The uterus is in good shape the second day. Increased uterine tone: an unpleasant phenomenon during pregnancy

The tone of the uterus is understood as the degree of tension of its muscles: during the normal course of pregnancy, the uterus should be soft, be in a relaxed state, which is a necessary condition for the progression of pregnancy and the development of the fetus. Uterine hypertonicity is an increase in the tone of the uterus, which, upon palpation (palpation), is defined as a thickening of its walls. As a rule, uterine hypertonicity is not a cause, but a consequence of any disorder in the body, often representing a real threat of complications during pregnancy.

The uterus is an organ made up mostly of muscle fibers. It is unique in some way, since during pregnancy it should play the role of a house for the fetus, ensuring the growth and development of the fetus, the normal functioning of the placenta, and then moving to a diametrically opposite role during childbirth - a powerful expelling force that promotes the birth of a child. Such a different "behavior" of the uterus during pregnancy and childbirth is mainly due to the influence of hormones. Progesterone is considered to be the main pregnancy hormone. In the early stages of pregnancy, it is synthesized in the ovary, and after the completion of the formation of the placenta, it takes over the function of producing this hormone. It is he who has a relaxing effect on the uterus, which contributes to the bearing of pregnancy and the growth and development of the fetus. By the end of pregnancy, the hormonal background of the expectant mother changes, and the level of estrogen hormones rises significantly - while the uterus becomes “excitable” (it comes into tone on its own), which is a necessary adaptive moment before the upcoming birth.

Thus, normally, during pregnancy, the uterus should be soft, relaxed, which is necessary to ensure the growth and development of the fetus. A periodic increase in the tone of the uterus by the term of full-term pregnancy (that is, after 38 weeks) should be considered as a sign of normal preparatory processes occurring in the body on the eve of childbirth.

Why does the tone of the uterus increase?

The reasons leading to an increase in the tone of the uterus are very diverse. It is important to remember that increased uterine tone is almost always the result of some kind of pathology, and in order for the treatment to be effective, it is necessary to find out and, if possible, eliminate this cause.

Among the reasons that play a role in increasing the tone of the uterus, there are not only medical, but also such as a state of chronic stress, unfavorable working and living conditions, conflict relationships in the family, the presence of harmful factors at work, work in night shifts, unbalanced irregular meals, the presence of bad habits (smoking, drinking, etc.), as well as harmful environmental influences.

Of the medical reasons leading to an increase in the tone of the uterus, the following should be noted.

In the early stages of pregnancy, the most important are endocrine disorders. This is a fairly large group of diseases (ovarian dysfunction, leading to inadequate preparation of the uterine mucosa for pregnancy, genital infantilism (underdevelopment, small size of the internal genital organs), increased levels of male sex hormones, increased levels of the hormone prolactin, thyroid pathology, etc. .).

The condition of the uterus plays a significant role during pregnancy. The so-called uterine factors include malformations of the uterus(bicornuate uterus, the presence of partitions), presence of uterine fibroids- a benign tumor of muscle tissue, endometriosis- proliferation of tissue similar in structure to the tissue of the endometrium (the lining of the uterus) in other organs.

Complications of pregnancy- such as multiple pregnancy, large fetus, polyhydramnios - lead to a pronounced stretching of the muscles of the uterus, provoking an increase in tone.

Availability obstetric(the presence of abortions, miscarriages with curettage of the uterine cavity, inflammatory diseases of the uterus after previous births and abortions, etc.) and gynecological problems(inflammatory diseases of the ovaries, menstrual disorders, etc.) also increases the risk of uterine hypertonicity.

Impact infectious factors leads to an increase in the tone of the uterus quite often. The infection can penetrate to the fetal egg. Especially dangerous is the so-called latent, or hidden, infection, which until the onset of pregnancy does not give any symptoms.

The presence of a risk factor may also be extragenital pathology(that is, diseases not related to reproductive organs), such as diabetes, kidney and cardiovascular diseases, etc.

Why is uterine tone dangerous?

As already mentioned, for the normal course of pregnancy, the uterus must be in a relaxed state to ensure adequate blood flow to the placenta. With an increase in tone - a reduction in muscle elements - there is a clamping of small uterine vessels, blood circulation worsens, less blood flows to the placenta and fetus. An increase in the tone of the uterus in early pregnancy can lead to spontaneous miscarriage and non-developing pregnancy.

