, progesterone-based drugs will help eliminate discomfort, and following simple rules of prevention significantly reduces the risk of developing a dangerous condition.

Even a minor stressful situation can cause uterine tone

The uterus is in good shape - what does it mean?

In the natural course of pregnancy, without deviations, the muscles of the uterus are in a calm, relaxed state - this is normotonus.

Hypertonicity is a pathological muscle tension of the reproductive organ, which can cause miscarriage or premature birth. A short-term increase in tone occurs with laughter, a change in body position, sneezing, excitement. With a total form, the muscles of the walls and bottom of the uterus contract, with local hypertonicity - only the anterior or posterior wall, any of the pathologies can have I, II severity.

Normal uterine tone during pregnancy is 8–12 mm Hg. Art.

Symptoms of uterine tone

Signs of hypertonicity are pronounced, which allows a woman to independently feel the development of the pathological process, discomfort can occur in early and late pregnancy.

How hypertonicity manifests itself at different times:

In the 1st trimester, a woman may experience pain in the lower abdomen, such symptoms should not be overlooked

• in the 1st trimester- pain of a pulling nature in the lower abdomen, radiating to the lower back, bloody spotting, muscle spasms;
• in the 2nd trimester- spotting, severe constant back pain;
• in the 3rd trimester- during this period, training contractions often occur, they can be distinguished from hypertonicity by increased pain in the back, lower abdomen.

A sign of uterine tone is the occurrence of severe pain when the child moves, the hard walls of the uterus press on the fetus. The presence of pathology is also evidenced by the absence of movements in the abdomen in a pregnant woman for more than 12 hours.

With hypertension of the II degree, pain in the lower abdomen and lower back becomes constant, increases when walking, gives to the perineum, rectum. If these symptoms appear, hospitalization is required. What the stomach looks like with increased tone can be seen in the photo.

Causes of the uterus in good shape

Hormonal disorders, some anatomical features of the structure of organs, and non-compliance with the doctor's recommendations can provoke an increase in the tone of the uterus.

What causes hypertonicity:

• - this hormone helps to relax the smooth muscles of the uterus, if it is not enough, the tone of the uterus increases;
• high content of the male hormone testosterone;
• a bicornuate uterus or its bend - pregnancy proceeds without any special complications, but it is often not possible to bear a child due to the strong tension of the muscles of the organ;
• early toxicosis - against the background of strong and prolonged vomiting, a spasm of the muscles of the uterus occurs;
• Rhesus conflict;
• the presence of scars, adhesions in the uterus after surgical interventions, abortions, severe muscle strain after previous births;
• frequent constipation, bloating;
• weight lifting, severe stress, active sexual intercourse;
• disruption of the thyroid gland, infectious diseases of the genital organs;
• smoking, drinking alcohol, weakened immune system.

One of the causes of uterine hypertonicity is early toxicosis.

Retrochorial hematoma provokes an increase in uterine tone, occurs against the background of hypertension, hormonal disorders, STDs, stress, accompanied by dark red or bloody discharge.

The risk of developing hypertension increases with polyhydramnios and multiple pregnancies if the woman's age is less than 18 or more than 30 years.

How to determine the tone of the uterus during pregnancy?

Diagnosis of increased tone includes palpation, examination, if a pathology is suspected, the doctor prescribes an ultrasound scan - the study helps to determine the violation of the shape of the uterus, recognize which muscles are tense, and identify the degree of contractions.

With an increase in the tone of the muscles of the back wall, the woman does not feel much discomfort, pathology can only be detected during a planned ultrasound scan, to confirm the diagnosis, tonusometry is prescribed.

In order to independently understand whether the uterus is in good shape or not, you need to lie on your back, breathe calmly for a few minutes, relax, with your lungs. Feel the abdomen with gentle movements. Normally, the abdomen is soft, with hypertonicity - elastic, muscle tension is felt.

After childbirth, women often experience a decreased tone against the background of a strongly relaxed uterine musculature - pathology indicates the presence of hypotonic uterine bleeding.

What to do at home?

If the uterus enters into tone, complete physical rest is necessary, stress should be avoided, sexual intercourse is prohibited. The diet should contain more foods with fiber, which normalize the functioning of the intestines, coffee, strong tea, chocolate are contraindicated.

