Orthopedic products

Constant tone of the uterus during pregnancy. How does uterine tone manifest during pregnancy? What should you be wary of?

Pregnancy is an almost magical state, well, at least definitely miraculous. Naturally, at this time a woman simply must be attentive to herself and very careful. During pregnancy, a woman faces a huge number of dangers and unpleasant diagnoses. One of the most common diagnoses is the so-called uterine tone during pregnancy, or uterine hypertonicity. What does “Uterus in good shape” mean?

What is uterine tone?

The uterus is a hollow muscular organ consisting of three layers: the outer mucous membrane - the perimeter, the middle muscular layer - the myometrium and the inner mucous membrane - the endometrium. Myometrium is smooth muscle tissue capable of contraction, for example, it contracts during childbirth. However, in its natural state, this muscle should be relaxed; this state is usually called normal uterine tone.

If during pregnancy, but before the onset of labor, the uterus begins to contract, they say that the tone of the uterus is increased during pregnancy. It’s worth making a reservation here: since the process of muscle contraction is natural, it is not always the fact that the uterus is in good shape that is a problem.

In Western medicine, this condition is considered a normal physiological process. Of course, in the event that this diagnosis is not associated with other symptoms that cause discomfort or indicate serious disorders. There is some common sense in this reasoning, because even in the process of sneezing or laughing, almost all muscles contract, including the uterus. The same applies to ordinary orgasm. Affects the condition of the uterus and the psychological state of the pregnant woman. Very often, tension in the muscles of the uterus is observed during a gynecological examination.

However, the peculiarity of uterine tone in all these cases lies in its short duration. And this condition usually does not cause any unpleasant sensations. It’s another matter if the uterus is in good shape for a long time. Constant tone of the uterus during pregnancy is fraught with the most unpleasant consequences for the fetus, and for maintaining the pregnancy too.

Why is uterine tone dangerous?

The consequences of uterine hypertonicity can be very dire, even spontaneous miscarriage, if we are talking about uterine tone on early pregnancy, before premature birth, if they talk about uterine tone in the second or third trimester pregnancy.

Most often, uterine tone is observed precisely in the early stages, when uterine tension can complicate the process of implantation of the fertilized egg, and can also cause its rejection or death. In this case, they talk about spontaneous miscarriage.

Sometimes there is uterine tone before childbirth, in this case it is customary to talk about training contractions. They are generally not dangerous. In this way, the uterus prepares for the birth process, roughly speaking, it trains.

May threaten the tone of the uterus and the condition of the baby. So, due to the fact that the tense muscles of the uterus compress the vessels of the umbilical cord, the fetus may not receive enough oxygen, which entails the development of hypoxia. If, for the same reason, the baby does not receive additional nutrients, then malnutrition and growth arrest may develop.

Causes of uterine hypertonicity

The reasons for uterine tone during pregnancy can be very diverse. So, above we have already described why the uterus can become toned for natural reasons. Unfortunately, in many cases, the causes of hypertension lie in a variety of problems associated with pregnancy.

It is practically impossible to list and describe all the causes of hypertension in one article, but we will try to give readers as much information as possible about such a common diagnosis. After all, more than 60% of women are diagnosed with increased uterine tone at least once during their entire pregnancy.

In the early stages, the cause of a toned uterus is most often lack of the hormone progesterone. During pregnancy up to 4 months, this hormone is produced by the so-called corpus luteum, formed at the site of the follicle that burst during release of a mature egg. The main function of progesterone is to prepare the endometrium for implantation of the fertilized egg, as well as to relax smooth muscles in order to prevent the development of uterine tone. Lack of progesterone can thus cause hypertension.

There are other hormonal disorders, the consequence of which can be the same diagnosis. In particular, an excess of certain male hormones. This is why it is very important to closely monitor a woman’s hormonal levels during pregnancy.

Severe toxicosis also affects the condition of the uterus. Especially if accompanied by profuse and frequent vomiting. During vomiting, many muscles of the body, particularly the abdominal cavity, contract. This process also affects the uterus. Unfortunately, toxicosis in the early stages cannot be completely removed; you can only alleviate the woman’s condition a little, but it makes sense to do this too.

Hypertonicity, as well as miscarriage in general, may be associated with the presence of abnormalities in the development of the uterus: the uterus may be bicornuate or saddle-shaped, as well as have other abnormalities. Any anomaly in the development of the uterus creates difficulties for bearing a child, and sometimes makes it impossible.

It is very important that at the time of conception a woman is aware of all her problems, and throughout her pregnancy the woman should be under constant medical supervision. All abnormalities in the development of the uterus will make themselves felt in the very early stages of pregnancy.

In some cases, the cause of uterine tone may be the so-called Rhesus conflict. If the mother’s blood Rh factor is negative and the child’s father is positive, the woman’s body can reject the fetus as a foreign body. The rejection process will be expressed in an increase in tone.