In the later stages of pregnancy, increased uterine tone leads to the threat of premature birth. In the physiological course of pregnancy to full-term (a full-term pregnancy is considered after 38 weeks), the cervix acts as a “lock” that holds the fetus in the uterine cavity - that is, the cervix must be dense, sufficiently long and closed. With an increase in the tone of the uterus under the influence of various predisposing factors, the cervix begins to shorten, soften, the cervical canal opens slightly. In the future, this can lead to an abortion.

In addition to termination of pregnancy, an increase in the tone of the uterus can lead to premature detachment of a normally located placenta. Normally, the placenta should separate from the uterine wall after the baby is born. With premature detachment, the placenta is separated when the fetus is in the uterine cavity. The fact is that the placenta is not capable of contraction, unlike the uterine wall, and in the presence of factors predisposing to placental abruption, in the event of an increase in uterine tone, its detachment may occur. Premature placental abruption is a very dangerous condition that threatens the life of not only the fetus, but also the mother, as it is accompanied by the occurrence of intrauterine bleeding.

An increase in intrauterine pressure, observed with uterine hypertonicity, in some cases can lead to premature discharge of amniotic fluid, resulting in an increased risk of infection of the fetus and abortion.

An increase in uterine tone is the cause of a decrease in blood flow in the uteroplacental circulation system, therefore, fetal hypoxia (insufficient supply of oxygen and essential nutrients to the fetus) is a fairly common concomitant complication. With a prolonged increase in uterine tone, fetal growth retardation syndrome can form - a pathological condition when the size of the fetus does not correspond to the gestational age as a result of its insufficient blood supply (in this case, the fetus does not receive the necessary nutrients for normal growth and development).

How does the increased tone of the uterus feel?

The tone of the uterus can increase at various periods of pregnancy, starting from the early stages. With an increase in the tone of the uterus, the following symptoms can be observed:

drawing or aching pain in the lower abdomen and lower back, as well as in the sacrum, very similar to pain on the eve of menstruation;
pain can be constant or periodic, taking on a cramping character;
pains may be accompanied by a feeling of "heaviness" in the lower abdomen, while the uterus becomes a dense consistency, as if "stony";
not always, but in some cases, bloody discharge from the genital tract of varying intensity may join the pain;
given that with an increase in the tone of the uterus, there is a decrease in uteroplacental circulation, signs of intrauterine suffering of the fetus may be observed: increased or, conversely, reduced motor activity, lack of movement for several hours, etc.

These sensations are a reason for an urgent visit to the doctor.

Diagnosis of increased uterine tone

Diagnosis of increased uterine tone usually does not cause much difficulty. To begin with, the obstetrician will find out what worries the pregnant woman, what are the location and nature of abdominal pain. Next, the doctor will proceed to a detailed examination:

The doctor will palpate the abdomen, laying the patient on a hard couch in a position with legs slightly bent at the knees. With an increased tone, the uterus acquires a dense texture, while it becomes difficult to feel parts of the fetus. Palpation of the abdomen is informative in the second half of pregnancy, when the uterus can be well felt through the anterior abdominal wall.

When registering an increased tone of the uterus and the presence of complaints, a vaginal examination is indicated to determine the condition of the cervix. The detection of such pathological symptoms as shortening, softening of the cervix, opening of the cervical canal dictates the need for inpatient treatment so that premature termination of pregnancy does not occur.

In the early stages of pregnancy, an ultrasound examination acquires an important role in diagnosing an increase in the tone of the uterus, since when palpated, the uterus is not yet determined through the abdominal wall. With ultrasound, segmental contractions of the uterine muscle can be determined (it should be noted that in some cases the appearance of segmental contractions is a reaction to the ultrasound itself), as well as local areas of increased uterine tone (determined by ultrasound in the form of areas of thickening of the muscle). The value of ultrasound is that it is possible to conduct a preclinical diagnosis of increased uterine tone, when there are no obvious clinical manifestations.

It is possible to study the tone of the uterus in more detail during hysterography - registration of an increase in the tone of the uterus. Indications are recorded on paper using a special apparatus through sensors placed on the abdomen.

Treatment of increased uterine tone

With an increase in the tone of the uterus, a woman is hospitalized. An examination is carried out in the hospital to identify possible causes that caused the complication, as well as treatment aimed at eliminating these causes (if possible) and normalizing the tone of the uterus.

Regardless of the gestational age, an important component of therapy is the creation of a therapeutic and protective regimen, which includes not only the use of sedatives (valerian, motherwort, peony decoction, etc.), but also ensuring maximum psychological comfort for the pregnant woman in the family and at work.