If there is a suspicion of uterine tone, then it is necessary to ensure complete rest

At the initial stage, No-shpa, Papaverine will help eliminate spasms, normalize the psycho-emotional state - tincture of motherwort or valerian. When unpleasant symptoms appear, you need to drink tea with chamomile or lemon balm, raise your legs above your head, stroke your stomach with gentle circular motions.

Drug treatment

In the treatment of hypertension, hormonal preparations based on progesterone or estrogen are used, depending on the cause that provoked the development of the pathology. To reduce the manifestations of toxicosis, antiemetics are prescribed, calcium antagonists will help reduce muscle tension.

How to remove the tone of the uterus:

A modern drug that will relieve symptoms

1. - a hormonal synthetic drug of the latest generation, contains an analogue of progesterone, has practically no contraindications and side effects. Dosage for threatened miscarriage - 40 mg of the drug once, then 10 mg of the drug every 8 hours.
2. Utrozhestan is a progestogen preparation based on micronized progesterone, produced in the form of capsules with a dosage of 100 and 200 mg, they can be used orally or intravaginally. The drug is often prescribed in the first trimester, the daily dose is 200-400 mg, it should be divided into 2 doses.
3. Partusisten is a beta-blocker that relaxes the muscular layer of the uterus, improves cell metabolism, and normalizes blood flow between the fetus and the placenta. Reception schedule - 5 mg every 4 hours, but not more than 40 mg per day. The medicine is prescribed in the II, III trimester.
4. Corinfar is a calcium channel blocker, reduces smooth muscle contraction, improves blood circulation and tissue nutrition. The drug acts quickly, but is rarely prescribed, and only from the second trimester, when other drugs do not help. Take 1 tablet per day after meals with plenty of water, the drug is withdrawn gradually over 3-5 days.
5. Hexoprenaline - the drug reduces the tone and contractile activity of the myometrium, uterus, eliminates spontaneous contractions. Take 1-2 tablets three times a day until the unpleasant symptoms are completely eliminated. In the first trimester, the medicine should not be taken.

Additionally prescribe drugs that contain magnesium, vitamins of group B.

Exercises

If hypertonicity is in the initial stage of development, simple exercises will help to relax the muscles of the uterus, they can be done at any stage of pregnancy.

Gymnastics to reduce uterine tone:

One of the exercises to normalize the condition is diaphragmatic breathing.

1. In a lying or sitting position, relax the muscles of the neck and face as much as possible, and the tone of the uterus automatically decreases.
2. Get on all fours, lean on your elbows or palms, bend your back up, lower your head, stay in position for a count of 5. Bend your back down, raise your head, count to 5. Do 5-7 repetitions, then just lie down.
3. Diaphragmatic breathing is the best way to relax all the muscles. Lie on your back, bend your knees, close your eyes. Put the right hand on the stomach, the left hand on the chest. While inhaling, round the stomach, the chest remains motionless, take a slow breath, gradually retract the stomach.

Aromatherapy helps well with uterine tone - add jasmine, lotus, rose, vanilla, chamomile, mint oil to a warm bath, aroma lamp.

What is the danger of uterine tone during pregnancy?

Prolonged hypertonicity of the uterus negatively affects the development of the fetus, can cause intrauterine death of the child. If the pathology occurs at 12–16 weeks, the embryo cannot gain a foothold in the endometrium, the fetal egg exfoliates, is rejected, and a miscarriage occurs.

What threatens the increased tone of the uterus:

• violation of the process of nutrition, blood supply to the fetus;
• oxygen starvation, hypoxia, fetal growth and development arrest, malnutrition;
• detachment of the placenta;
• premature birth.

The most terrible consequence of uterine tone is premature birth.

If the tone rises shortly before childbirth, this is normal, the process of fetal formation is completed, training contractions begin.

Hypertonicity is one of the main causes of missed pregnancy. In the early stages, this manifests itself in the form of a decrease in basal temperature, toxicosis abruptly disappears, in the II and III trimesters, chills appear, temperature indicators increase, and the mammary glands decrease.

Prevention

To reduce the risk of developing uterine tone during pregnancy, it is necessary to regularly undergo all examinations, follow the doctor's recommendations.

Compliance with hygiene rules, proper sleep, long walks in the fresh air, moderate physical activity, emotional peace - all this has a beneficial effect on the condition of a pregnant woman, avoiding the development of hypertonicity.

To prevent uterine tone, spend more time outdoors and do light exercise

Hard physical labor, frequent and excessively active sexual intercourse, addictions, unhealthy diet increase the risk of increasing the muscle tone of the uterus.