Some infectious diseases and inflammatory processes genital organs or in the uterine cavity also cause an increase in uterine tone. Typically, infections are accompanied by other symptoms, such as: changes in the nature of discharge, pain, itching, and so on.

The cause of tone may be excessive uterine distension. This condition occurs if the fetus is too large or the pregnancy is multiple. Also, stretching of the uterus occurs with polyhydramnios.

The list can be almost endless: tumors, abortions/miscarriages before real pregnancy, and so on - all this can also cause uterine tone and other painful conditions. We have not yet touched upon psychological problems, tension and stress, which also affect the state of smooth muscles.

There are also completely prosaic reasons. Thus, uterine tone often develops due to intestines, more precisely, due to severe gas formation and altered intestinal peristalsis.

The main thing you need to understand and remember from this section: uterine tone is a symptom, so it would be fundamentally wrong to treat it as an independent disease. It is always necessary to conduct additional research and establish an accurate diagnosis, and only then prescribe treatment.

Symptoms: how to determine that the uterus is toned?

How determine the tone of the uterus yourself? In most cases this will not be difficult to do. Symptoms of uterine tone during pregnancy are simple and understandable, although they vary at different stages.

Symptoms of increased uterine tone early pregnancy- this is heaviness in the lower abdomen, nagging pain, as during menstruation, sometimes these pains radiate to the lower back or to the sacral area. Symptoms of uterine tone in the second and third trimester almost the same, in addition, at such periods hypertonicity can be noticed even visually: the abdomen shrinks, becomes hard, the uterus “turns to stone.” In general, every woman can easily understand how the tone of the uterus feels during pregnancy.

In some cases, uterine tone appears spotting and spotting. These are very alarming symptoms, you need to immediately call an ambulance and try to calm down. In most cases, with timely treatment, pregnancy can be saved. It remains to add that in some cases the tone of the uterus is asymptomatic, or rather, the woman may not feel them.

Diagnosis of uterine tone

There are several methods for medical diagnosis of uterine hypertonicity. It is often noticeable even during a simple gynecological examination. However, the most common diagnostic method is ultrasound. An ultrasound shows the condition of the uterine muscles. In particular, it is ultrasound that shows such pathologies as uterine tone along the posterior or anterior wall, grade 1 or 2. The fact is that the tone along one of the walls of the uterus is expressed by a change in its shape, and the degree directly depends on which wall the fetus is attached to.

There are also special devices that measure the tone of the uterus. However, they are not widely used due to the fact that diagnosing this problem is not difficult. It can be much more difficult to determine the cause of tone.

Hypertonicity of the uterus: treatment

But now, the diagnosis is known, the uterus is in good shape. What to do? First of all, listen to your doctor's advice. The choice of treatment largely depends on how strong the tone of the uterus is during pregnancy, as well as on what causes it. If the situation is not associated with a serious risk, treatment of uterine tone during pregnancy is carried out on an outpatient basis.

The woman is advised to remain in bed and is prescribed antispasmodics, usually no-shpu or papaverine. Magnesium B6 and sodalite agents, for example, motherwort, are often prescribed for uterine tone. Please note that all these remedies should only relieve the tone of the uterus during pregnancy; in addition, you will probably be prescribed other medications that should cure the cause of the appearance of tone.

So, if we are talking about a lack of progesterone, then the woman is prescribed a drug containing it. If the cause of uterine tone is an excess of male hormones, then their antipodes are prescribed. In case of toxicosis, they do everything necessary to alleviate this condition, and if the cause is problems with the intestines, it is necessary to reduce gas formation. There is a treatment for both Rhesus conflict and any other diagnosis.

If the tone of the uterus cannot be relieved for a long time, or the situation initially becomes very serious, doctors will insist on hospitalization and further treatment in a hospital. In a hospital, the patient will not be able to systematically violate bed rest, as women usually do while at home: cleaning, cooking and other household chores do not give rest to housewives. In addition, only in a hospital will doctors be able to more closely monitor the condition of the mother and child, as well as promptly reduce the increased tone in order to prevent premature birth from occurring.

Here it’s worth making a short digression, in which we’ll talk about why, starting with 28 weeks indicate preterm birth, although the baby is clearly not full term yet. The fact is that with the current state of medicine, it is from the 28th week that you can try to save the life of a newborn. Of course, this is far from the best outcome; it is always advisable to extend the pregnancy by at least one more day.

So, if the tone of the uterus at the 26th week of pregnancy provokes the onset of labor, then doctors will do their best to stop it. To do this, tocolytic therapy is carried out, that is, they relax the uterus in every possible way using appropriate regimens and medications. And it is very important to start on time, since at this time the child most likely will not survive. That is why doctors in hospitals fight for every day to preserve pregnancy. Still, uterine tone at 36-38 weeks of pregnancy is not so risky, although it threatens the condition of the fetus. Therefore, after 28 weeks, first of all, they try to maintain the pregnancy.