In early pregnancy, hormonal therapy is of paramount importance for successful treatment, since an increase in uterine tone in the first trimester of pregnancy is most often due to hormonal disorders.

In the second half of pregnancy, to normalize the tone of the uterus, tocolytics are used - drugs used to reduce the tone of the uterus.

Also, antispasmodics are prescribed to eliminate the increased tone of the uterus. Antispasmodics can be used in the form of suppositories (more often this route of administration is preferred in early pregnancy), tablets, intravenous and intramuscular injections.

It is necessary to emphasize the need to eliminate the cause that served as the starting point for increasing the tone of the uterus. Unfortunately, this is not always possible during pregnancy, which once again underlines the importance of careful preparation at the stage of pregnancy planning.

When not to worry

In some cases, the uterus may come into a short-term uterine tone, which is not a sign of any disorders. An increase in the tone of the uterus can normally occur:

with a sharp change in body position (getting up from a prone position, quickly turning the body, etc.);
with a tendency to constipation, since a crowded intestine has an irritating effect on the uterus;
with overflow of the bladder, which, like the intestines, helps to increase the tone of the uterus;
after 38 weeks of pregnancy, when, due to hormonal changes, the processes of preparation for childbirth begin, the uterus begins to “train”. An increase in the tone of the uterus can occur spontaneously several times a day, this is a necessary adaptive mechanism, since due to preparatory contractions (which are also called Braxton-Hicks contractions), the processes of “ripening” of the cervix, the formation of the lower segment of the uterus, which is necessary for a normal course birth act.
An increase in the tone of the uterus, not associated with pathological processes, is characterized by a short duration, a feeling of compaction of the uterus with minimal pain, goes away on its own, and does not adversely affect the well-being of the pregnant woman.
In all other cases: if the uterus comes into tone spontaneously, which is accompanied by pain, unusual discharge from the genital tract, changes in well-being, pain increases in strength, frequency and duration, there is a violent or, on the contrary, weak motor activity of the fetus, it is necessary to urgently turn to doctor.

Why is it dangerous for the fetus, what are the symptoms and treatment? Doctors diagnose uterine tone during pregnancy in 60% of cases.

What is uterine tone during pregnancy

Uterine tone- This is an indicator of the state of the muscles of the uterus, which expresses the degree of its tension. The tone of the uterus is measured in millimeters of mercury.

The following options for the state of the muscles of the uterus are possible:

Decreased tone of the uterus- a pathological condition that occurs in the early postpartum period, characterized by excessive relaxation of the uterine muscles. Decreased tone may be the cause of hypotonic uterine bleeding.
Normal uterine tone- the physiological state of the uterus, regardless of the presence of pregnancy, in which the muscles are at rest.
Increased uterine tone during pregnancy- the state of tension of the muscles of the uterus. It can be permanent and temporary (contractions during childbirth). The increased tone of the uterus can be complete (covers the uterus completely) or local (manifested in one specific place).
Uterine hypertonicity- pathology of labor activity, in which more than four contractions occur within 10 minutes. Often, both doctors and patients use the term "hypertonicity" to refer to the high tone of the uterus in pregnant women - this is not entirely correct, since hypertonicity manifests itself precisely in the process of childbirth.

Normal and pathological uterine tone

During pregnancy, the norm of tone are indicators within 8-12 mmHg st. A slight and short-term increase in these values \u200b\u200bmay be normal and physiological if, for example, it occurs in response to fetal movements. But if such tension of the uterus is prolonged and accompanied by painful sensations, then this is a dangerous sign of an increased risk of premature birth and miscarriage. If uterine contractions become periodic and repeat at regular intervals, which leads to the opening of the cervix, these are alarming symptoms of incipient preterm labor (with a period of weeks) or spontaneous abortion (with a period of up to 22 weeks). This situation requires emergency hospitalization and medical intervention.

Causes of increased uterine tone

There are many reasons for increased uterine tone. Most often, these are infections in the mother's body, such as: infections of the oral cavity, urinary tract, gastrointestinal tract, skin diseases. An important role is played by socio-economic factors:

too young or, conversely, mature age (less than 18 and more than 35 years old);
bad habits (alcohol, smoking, drug use);
the presence of severe chronic diseases, especially such as obesity or arterial hypertension;
complex relationships in the family;
poor living conditions;
emotional overload;
difficult working conditions, chronic fatigue syndrome.

All these factors or their combination can adversely affect the development and course of pregnancy.