Symptoms of uterine tone during pregnancy scare women in anticipation of a “miracle”. However, such manifestations are not always a pathological condition that threatens the normal course of gestation. After all, the uterus and the fetus developing in it are sensitive not only to physical influences, but also to changes in the psycho-emotional status of the expectant mother. Therefore, a temporary tone can occur even in the norm, reflecting the well-being of a woman. What does the tone of the uterus mean during pregnancy and how to find the line between the norm and pathology?

The uterus is a "ball" of smooth muscle fibers, inside which the fetus develops. The walls of the uterus and the body of the fetus do not directly touch each other, they are separated by a thin membrane - the fetal sac, as well as the placenta. The state in which most of the muscle fibers of the uterus are in the contraction phase is called tone. It is observed in childbirth, which ensures the “pushing out” of the baby from the womb and is absolutely normal. But the tone during premature pregnancy can lead to disastrous consequences.

How to identify yourself

Signs of uterine tone during pregnancy are not always noticeable to a woman. It all depends on the duration of pregnancy, as well as on the severity of the tone. How can you independently determine whether there is uterine tone during the current pregnancy or not? You can do this by listening to the body and examining your own feelings.

In the first half of the term

Immediately after conception and throughout the entire 1st trimester, the expectant mother can judge that the uterus is in good shape only by subjective sensations. At this time, the body of the uterus is deep in the cavity of the small pelvis, and it is not possible to probe it through the stomach on its own. Therefore, for diagnosis, it is important to know the main signs of hypertonicity.

• Painful sensations. Most often, pains over the bosom are similar to menstrual ones. Women describe them as pulling, constant or intermittent. Indeed, during menstruation, the uterus also contracts to evacuate the contents. Therefore, the symptoms are very similar.
• Frequent urge to go to the toilet. The body of the uterus lies in close proximity to the bladder. With the contraction of her muscle fibers, she literally puts pressure on the bladder, causing false urge to urinate.
• Pressure on the rectum. If the body of the uterus is tilted back, then the effect is not on the bladder, but on the rectum. In this case, there is a feeling of pressure and a feeling of incomplete emptying of the rectum, soreness in the perineum in the sitting position.
• Special sensations. Many women find it easier to describe what they feel during pregnancy in figurative terms. Often they note that in the lower abdomen "something dense as a stone" or "the uterus clenched like a fist", others describe the tone of the uterus as "coldness in the stomach."

For the doctor, these complaints become a reason for an extraordinary examination. A two-handed examination (through the vagina and abdomen) allows you to accurately find out if there is uterine hypertonicity, or if the sensations during pregnancy are caused by something else.

Symptoms of uterine tone may appear for no apparent reason. But more often, hypertonicity occurs after physical overwork, psycho-emotional experiences, during an exacerbation of chronic diseases, with a cold.

In the second half of the term

In the 2nd trimester (closer to 18-20 weeks), the enlarged uterus is already well palpable above the womb. From this moment on, a woman can not only subjectively, but also objectively judge the tone. Increased urge to go to the toilet, a feeling of pressure on the rectum, pain in the lower abdomen - all this worries as well as in a short time. In addition to this, you can simply try to feel the uterus through the abdomen. Normally, it should be soft, practically no different from the surrounding tissues. If a woman defines a "hard ball", this may indicate hypertonicity.

In the 3rd trimester, especially on the eve of childbirth, women clearly determine when the uterus contracts. At the same time, the stomach becomes more formed, and not “blurred”. When stroking, the uterus is dense, but there should be no pain and discomfort. When they occur, acute conditions (for example, placental abruption) should be excluded.

How can you confirm the tone of the uterus during pregnancy

Every expectant mother can exaggerate her feelings, worrying about the child's condition. Therefore, additional diagnostic methods are used to confirm the tone of the uterus and the presence of threatening conditions.