Should I agree to hospitalization?

Very often women have a question: how necessary is hospitalization? This question is usually asked by those who have older children or those who are afraid of losing their job due to a long absence, they say, the child needs to be fed, money needs to be earned, but no-shpa and papaverine can be taken at home.

Unfortunately, there is no single correct answer here. It all depends on the specific situation: how great the risk of miscarriage or premature birth is, how strong the tone is, and so on. A woman must understand that she refuses hospitalization at her own peril and risk, and she risks, first of all, her unborn child. Is the job, for example, worth the risk? And you can ask your husband, relatives or close friend to look after your older child. There is almost always a solution to the situation.

How to relieve uterine tone at home?

In some cases, tone can actually be relieved at home, and not only with medications, although you should not give them up too hastily. How to relieve uterine tone at home?

The best way to do this is exercises to relieve uterine tone. For example, "Cat". You need to get on all fours, raise your head and arch your back, stand in this position for a few seconds, and then slowly return to the starting position. This exercise must be repeated several times, and then lie down for an hour.

It has long been noted that relaxation of the uterine muscles helps relaxation of facial muscles. That is why the second exercise recommended for uterine tone is related specifically to the face. You need to lower your head and relax all the muscles of your face and neck as much as possible. You only need to breathe through your mouth.

Sometimes, in order to get rid of the unpleasant sensations and symptoms of hypertonicity that appear, it is enough to simply stand in such a position that uterus turned out to be in a suspended position: that is, again, on all fours, with emphasis on the elbows.

By combining this simple set of exercises with sedatives and antispasmodics, uterine tone can be relieved quite quickly. However, do not forget that it is important not only to relieve the tone of the uterus, but also to eliminate the cause, and for this it is important to strictly follow all the instructions of the attending physician. In addition, we consider it our duty to remind you that if this condition cannot be relieved, or the discomfort intensifies, you will still have to agree to hospitalization.

Prevention

Preventing hypertension is a very simple matter. The main thing is to avoid unnecessary physical activity and stress. It is also useful to eat right and follow a daily routine: go to bed and get up at approximately the same time. At this time, proper rest and healthy sleep are very important.

Separately, it is worth mentioning a variety of bad habits, such as drinking alcohol and smoking. Both, as is known, increase, among other things, the risk of uterine tone, and other, even more unpleasant pathologies. Therefore, it is better to give up tobacco and alcohol at the pregnancy planning stage.

Of great importance for prevention and timely detection is constant observation by a gynecologist, as well as timely completion of all related studies: tests, ultrasound, examinations by specialists, and so on. This is especially true if a woman belongs to one of the risk groups.

Well, and most importantly, worry less. Especially if you still haven’t saved yourself. Uterine tone, of course, is not a death sentence. In the vast majority of cases, pregnancy can be saved, and the consequences for the child are minimized. But excitement will in no way help improve the condition of the pregnant woman with uterine tone.

Replies

Almost every woman who is about to become a mother, at least once, has encountered such a condition as increased uterine tone. Hypertonicity of the uterus during pregnancy is not a diagnosis, it is only a symptom that indicates a threat of miscarriage. But this symptom is considered quite serious and requires urgent action.

What does the uterus consist of?

The uterus is a muscular organ and therefore is capable of contracting, which is necessary for labor to occur. The outside of the uterus is covered with a serous membrane called perimetry. The middle layer is the most pronounced and consists of smooth muscle tissue.

During gestation, the muscle layer (myometrium) thickens and grows due to an increase in the number and volume of muscle fibers. By the end of pregnancy, the uterus “occupies” almost the entire abdominal cavity. Preparing the fetal sac for contractions during childbirth involves the accumulation of calcium, glycogen and enzymes in the myometrium, which stimulate the contraction of muscle fibers.

In addition, by the end of pregnancy in the myometrium, the production of a protein, actyosin, increases (activates contractions). The inner layer of the fetal sac is the mucous membrane or endometrium, in which the fertilized egg is implanted.

Types of uterine tone

The tone of the uterus characterizes the state of the myometrium, its tension:

In addition, a distinction is made between local hypertonicity (tension of the myometrium in a certain place) and total hypertonicity - the entire uterus “turns to stone.”

Supports normal uterine tone

Signals from nerve receptors located in the uterus enter the woman’s central and autonomic nervous system, as a result of which a pregnancy dominant is formed in the cerebral cortex. The function of this dominant is to suppress nervous processes not related to the maintenance and development of pregnancy.

But in case of nervous overstrain, other foci of excitation are formed in the brain, which weaken the effect of the dominant pregnancy, which causes increased tone of the uterus. During the entire period of gestation, the excitability of both the spinal cord and uterine receptors is minimal, which ensures the normal course of pregnancy. In turn, by the time of birth, a generic dominant is formed, which is responsible for the contractile activity of the uterus - contractions (see).