Also, an increase in the tone of the uterus can provoke complications of pregnancy:

incorrect position of the fetus (oblique or transverse);
various pathologies of the placenta (hypoplasia, placenta previa, premature aging);
anomalies in the development of the uterus (bicornuate or saddle shape, uterus with an incomplete septum);
and scars after its removal;
scars after a previous caesarean section;
a history of premature birth, miscarriage, abortion;
nephropathy;
the occurrence of fetal malformations, as a rule, incompatible with life.

Symptoms of increased uterine tone during pregnancy

How to determine the tone of the uterus during pregnancy yourself? Most often elevated tone during pregnancy manifested by pulling or aching pain in the lower abdomen, similar to menstrual pain. Periodically, there may be sensations that the uterus is "stiffening", a feeling of tension in the stomach, increased urge to urinate, and sometimes an increase in the fetal motor activity. In a more rare case, it can be observed from the genital tract, softening and shortening of the cervix.

Rare and painful fetal movements can signal that placental blood flow is disturbed due to tension in the muscles of the uterus, and the fetus experiences oxygen deficiency, which leads to hypoxia, developmental delay, and placental pathologies.

Diagnosis of uterine tone

Increased uterine tone is not a diagnosis as such, it is only the main symptom. To diagnose the tone of the uterus, sometimes palpation of the abdominal wall is quite enough, but it should be remembered that this assessment is not always objective. A more accurate diagnostic method is KTG(cardiotocography - registration of the fetal heartbeat and uterine contractions), which gives an objective assessment of the situation during uterine contractions and between them, which allows you to track the effectiveness of treatment and the dynamics of uterine activity.

Treatment of increased tone

If a uterus in good shape during pregnancy what to do? To prevent an unfavorable outcome of pregnancy (miscarriage or premature birth), increased uterine tone must be normalized. Since there is a real threat of abortion, it is necessary to seek medical help at the first sign of increased uterine tension.

The tone of the uterus impairs oxygen saturation and nutrition of the fetus, so treatment is necessary.

To reduce the activity of the uterus, prescribe the use of special drugs called tocolytics. This is a series of drugs that belong to different pharmacological groups, but have the same effect - they reduce the muscular activity of the uterus.

These include:

Ginipral, Partusisten, Salbutamol. Currently, the most effective and safe drug in this group is Ginipral. In extreme cases, drugs are prescribed in the form of intravenous injections, and as the condition improves, they switch to the form of tablets.
Nifedipine- the drug exists only in the form of tablets, it is prescribed in exceptional cases strictly under the supervision of a physician.
Magnesium sulfate as a solution for intravenous infusion. It is used only in the presence of objective contraindications to other drugs.
Indomethacin- is prescribed in the form of suppositories, as a rule, as maintenance therapy.

Predictions for increased tone

A favorable outcome depends on many factors: the duration of pregnancy, the condition of the fetus and its position in the uterus, the condition of the cervix, the integrity of the mucous membranes (rupture of the membranes), complications during pregnancy, the presence of concomitant diseases, the timeliness of contacting a doctor and, accordingly, the time of treatment started. . And, of course, it is very important to remain optimistic and not panic.

Prevention

A very important and crucial stage is the planning of pregnancy and the preparation of the body for conception. It is advisable to go through a complex even before the onset of pregnancy, to cure possible foci of infection of the genitourinary system, oral cavity. You should pay close attention to the hygiene of work and rest, as well as strictly follow all the appointments and recommendations of your doctor.

The body needs a sufficient amount of magnesium. With the onset of pregnancy, the daily requirement for magnesium increases to 400 mg per day! Magnesium has a direct effect on the ability of the uterus to relax, and in addition, reduces nervous excitability, which is of great importance for a pregnant woman and an unborn child. Magnesium is found in nuts, green vegetables, bread, bran, buckwheat and oatmeal.

In such a crucial period of life as pregnancy, a woman may be haunted by certain problems, one of which is the tone of the uterus. It is important to know that increased uterine tone in early pregnancy is considered a common occurrence that can be easily eliminated. The main thing for a future mother is to monitor her health and, at the slightest suspicion of any violations, consult a doctor.

To get a complete picture of what constitutes an increased tone of the uterus, you first need to understand the structure and functioning of this organ. The uterus is a female reproductive organ that has a hollow structure and consists of myometrium. Myometrium, in turn, is a muscular membrane, which is formed by muscle cells and loose connective tissue with high elasticity.