• Expert review. Already at the beginning of pregnancy, the gynecologist can detect the tone of the uterus. Normally, when palpated, the pregnant uterus is soft, pliable. But with an increased tone, it thickens, and a woman may feel discomfort and pain during examination.
• Ultrasound procedure. With the help of ultrasound, local tone can be detected. This definition is especially reliable at the beginning of pregnancy. Local tone may be associated with areas of detachment or be caused simply by the study itself. In the latter case, it passes after 10-15 minutes of rest.
• Cardiotocography (CTG). With the help of this study, it is possible to determine not only the fetal heartbeat, but also the presence of uterine muscle contractions. For this, a separate sensor is used, which is most often installed in the region of the fundus of the uterus on the right or left. Rhythmic muscle contractions will be visible on the graph as waves of different amplitudes, and a constant tone as a horizontal line of a certain height. This method is informative to use only from the third trimester. So you can confirm the onset of labor in normal and premature births.

Pathological tension

The causes of uterine tone during pregnancy are diverse. Periodic tone, which is clearly associated with stress or overwork, is experienced by many expectant mothers. However, causes that increase uterine contractions until full-term pregnancy should be avoided as much as possible.

Pathological tone is characteristic of the following conditions.

• Placental abruption. This is one of the most formidable complications of pregnancy. Detachment is the pathological separation of the placenta from the uterine wall with the formation of a hematoma and subsequent uterine bleeding. In addition to a constant tone, a woman will notice soreness in the entire surface of the uterus and a change in fetal movements. Later, bloody discharge from the genital tract may join. The condition requires immediate medical attention.
• Abortion. Most often, tone is associated with this condition. At the same time, bloody discharge may join for a short time. At the onset of labor before the due date, the tone of the uterus acquires a cramping character.
• Anomalies in the structure of the uterus. Periodic tone is observed in women with congenital anomalies of the uterus: bicornuate, with a septum, saddle. Such features of development increase the risk of miscarriage, which is the reason for the increase in tone.
• Neoplasms and other diseases. Myoma often causes tone due to abnormal tissue extensibility in the area of ​​the nodes. When fibroids are located on the anterior wall of the organ, they are palpable as rounded focal dense formations. Severe endometriosis of the uterus (adenomyosis) is also the cause of such changes in the myometrium.
• pathology of pregnancy. If the uterus is overstretched, for example, with polyhydramnios, a large fetus or multiple pregnancies, it can artificially create the feeling that it is constantly in good shape. At the same time, only a doctor can distinguish the norm from the pathology.
• Diseases of nearby organs. With the pathology of organs that are located close to the uterus, the latter can come into tone. For example, with renal colic, appendicitis. Ordinary constipation or bloating can also provoke tone.

Norm Options

In some situations, a normal tone occurs, which passes on its own without consequences.

• Physical labor. Any physical labor, even if a woman feels good during its performance, can lead to hypertonicity. This is a kind of evidence of overwork.
• Touch. As soon as the uterus is well defined above the bosom, a woman may notice that when touched, she quickly comes into tone. This is especially clearly seen when examined by a doctor and is a normal reaction to touch.
• intimate relationships. During sex and for some time after it, the muscles of the uterus continue to contract due to the release of the hormone oxytocin, which causes an increase in tone.
• Fetal movements. Starting from 26-28 weeks, the baby reaches a fairly large size. His movements each time bring the myomerium into a state of some contraction, which is the more frequent and more intense the closer to childbirth.
• Mom's stress. Psycho-emotional overstrain leads to the release of hormones into the blood, which leads to contraction of the myometrium and the appearance of tone.
• Training bouts. From the 37th week of pregnancy, a periodic tone appears, especially often occurring at night. Such activity of the myometrium is necessary for the preparation of the cervix.

Although increased uterine tone during pregnancy is not always accompanied by pathological conditions, you should definitely see a doctor if hypertonicity is noted for a day or two, is cramping in nature, or, in addition to tone, there are abdominal pains, changes in fetal movements (very violent or absent) or discharge with an admixture blood from the vagina.

What is the danger

Normal contractions, for example, before childbirth and after stroking the abdomen do not provoke any pathological changes. But the constant tone of the uterus, especially during late pregnancy, can be dangerous, so if it is present, it is better to get expert advice rather than waste precious time.

The fact is that when the child's place is located along the back wall of the uterus, tone is the only symptom of detachment. Other conditions, which in this case should be ruled out by a specialist, are:

• the threat of termination of pregnancy;
• uterine bleeding.

But only a doctor can distinguish a physiological tone from a pathological one after an examination and a minimal examination (ultrasound, CTG).

How to cope on your own

The gynecologist observing her should tell the woman how to remove the tone of the uterus during pregnancy and prevent its occurrence. The following is usually recommended to prevent hypertension.