In addition, it is responsible for maintaining normal uterine tone, which is first (up to 10 weeks) produced by the corpus luteum, and later by the placenta. Estriol, necessary for the regulation of uteroplacental blood flow, is also produced in the placenta from a hormone produced by the adrenal glands of the fetus and woman. In addition to relaxing the smooth muscles of the uterus, intestines and ureters, progesterone inhibits the excitability of the central nervous system, as if protecting the dominant of pregnancy.

Calcium ions are necessary for the contractile activity of the uterus. Progesterone and estriol maintain proper permeability of myometrial cells and prevent excess calcium from penetrating into the intracellular space.

What causes uterine hypertonicity?

The reasons that can lead to an increase in uterine tone are numerous and varied. As a rule, not one, but several factors are involved in the development of uterine hypertonicity. The main culprits of uterine hypertonicity include:

Infections

First of all, we mean sexually transmitted infections (ureaplasmosis, chlamydia, genital herpes, cytomegalovirus infection and others). They cause inflammation of the genital organs, in particular endometritis, as a result of which biologically active substances or cytokines begin to be synthesized, which increase the contractile activity of the myometrium. Intrauterine infection of the fetus is also possible.

Hormonal disorders

A lack of progesterone will certainly negatively affect the tone of the uterus and cause its increase, especially in the first 14 weeks of gestation, when the fertilized egg is fixed and the placenta is formed.
Deficiency of the main pregnancy hormone leads to spontaneous miscarriage or detachment of the chorion (future placenta) and non-developing pregnancy.
Progesterone deficiency is also observed with hyperandrogenism (excess of male sex hormones), with hyperprolactinemia, as well as with sexual infantilism. Genital infantilism is characterized by underdevelopment of the genital organs, in particular the uterus, which, in response to stretching, begins to shrink as the gestation period increases, which ends in miscarriage.
In addition, an increase in uterine tone can be caused by pathology of the thyroid gland (hyperthyroidism and).

Structural changes in the uterine walls

As a rule, an increase in uterine tone is caused by tumors and tumor-like diseases of the uterus (polyps, fibroids, adenomyotic nodes), which not only interfere with normal implantation and growth of the embryo, but also prevent the stretching of the fetal sac as the gestational age increases, which causes hypertonicity.

In addition, these diseases are caused by hormonal imbalances, which cannot but affect progesterone levels. Various curettages of the uterus and) cause an inflammatory reaction in the endometrium, which leads to the formation of intrauterine adhesions, and makes the uterine walls unable to stretch.

Chronic diseases

Often, an increase in the tone of the uterus while expecting a child is caused by chronic diseases of the mother (arterial hypertension, diabetes, excess weight, and others).

Uterine malformations

Various anomalies in the structure of the uterus cause inferiority of the uterine walls, which leads to an increase in uterine tone. This pathology includes a double uterus or a uterus with an additional horn, an intrauterine septum, as well as an existing scar on the uterus after surgery (cesarean section, myomectomy).

Socio-economic factors

This group of factors is the largest and most numerous. These include: the woman’s age (less than 18 and more than 35 years), low income, heavy physical labor, constant stress, occupational hazards, marital status (divorced or unmarried), poor nutrition, neglect of the regime, chronic lack of sleep, bad habits, etc.

Complications of real pregnancy

Incorrect position and presentation of the fetus often causes hypertonicity of the uterus due to its overstretching (for example, transverse position). Polyhydramnios and multiple pregnancies also contribute to overstretching of the uterus. Violation of fetoplacental blood flow during gestosis or placenta previa also causes uterine hypertonicity.

How to identify uterine hypertonicity

Increased uterine tone, as already mentioned, is not an independent disease, but just one of the signs of miscarriage. Symptoms that accompany uterine hypertonicity can appear at any stage of gestation (see):

As the tone of the uterus increases in the first 14 weeks, a woman notices the appearance of pain in the lower abdomen, or in the lumbar and sacral areas, especially after some physical exertion.
Pain may radiate to the perineum. The nature of pain varies. This may be a pulling or aching pain, similar to discomfort during menstruation.
A woman should be alerted to the appearance of bloody, brownish, pinkish or blood-streaked discharge, which indicates an incipient miscarriage.

In subsequent trimesters, the pregnant woman independently determines the tension of the uterus, which can occur locally or affect the entire uterus. In such a case, a woman compares uterine hypertonicity to “stoniness.”

During a gynecological examination In the first trimester, a doctor can easily diagnose uterine hypertonicity, as he can determine its contraction and tension during palpation. At a later date, increased tone is determined by palpation of parts of the fetus.
Ultrasound – Ultrasound is also of no small importance in diagnosing hypertonicity. In this case, the ultrasound specialist sees local or total thickening of the myometrium.