During the period of bearing a baby, a woman's uterus increases significantly in size, its fibers stretch many times over. In order for the pregnancy to proceed normally, the tissues of the organ must always be in a relaxed state, not contracting for no reason. The cause of natural contractions can be considered training contractions, which are harbingers of childbirth, or real contractions that provoke the birth of a child immediately at the end of pregnancy.

In women suffering from increased uterine tone, the muscles of the organ are in a tense state for a long time, contracting from time to time for no reason. This provokes an increase in pressure in the uterine cavity and, if not properly treated, can lead to disastrous consequences. Uterine tone in the early stages is a fairly common problem. Noticing the symptoms of this condition, a woman should tell her doctor about it, get advice and a prescription for treating the disease.

The term "uterine tone" refers to the degree of tension of the muscle tissue of the organ, which is measured in millimeters of mercury. In medicine, several conditions of the myometrium are distinguished:

Hypotension of the uterus means that the muscles of the reproductive organ are too relaxed. This condition is considered a pathology, it can develop as a result of childbirth and be the cause of heavy bleeding in the early postpartum period.
Normotonus of the uterus is the normal state of the musculature of the organ. With normotonus, the uterus is in a calm state, while not being overly relaxed.
The increased tone of the uterus is manifested in the periodic or constant tension of the myometrium. This problem can be localized in a specific place, or it can cover the entire organ.
Uterine hypertonicity is a pathology that occurs exclusively during childbirth. Many obstetrician-gynecologists use this term to refer to an ordinary increased uterine tone that occurs during pregnancy.

Consequences of increased uterine tone

Many women, feeling mild symptoms of the disease, are in no hurry to complain to the doctor. Meanwhile, in some cases, increased tone can cause serious problems that threaten further pregnancy. The most deplorable consequence of this condition can be a spontaneous abortion, or, more simply, a miscarriage. In the last weeks of pregnancy, the tone of the uterus sometimes leads to premature pregnancy and is the cause of premature birth.

Another problem that such a disease threatens is fetal fading. During the normal course of pregnancy, the woman's blood vessels supply oxygen and various nutrients through the placenta, which are necessary for the development of the child. Increased tone can lead to the fact that the amount of these substances is noticeably reduced or stops altogether. As a consequence, the fetus suffers from hypoxia and may die.

Feeling slight pulling pains in the abdomen, some simply do not pay attention to them, while others, overly impressionable women, may immediately suspect the worst. Regardless of which category of pregnant you belong to, in case of any suspicious conditions, it is better not to delay and visit a doctor as soon as possible. Only he will establish the true cause of discomfort and, if necessary, prescribe the correct treatment.

Causes and symptoms of increased uterine tone

Let us consider in more detail the prerequisites for the occurrence of this state:

The main hormone responsible for the normal course of pregnancy is progesterone. In the first half of pregnancy, the corpus luteum intensively produces this substance in the amount necessary for the body. Progesterone is responsible for preparing the inner uterine epithelium for embryo attachment, as well as for relaxing the myometrium. But it also happens that a pregnant woman is deficient in progesterone. In such a situation, the woman's body begins to perceive the fetus as a foreign body, the muscles of the uterus tense and often contract, which can lead to rejection of the embryo and provoke a miscarriage.
Toxicosis in early pregnancy is also considered one of the causes of increased uterine tone. Frequent vomiting reduces the muscles of the abdomen, as well as all the organs inside. Daily manifestations of toxicosis cause frequent tension of the uterus, provoking tone. Unfortunately, in the first weeks of pregnancy, toxicosis is a common problem, which cannot be eliminated with medication. In such a situation, a woman can be advised to be careful, avoid foods that make her sick, and after a while this unpleasant phenomenon will pass by itself.
A possible cause of increased uterine tone can be a different Rh blood of the mother and her unborn child. In such a case, the body of the pregnant woman perceives the fetus as a foreign body and tries to get rid of it.
Any diseases and inflammations in the genitourinary system can also lead to tension in the myometrium. In addition, if the pregnancy is multiple, or the baby in the womb is very large, the muscles of the uterus stretch too much. Such excessive stretching is another prerequisite for the development of tone.
During pregnancy, it is important to monitor the quality of your diet, since intestinal disorders can also lead to increased uterine tone. Pregnant mothers are advised to eat safe foods that won't upset the stomach or cause flatulence.