• Relaxing gymnastics. For pregnant women, special sets of exercises have been developed to relax and strengthen the muscles of the pelvic floor. There is also a whole area of ​​yoga that pursues the same goals. But it is better to engage in such exercises after consulting a gynecologist.
• Swimming in the pool. Swimming is good for muscle and psychological relaxation. But the pool should be used only with the permission of a doctor.
• Calming herbs. Pregnant women are more prone to mood swings, they are more sensitive and vulnerable. And psychosomatics can not only provoke the threat of interruption, but also contribute to the development of toxicosis and preeclampsia. Therefore, with increased anxiety, irritability and emotional stress, it is useful to take valerian or motherwort.
• Fight against constipation. The well-coordinated work of the intestines is important for maintaining the normal tone of the uterus. Constipation and the constant straining that follows them can increase the tone. It is especially important to prevent constipation in the event of a threatened miscarriage. To improve intestinal motility, you should increase the amount of fiber-rich foods (fruits and vegetables) in your diet. If necessary, you can use safe medicines for constipation, for example, containing lactulose (Duphalac).
• Rest properly. It is important for pregnant women to know how to lie down, especially for long periods, so as not to provoke hypertonicity. In a horizontal position, you should spend more time on your left side. So the inferior vena cava will not be compressed.

By following these simple recommendations, you can remove the tone of the uterus, which is provoked by overwork or minor functional disorders. If discomfort persists or when other complaints (for example, doubtful discharge) are attached, it is necessary to consult a specialist as soon as possible.

Therapy

Treatment of uterine tone during pregnancy can take place at home as prescribed by a doctor or in a hospital, and early and late therapy is different. Medicines are prescribed in the form of vaginal and rectal suppositories, tablets, droppers or intramuscular injections - it all depends on the severity of the tone.

Medications at the beginning of pregnancy

It is important to observe the medical-protective regimen and rest. With psycho-emotional instability, a pregnant woman is prescribed sedative herbs in the form of decoctions or tablets. For the main treatment, the following groups of drugs are used.

• Antispasmodics. Help relieve tension in the smooth muscle fibers of the uterus. Tablets or injections of drugs also dilate blood vessels and increase blood flow in the placenta. Examples of funds: "No-shpa", "Papaverin", "Drotaverin".
• Hormonal preparations. Progesterone-based products are used (Dufaston, Utrozhestan, Susten). Their appointment is effective for really low levels of progesterone in blood tests. With increased tone, natural progesterone (in Utrozhestan) is more often used, which can be used up to 32-34 weeks. Doses and regimens are set individually depending on the clinical picture.
• Vitamins and microelements. Magne B6 or other magnesium preparations are used (for example, Magvit, Magnefar). This microelement affects muscle contractions, including relaxing the myometrium. It can be prescribed both in prophylactic doses (one tablet once or twice a day) and in therapeutic doses (two tablets two or three times a day).

If during the course of treatment the cause of hypertonicity is found out (detachment, inflammation in the vagina), the corresponding groups of drugs (hemostatic, anti-inflammatory suppositories, antibiotics) are additionally prescribed.

Preparations after 20-22 weeks

After 20-22 weeks, the range of drugs expands. The following medicines are used.

• "Ginipral". The drug acts on certain receptors, which are concentrated in large numbers in the muscle fibers of the uterus. The drug in the form of an intravenous infusion is effective for relieving an acute condition (even contractions), and tablets are used as maintenance therapy. But "Ginipral" has a side effect in the form of an increase in the heart rate of a woman and a fetus. The prescription of drugs that slow down the heart rate helps to avoid such adverse reactions (for example, it can be both Nifedipine and Verapamil).
• Magnesia. This remedy is universal during pregnancy. It has a complex effect and almost no contraindications. Most often, it is administered intravenously by drip, less often intramuscular injections are prescribed (they are very painful, according to reviews, and can also be complicated by the formation of seals). Usually, the infusion of the solution is carried out in the first half of the day - in the morning.
• Physiotherapy. Magnesium electrophoresis, Shcherbak's collar, therapeutic sleep are prescribed.

If, during research, changes in the condition of the fetus are detected, for example, the blood flow between the child and the woman is disturbed, vasodilators and agents that improve metabolic processes (Pentoxifylline, Actovegin) are added to the treatment.