It should be noted that local hypertonicity of the uterus may appear in response to any actions being performed at the moment. For example, fetal movement, a full bladder, etc. That is, each case of recorded increased tone is individual, and the decision on the need for treatment is made after taking into account all causative factors, assessing the degree of risk of miscarriage, existing pregnancy complications and extragenital diseases.

Uterine hypertonicity: what to do?

Treatment of uterine hypertonicity is prescribed only when, in addition to uterine tension during palpation or ultrasound, there are additional signs indicating a threatening miscarriage (pain syndrome: abdominal and/or lower back pain, discharge mixed with blood, the formation of isthmic-cervical insufficiency). If the specified symptoms are present, the pregnant woman should consult a doctor as soon as possible, who will decide on hospitalization. It is possible to prescribe outpatient treatment for moderate hypertonicity, when tension or “petrification” of the uterus is felt only in some situations, periodically.

To successfully reduce hypertension during pregnancy, the cause that caused the increase in uterine tone is determined, if possible. Therapy for increased uterine tone is aimed at providing psycho-emotional and physical peace, relaxing the uterus and normalizing fetoplacental blood circulation:

Sedatives— in a hospital, a pregnant woman is prescribed psycho-emotional rest, usually bed rest and sedatives (motherwort, valerian, peony in tablets or tinctures). An appointment is mandatory, as worries about the child aggravate the situation.
Tranquilizers- in case of ineffectiveness of herbal sedatives, they are prescribed (diazepam, phenazepam, chalcionine).
Progesterone - in case of progesterone deficiency, drugs with synthetic progesterone (duphaston or utrozhestan rectally or orally) are prescribed until the 14th - 16th stage of pregnancy.
Antispasmodics - antispasmodics are mandatory, they stop contractions and improve blood supply in the utero-placental-fetal system (, droverin). They are prescribed either intramuscularly or in tablets or rectal suppositories.
Tocolytics - after 16 weeks, it is possible to prescribe tocolytics - special drugs that relieve uterine spasms (ginipral, partusisten) intravenously by drip, and then in tablet form.
Calcium channel inhibitors, they prevent the penetration of calcium into muscle cells: Nifedipine, Corinfar.
Magne B6 or magnesia- also used intravenous infusions or intramuscular injections of magnesium sulfate - relieves uterine tone, causes a sedative effect, lowers blood pressure. An alternative to magnesium sulfate solution are Magne-B6 tablets, which can also be taken in the first trimester (vitamin B6 serves as a conductor for magnesium into the cell).
Improving uteroplacental blood flow— therapy is carried out in parallel, the task of which is to improve blood flow (chimes, aminophylline, trental).
Metabolism regulating agents( , riboxin)
Hepatoprotectors(chophytol, essentiale), see.

Simple physical exercises will help relieve uterine hypertonicity at home.

First, you should relax the facial and cervical muscles as much as possible, which leads to a decrease in the tension of the uterus.
Secondly, the “cat” exercise is effective. You need to get on all fours, carefully raise your head, arching your lower back. You should breathe deeply and calmly. Maintain this position for 5 seconds.

Why is hypertension dangerous?

The consequences of uterine hypertonicity can be very disastrous. If you ignore the “first bell” - periodic tension of the uterus, then the pregnancy will end either in spontaneous abortion or early miscarriage, or in premature birth in the second or third trimester.

In addition, a permanent increase in uterine tone leads to the development of fetoplacental insufficiency, which impairs the nutrition of the fetus and its provision of oxygen. This provokes the development of intrauterine hypoxia, and subsequently delayed fetal development.

The prognosis for uterine hypertonicity depends on existing complications of pregnancy and extragenital diseases, the condition of the cervix, gestational age and condition of the child, and, of course, on timely medical care. An equally important role is played by the woman’s attitude towards a favorable outcome.

Pregnancy is a time that brings a lot of joy and positivity. However, in this condition, a woman can expect a lot of unpleasant diagnoses. The most common include tone (hypertonicity) of the uterus. What is this condition and what should the expectant mother expect?

Uterine tone: causes and dangers 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 birth it begins to contract, then in medical practice it is customary to say that the tone of the organ is increased. Since the described muscle behavior is natural, this condition is not always a pathology and a cause for concern. If it is not associated with other symptoms and discomfort, then most likely there is no need to worry. However, this does not mean that the condition should be ignored. Especially if the tone of the uterus is not short-lived.

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 harmful consequences. Hypertonicity of the uterus can lead to spontaneous miscarriage (in the first trimester) or premature birth (in the second and third trimesters). Increased tension in the uterus in the early stages can negatively affect the process of attachment of the fertilized egg, causing its rejection by the uterine organ or death. Myometrial activity immediately before birth is often not dangerous. In this way, the woman’s body prepares for childbirth.