In order to notice the presence of pathology in time, it is important to monitor the state of health and pay attention to various pains, pulling sensations and other manifestations of discomfort. The tone of the uterus in the early stages is characterized by the following symptoms:

In the first months of bearing a baby, an increased tone of the uterus makes itself felt with unpleasant pulling sensations in the lower abdomen. A woman may feel a slight dull pain, reminiscent of pain during menstruation. Sometimes these sensations extend to the lower back and sacrum.
When the fetus in the womb is already large enough, the tone of the uterus can be distinguished tactilely - the stomach hardens, it becomes as if “stone”.
Another symptom of increased tone is bloody spotting, they can be brownish or pinkish in color. As mentioned earlier, the tone of the uterus sometimes leads to spontaneous abortion, and its main symptom is bleeding from the genital tract. In the presence of blood or the above discharge, you should go to the hospital as soon as possible. Modern medicine, in most cases, eliminates the threat of miscarriage and enables a woman to safely carry the child to the desired date.
Sometimes signs of uterine tone in early pregnancy may be absent altogether. Feelings are so weak that a woman simply does not notice them.

Methods for diagnosing pathology

Determining the tone of the uterus at an early date is not so difficult. The doctor must first listen to the patient's complaints and, based on the symptoms, make a preliminary diagnosis. After that, the pregnant woman will be sent for an ultrasound examination, which will confirm or refute the presence of increased uterine tone. The use of ultrasound in this case is the most reliable and simple method of diagnosis. However, many gynecologists can determine a similar problem with the help of palpation.

Ways to eliminate the increased tone of the uterus

Having determined the presence of an increased tone of the uterus in the early stages, one should proceed to its treatment. To fix a problem, it is first important to identify its cause. Special tests for hormones will help determine the amount of progesterone in the female body, and if its level is low, the doctor will prescribe certain medications. In general, the treatment of increased uterine tone consists in the following actions:

The first step is to eliminate any factors that negatively affect the emotional and mental state of the expectant mother. A pregnant woman should be in a healthy and favorable atmosphere, avoid conflicts, fears, excessive nervousness, try to surround herself only with positive emotions and people who give them.
Overwork and insufficient rest aggravate the condition, so it is important for a woman to organize a normal work schedule that will allow her not to get too tired.
Important conditions in the treatment of uterine tone are good nutrition and healthy sleep. We must not forget about moderate physical activity, which, above all, will be a pleasure.
In difficult cases, when the increased tone provoked a threat of miscarriage, the woman will be admitted to the hospital for inpatient treatment. For this period, and also for some time later, the patient will be prescribed bed rest and abstinence from sexual activity.
As medicines, hormonal, sedative and other means that help to relax the myometrium can be used. Almost harmless herbal preparations, such as valerian, are used as sedatives. If this remedy turns out to be ineffective, and the emotional state of the woman does not return to normal, she may be prescribed Nozepam, Trioxazine or Sibazol.
To relieve the tension of the uterine muscles, many doctors advise taking "No-shpa" or putting papaverine suppositories in the anus. A popular and practically harmless drug today is Viburkol - rectal suppositories. Sometimes calcium channel blockers are used to relieve tension in the uterus, such drugs include Nifedipine and Corinfar.
If progesterone tests reveal a hormone deficiency, the doctor will most likely prescribe Duphaston or Utrozhestan - drugs that contain the necessary substance. Such treatment is relevant only for short periods of pregnancy.
If there is a threat of spontaneous abortion, accompanied by bleeding from the genital tract, the hospital will also use hemostatic agents.

Treatment of increased tone at home

Treatment of tone at home should be, first of all, agreed with the doctor. All non-pharmacological agents should be used as an additional therapy to the main treatment.

You can remove the tone of the uterus in the early stages by performing simple physical exercises aimed at relaxing the myometrium. Let's consider them in more detail:

Exercise "Cat" perfectly copes with this task, and it is very simple to perform. Get on all fours, resting your palms on the floor, throw your head back and arch your back. After a few seconds, return to the original position. You should not be too zealous with the exercise, physical efforts should not cause pain or discomfort. After several such manipulations, you need to lie down in a comfortable position and lie down for 30-40 minutes.
If for any reason it is difficult for you to bend your back, then just get on all fours, resting your elbows on the floor. In this position, you need to stay for several minutes. The uterus, being in limbo, will relax after a while.
It is believed that the relaxation of the muscles of the face also favorably affects the state of the myometrium. To achieve the effect, sit comfortably and tilt your head down. Try to breathe only through your mouth and, if possible, completely relax your facial muscles.

Tone of the uterus. Video

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 the contraction of the uterus, lengthening of labor, sometimes you have to resort to performing 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.