Regulation of labor activity

Pathological tone can occur even during childbirth. This leads to a violation of uterine contraction, lengthening of labor, sometimes you have to resort to a caesarean section. To quickly reduce the local tone of the cervix, which arose during active labor, use both antispasmodics and painkillers. At the same time, to ensure adequate pain relief:

• perform spinal anesthesia;
• narcotic analgesics are administered ("Promedol").

With their ineffectiveness, in most cases, delivery ends with an operation.

It is important for women to understand what uterine tone is during pregnancy, when it can be normal and pathological. Timely identified deviations can save not only the baby, but also the life of the woman herself. Therefore, with disturbing symptoms, it is better to once again consult with your doctor.

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), set quite often. Unfortunately, this condition often occurs in the early stages of pregnancy and brings mother and baby not only a lot of inconvenience, but also creates a real threat to the bearing and health of the child.

What is hypertonicity?

The prefix "hyper" is of Greek origin and means something in excess of the norm, increased at times. In everyday life, we often use words with this prefix: hypertension (high blood pressure), hyperactive (too active), hyperventilation (excessive ventilation), etc.

Hypertonicity of the uterus is called a special condition, which is characterized by certain contractions of the muscles of this organ.

The pregnant uterus can be compared to a sponge in which the tubes are stuck. If you put water through the tubes, then the water will easily penetrate into the sponge. If you squeeze the sponge, then the water will pass with difficulty. The uterus is the same: while in a relaxed state, the blood moves easily through the blood vessels and supplies the fetus with oxygen and nutrients without interruption. The “compressed” uterus, which is in a state of hypertonicity, does not allow the embryo to be fully nourished. This can lead to sad consequences -,. A baby born on time may experience developmental and growth disorders, since a lack of oxygen causes.

Sensations during uterine hypertonicity are varied in intensity: for some, they are weak and aching, for others, on the contrary, they are strong and pronounced. They are very similar to those that occur before or during menstruation. Often the uterus is so tense that it feels like a stone to the touch. The most alarming sign in this condition is the appearance of bloody (or other colored) from the vagina. In this case, urgently call a doctor or go to him.

Causes of uterine hypertonicity

• lack of the hormone progesterone;
• stress (especially strong);
• heavy physical activity;
• - the presence of tumors, hormonal and inflammatory diseases;
• occurrence or exacerbation of chronic diseases;
• polyhydramnios, multiple pregnancy, too large a child;
• bad habits.

Diagnosis of increased uterine tone

To begin with, let's say that only the doctor makes the final diagnosis, so the trip to him should not be postponed, even if the pain is not strong and does not cause much discomfort. There are hypertonicity, diagnosed with the help, and hypertonicity, which the woman herself feels.

The gynecologist will make a diagnosis during an internal examination. If he doubts, he will send the pregnant woman for ultrasound diagnostics and tonusometry.

The diagnosis was confirmed. What to do?

To be treated! Firstly, at first it is very important to rest and relax, to bring the mental state back to normal. To do this, pregnant women who have been diagnosed with uterine hypertonicity are prescribed bed rest, sedatives of plant origin (this can be valerian, motherwort) and approved antispasmodics (for example, No-shpa or Papaverine). It is not uncommon for treatment to take place in a hospital (usually in the pregnancy pathology department at the maternity hospital), but it is possible that the doctor will allow the woman to stay at home.

If the cause of uterine hypertonicity is a lack of progesterone, prescribe drugs containing it (Utrozhestan, Duphaston). Also often used hormonal drugs Metipred, Dexamethasone.

In the treatment of hypertension, the drug Magne-B6, which is a combined preparation of magnesium and vitamin B6, significantly alleviates the condition. Magnesium compounds prevent the penetration of calcium into the cells of the organ and thus relieve muscle spasm, preventing the formation of blood clots. In turn, vitamin B6 has an anti-stress effect. If necessary, to reduce the muscular activity of the uterus, a solution of magnesium sulfate is used, which is administered both intravenously and intramuscularly.

Well relaxes the muscles of the uterus Ginipral, but it has side effects and can cause premature.

If the pregnant woman feels that the uterus is tense, then you can get on all fours in the “cat pose”. In this case, the woman should slowly and smoothly raise her head and bend in the lower back. After 5-6 seconds, you need to lower your head and bend your back up. Repeat several times.

On our website, this topic has already been discussed in the material: “How to cope with increased uterine tone during pregnancy?”. Therefore, we suggest that you read this article additionally.

Specially for- Ksenia Dakhno