With hypertonicity of the uterus, tense muscles limit the flow of oxygen to the fetus, compressing the vessels of the umbilical cord

Hypertonicity of the uterus can negatively affect the health and development of the baby. Tense muscles limit the flow of oxygen to the fetus because they compress the umbilical cord vessels. This phenomenon can lead to hypoxia (oxygen starvation) or malnutrition (stunted growth), 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 identified:

lack of progesterone (steroid hormone of the corpus luteum, which is formed instead of a burst follicle). It is also responsible for muscle relaxation;
excess male hormones and prolactin (a hormone involved in the regulation of reproductive function);
severe toxicosis with frequent and profuse vomiting;
abnormalities of the uterine organ and pathologies of the placenta;
malfunction 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 distension of the uterus (possible with polyhydramnios or multiple pregnancies);
tumors, miscarriages, abortions and other painful conditions;
malposition;
disturbance of intestinal peristalsis (normal contraction);
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 can adequate treatment be prescribed.

Norms of uterine tone by stage of pregnancy

In order for the child to develop correctly within the uterine organ, the latter must be relaxed and pliable. Short-term 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 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. In this way, 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 hypertension with the onset of labor.

Video: why uterine hypertonicity occurs during pregnancy

Symptoms of hypertension by trimester

The development of pathology can be determined within each stage of pregnancy. Hypertonicity is most dangerous 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 copious vaginal discharge and pain.

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

In the second trimester, it will be more difficult to determine hypertension. During this period, a pregnant woman experiences a lot of new sensations, which is why it can be difficult to identify specific ones. A woman should be concerned about:

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

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

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

training contractions do not differ in regularity and significant duration;
pain when preparing the body for childbirth is excluded;
no bleeding is observed.

Training contractions are normal for the third trimester; they do not differ in regularity or duration

In the second and third trimesters, in a state of hypertonicity, every movement of the fetus gives off pain. Its activity decreases. Sometimes the opposite happens: the child begins to behave excessively. If this has not been observed before, then you should pay attention to this phenomenon. If the discomfort does not go away for a long time, then you should immediately consult a doctor.

Diagnosis of the condition

Hypertonicity of the uterus can lead to harmful 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 through a routine examination on a chair. When palpating (feeling) the abdomen, characteristic tension of the myometrium will be observed. Its intensity may vary. Usually during the examination the patient experiences discomfort or even pain.

Additional diagnostic methods include ultrasound scanning. Thanks to ultrasound, it will be possible to determine the degree of contraction of the muscles of the uterine organ and the location of the problem:
The first degree of hypertonicity is characterized by thickening of the muscle layer on only one side of the organ. If such a phenomenon is observed in the area where the placenta is attached, then there is a high probability of its detachment;

the second degree of uterine hypertonicity is characterized by thickening of the myometrium along the entire perimeter of the organ. In this case, accompanying clinical symptoms must be present.

To determine the degree of uterine contractility, tonuometry can also be used. This diagnostic method involves measuring the indicator using a special sensor. It is placed in 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

Using ultrasound diagnostics, it will be possible to determine the degree of localization of contraction of the muscles of the uterus. A gynecologist can determine the hypertonicity of the uterus by palpation (palpation) of the anterior abdominal wall. The tone of the uterus can be measured using a special sensor, which is placed in the area of the anterior abdominal wall

The appearance of uterine tone can be determined independently only based on the symptoms described above. It is often blurry, so it is hardly permissible 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 you should pay attention to is a “stone” stomach. He seems to freeze and become heavier for a few seconds.

All other diagnostic methods require medical knowledge or special equipment.

Treatment

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

Important: self-medication or practicing traditional methods without consulting a specialist is strictly prohibited. Not all available methods of therapy are medically substantiated and can boast of effectiveness.

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

Drug treatment

Usually, in the first trimester, pregnant women are prescribed No-shpa. The drug relieves spasms. For severe hypertonicity, it is better to give preference to injections.
No-spa can relieve spasms due to hypertonicity of the uterus

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

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

In addition, during the therapy period, the woman must avoid heavy loads and excessive activity; bed rest is recommended. She is prescribed sedative (calming) drugs, such as:

Persen;
Sedavit;
Novo-Passit;
valerian infusion.

Specific problems (Rh-conflict, hormonal imbalance) can be eliminated only with the help of well-chosen individual medication.

Exercises

Simple exercises can help relieve tension. However, before using them in practice, you should definitely consult your doctor.

Muscle relaxation

If you completely relax all the muscles, especially the face, you can have a positive effect on 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"

The “cat” exercise is effective. Execution sequence:

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

Hypertonicity is uterine contractions that occur before the expected date of birth. This often happens in the early stages. The tone of the uterus during pregnancy can be felt by a woman and determined by ultrasound. If treatment is not started in time, there is a significant risk of losing the child.

Symptoms

How does hypertension manifest itself? A pregnant woman should be alert to the following signs of uterine tone during pregnancy:

severe pain in the lower abdomen;
bleeding from the vagina;
hard “stone” belly;
heaviness in the lower abdomen;
dizziness and nausea.

If a pregnant woman independently discovers at least one of the symptoms, she should contact a gynecologist and prescribe treatment. Excessive muscle tension at the beginning of the pathological process is detected only during examination by a doctor, and most often through ultrasound.

Diagnostics

Palpation

The doctor determines the increased tone of the uterus during pregnancy after collecting an anamnesis. For diagnosis, the gynecologist will perform palpation. During advanced stages of pregnancy, this is done through the anterior abdominal wall. The woman lies on her back with her legs bent. This position eliminates tension in the abdominal wall, so the gynecologist feels the compaction.

Ultrasound examination

An additional examination - ultrasound - helps to evaluate the thickening of the muscle layer and the condition of the cervix. Based on the results of the examination, a conclusion is made about what the tension means and whether there is a threat of miscarriage.

The phenomenon of tone during pregnancy is noted locally (in some areas) or on the entire inner surface of the uterus. There are contractions on the anterior and posterior walls of the organ. A pregnant woman can feel on her own if the entire uterus is tense. With hypertonicity along the posterior wall, the woman feels nagging pain.

Ultrasound establishes local tone, which cannot be determined in the usual way. If the wall to which the placenta is attached is tense, there is a danger of its detachment. This is diagnosed by a doctor through an ultrasound examination. If there is increased tension in the posterior wall and pain in the organ is noted, the length of the cervix is additionally measured and its condition is assessed.

If there is a threat of premature birth (can be determined by ultrasound), fetal biometry is performed and blood flow in the vessels is examined. If increased uterine tone is noted during pregnancy, hospitalization is required.

Tonuometry

The tension in the uterus is recorded by special sensors. This method is rarely used. Palpation and ultrasound are more often used.

Etiology

The reasons that influence the tension of the uterine wall are different. They are divided into two categories - physiological and psychosomatic.

The causes of hypertension are:

numerous abortions;
large fruit size;
a certain number of pregnancies;
multiple births;
infantile (children's) uterus;
polyhydramnios;
endocrine diseases;
infections;
a certain age of the pregnant woman;
physical activity;
bad habits;
poor nutrition;
complications during pregnancy;
short sleep duration;
a certain type of occupation.

Cardiovascular, chronic kidney and liver diseases, hypertension - all this leads to tension in the organ. Uterine tone in the third trimester is the cause of premature birth. Malignant formations in the organ lead to hypertonicity.

Increased tension in the uterus is often a consequence of psychological problems. When a woman experiences fear, she develops symptoms of hypertonicity. Excessive tension is a consequence of certain mental states. Pregnancy brings many life changes and women need to be supported at home. If there are constant scandals and quarrels in the family, this causes tension throughout the body. This is why a woman’s anxiety and stress cause uterine tone.

Tension in the muscle organ is observed due to a lack of progesterone, which supports pregnancy in the early stages. Underdevelopment of the uterus and its mucous membrane occurs due to a lack of estrogen. If the level of male sex hormones is higher than normal, the uterus becomes toned.

Disorders in the thyroid gland can cause hypertension. Viral infections of the genital tract provoke tension in the muscle organ. Uterine tone in early pregnancy can lead to miscarriage. When the first symptoms appear, you should take the measures listed below.

First aid

If there is tension in the uterus, you can take an antispasmodic yourself and go to bed. It is advisable to consult a gynecologist on the same day.

If hypertonicity occurs along the posterior wall of the uterus, the woman should:

relax the muscles of the face and the whole body;
refuse any labor;
get on all fours and do an exercise that will help relieve tension. Slowly bend your back, raising your head, and return to the original position.

Treatment

If there is uterine tone in the early stages of pregnancy, the woman is advised to rest. The following treatment comes to the rescue:

herbal sedatives – valerian, motherwort;
"Magne B6";
vitamin therapy;
antispasmodics – “No-shpa”, “Baralgin”, “Papaverine”, “Drotaverine”;
treatment through psychotherapy.

Hormonal treatment must be justified. Progesterone-based medications are prescribed - Duphaston or Utrozhestan. Minimum doses of drugs are selected, taking into account the duration of pregnancy. If a woman has heavy bleeding, she is hospitalized.

Treatment consists of a set of measures that eliminate the causes of the threat of pregnancy. Therapy may include:

"Progesterone". 1 ml is administered intramuscularly for no more than 10 days.
Intramuscularly - "Oxyprogesterone" 1 time per week.
Within 5–7 days – “Folliculin”.
1 ml for 6–10 days carotene subcutaneously.
Tocopherol acetate is indicated - 1 ml intramuscularly.
3–5 ml of nicotinic acid is administered intravenously.
Injections of the drug "Papaverine" are given subcutaneously.

If uterine tone is observed in the second trimester, diathermy is recommended. In case of infectious diseases, it is necessary to eliminate the underlying cause.

In the second trimester, short-term hypertonicity is a physiological process. Often a woman cannot independently determine whether her condition threatens the fetus. If a pathology is suspected, the doctor will prescribe treatment. The following medications will help relieve muscle tension:

antispasmodics;
magnesium sulfate;
“Partusisten”, “Ginipral”, “Salbupart”, “Bricanil”, “Albuterol”;
"Atosiban", "Hexoprenaline";
magnesium sulfate;
Nifedipine, Finoptin, Verapamil are potassium antagonists.

What causes uterine tone in the third trimester? Braxton Hicks contractions are considered normal. This means that the uterus is preparing for childbirth.

Prevention

In order to relieve excess tension in a muscle organ, a number of rules should be followed:

Heavy physical labor and sports are contraindicated.
You can't lift weights.
Breathe fresh air, but without exhausting walking.
Sleep at least 8 hours.
Limit sex life.
Eat well.
Try to avoid long trips and crowded transport.
You should definitely give up bad habits.
Try to avoid stressful situations.

To prevent possible hypertension, even before pregnancy, a woman should be examined for infections in the pelvic organs. This is why you should consult a gynecologist. All tests must be done.

In order to get rid of threatening symptoms, a woman needs to relax. Soothing tea with honey made from lemon balm, mint, motherwort and valerian will help with this. You should also not neglect healthy and adequate sleep. Essential oils of chamomile, mint, jasmine, and lotus will help relieve tension.

Emotions

What does emotional state mean in the life of a pregnant woman? In the early stages, a woman experiences mood swings and is unstable. Psychological tension arises, which means that it also manifests itself at the physiological level. What to do to reduce it?

Communication with loved ones, proper rest and creative activities helps a woman relieve excessive anxiety. In the middle of pregnancy, women experience a feeling of wholeness and harmony. Many people feel comfortable in the second and third trimester. It is dangerous for a pregnant woman to be nervous, as this can manifest itself and lead to hypertension.

Consequences

Tension in a muscle organ is a dangerous pathology. It occurs at any stage, but attention is paid to pregnancy up to 14 weeks. If uterine tone occurs in the second trimester, fetal development may be affected. One of the consequences of contractions of the muscular organ in the period from the 12th to the 20th week is late miscarriage. If the uterus is too tense, embryo development may stop. What can cause placental abruption? Due to the same tension, the consequence of which is fetal hypoxia.

If placental abruption has begun and uterine tone is noted in the third trimester, delivery is indicated. The doctor determines the woman’s condition and, if necessary, performs emergency surgery. In this case, a caesarean section is performed to prevent fetal death.

In the later stages of pregnancy, certain symptoms may also appear, which do not yet mean hypertonicity. A thorough medical examination is necessary. Medications to relieve muscle tension are not prescribed after 35 weeks of pregnancy. With all threatening symptoms, the pregnant woman is hospitalized.

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

What is hypertonicity?

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

Uterine hypertonicity is a special condition that is characterized by certain contractions of the muscles of this organ.

The pregnant uterus can be compared to a sponge with tubes stuck into it. If you run water through the tubes, the water will easily penetrate the sponge. If you squeeze the sponge, the water will pass through with difficulty. The uterus is the same: while in a relaxed state, 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 dire consequences - ,. A baby born at term may experience developmental and growth disorders, since a lack of oxygen causes.

The sensations during uterine hypertonicity vary 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. The most alarming sign in this condition is the appearance of blood (or other color) from the vagina. In this case, urgently call or go to your doctor.

Causes of uterine hypertonicity

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

Diagnosis of increased uterine tone

To begin with, let’s say that the final diagnosis can only be made by a doctor, so you shouldn’t put off going to see him, even if the pain is not severe and does not cause much discomfort. There is a distinction between hypertonicity, diagnosed using, and hypertonicity, which is felt by the woman herself.

The gynecologist will make a diagnosis during an in-person examination. If he doubts, he will send the pregnant woman for ultrasound diagnostics and tonuometry.

The diagnosis was confirmed. What to do?

Get treatment! Firstly, at first it is very important to rest and relax, to bring your mental state back to normal. To do this, pregnant women who have been diagnosed with uterine hypertonicity are prescribed bed rest, sedatives of herbal origin (this can be valerian, motherwort) and approved antispasmodics (for example, No-shpa or Papaverine). Treatment is often carried out in a hospital (usually in the pregnancy pathology department located 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, drugs containing it are prescribed (Utrozhestan, Duphaston). Hormonal drugs Metipred and Dexamethasone are also often used.

When treating hypertension, the condition is significantly alleviated by the drug Magne-B6, which is a combined preparation of magnesium and vitamin B6. Magnesium compounds prevent calcium from penetrating 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 muscle activity of the uterus, use a solution of magnesium sulfate, which is administered both intravenously and intramuscularly.

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

If a 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 at the waist. After 5-6 seconds, you need to lower your head and arch your back upward. 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 additionally invite you to read this article.

Especially for- Ksenia Dakhno