What to do when your belly is toned during pregnancy? Hypertonicity in the expectant mother

From the very beginning of pregnancy, the concentration of progesterone in a woman's blood increases. This hormone acts in the interests of the fetus: it relieves the tone of the uterus and prevents its contractions, which is necessary to preserve the baby. If symptoms of uterine tone during pregnancy appear, then the likelihood of a baby being born prematurely increases. But there are treatments for this condition.

The tone of the uterus goes into the category of safe conditions when the moment of childbirth approaches. The uterus begins to increasingly come into a state of tension, sometimes reminiscent of contractions. This is a workout that starts with a gradual decrease in progesterone.

Symptoms of uterine tone during pregnancy

The muscles form the basis of the uterus. Before pregnancy, its size is small: it is no larger than a chicken egg and does not even protrude because of the pubic articulation. During the development of the baby, the uterus stretches many times. The muscles are arranged in three layers in three mutually perpendicular directions. This is necessary so that the baby is pushed out during labor during labor. Each muscle fiber thickens four to five times and lengthens 10-12 times.

Under the influence of progesterone, the uterus is in a relaxed state. But sometimes local or general tension arises. That is, the tone of the uterus during pregnancy is a temporary or permanent state of tension in the myometrium.

During pregnancy, the subjective signs of uterine tone may differ, therefore, to determine medical tactics, several degrees of tone are distinguished.

  • First degree. The pain in the lower abdomen is short-lived, does not bring pronounced discomfort and anxiety. It passes on its own at rest.
  • Second degree. Pronounced pain syndrome in the abdomen, pain can be given to the lower back, sacrum. The uterus goes into a state of high density.
  • Third degree. Small physical or mental stress leads to the appearance of tone. The uterus becomes "stony" and does not relax well. This condition requires medical attention.

Hypertonicity of the uterus during pregnancy can occur at any time and periodically appear until the moment of delivery.

How does it manifest

Increased tone can be a dangerous symptom of the onset of premature labor, so you need to listen to your body. A doctor should be consulted when the following symptoms appear, regardless of the gestational age:

  • lower abdominal pain;
  • cramping pain in the uterus;
  • stony density of the uterus;
  • bloody discharge from the genital tract.

When can it develop

It is possible to independently determine the tone during a normal pregnancy when the uterus is clearly visible. Sometimes she “turns to stone” even when she touches her stomach.

1 trimester

In the 1st trimester, the tension of the uterus becomes a sign of a possible termination of pregnancy. It is noticed that on ultrasound, a tone along the anterior wall of the uterus appears when a child has chromosomal pathologies. But many other reasons can also affect the condition of the uterus:

  • sex;
  • physical exercise;
  • stress;
  • constipation;
  • severe toxicosis.

2 trimester

In the 2nd trimester, the tension of the uterus may be more pronounced. The main reasons are the same conditions as at the beginning of gestation, but the rapid growth of the fetus is added to them. Other possible causes of uterine tone during pregnancy at this time:

  • polyhydramnios;
  • pregnancy with twins;
  • myoma;
  • endometriosis;
  • rhesus conflict;
  • placenta previa;
  • premature placental abruption;
  • pathology of the development of the uterus;
  • inflammatory processes in the genitals.

High birth parity (frequent pregnancies with a small interval between them) can also lead to increased tone.

For a pregnant woman, an additional increase in intra-abdominal pressure is dangerous, arising from vomiting in case of poisoning, severe diarrhea, flatulence. This can cause the uterus to contract.

3 trimester

In the 3rd trimester, the child is already big enough. But before 35 weeks, the appearance of an increased tone of the uterus is undesirable. There may be the following additional causes of this condition:

  • malposition;
  • gestosis;
  • placental insufficiency;
  • history of cesarean section;
  • miscarriage in the past.

The female body is influenced by external factors. Stress affects not only mood, but also sexual function, the ability to conceive and carry a child, and lactation. Constant emotional stress, lack of sleep also provoke the appearance of uterine tone. Some doctors refer to this condition as psychosomatics.

Risks

A toned uterus does not always go unnoticed. In the early stages, this condition can result in abortion. An additional symptom in this case is bleeding from the genital tract.

In the later stages, the tone of the uterus is dangerous by a violation of blood flow in the placenta. In this case, vasospasm appears, and then their relaxation. These processes can lead to detachment of the normally located placenta and fetal death.

If the tone occurs periodically, then the consequence is a malnutrition of the fetus, intrauterine growth retardation.

Ways to influence the condition

Diagnosis of uterine tone is not difficult. On examination, the doctor can determine a change in the shape of the abdomen, a hard uterus, which hurts even more when touched. In the short term, the tone is diagnosed during an ultrasound scan. Most often this is a local process along the front or back wall.

For a period after 27 weeks, the use of the CTG apparatus is informative. It contains two sensors. One reflects the fetal heartbeat, and the second reflects the uterine contractions. This allows you to assess not only the strength and duration of uterine contractions, but also the child's reaction to them. A pronounced decrease in heart rate, which takes a long time to return to normal, speaks of the suffering of the fetus.

Early dates

The cause of the pathological condition is often a lack of progesterone, and the consequence is the threat of interruption. Therefore, for treatment, hormonal drugs are used that can compensate for the hormone deficiency. Most often, "Duphaston" is prescribed. But for some women "Utrozhestan" is more suitable, which can be taken orally or vaginally. The vaginal form is indispensable for signs of toxicosis - severe vomiting in the morning.

Treatment with antispasmodics is supplemented. You can use tablets "No-Shpa" (analogue "Drotaverin"). With frequent vomiting, papaverine candles are prescribed, which are best placed at night.

In a hospital setting, Vikasol and Ditsinon can be prescribed to stop bleeding. You can calm your nerves with motherwort tincture. But you should not get carried away: it contains ethyl alcohol.

Treatment of uterine tone in early pregnancy involves changing the patient's lifestyle. The woman is assigned sexual rest. In some cases, hospitalization. It is recommended to normalize the mode of work and rest, sleep at night, but also go to bed for an hour during the day. Products that contribute to gas formation, as well as coffee, strong tea, are removed from the diet. If you suffer from constipation, then you need a laxative diet.



Mid-gestation

Approaches to the elimination of tone in this period are different. Some women with progesterone deficiency continue taking Duphaston until 20 weeks (followed by a gradual dose reduction). Help in the treatment of antispasmodics. If necessary, they are used in the form of injections.

But the main drug for a rapid decrease in the local tone of the cervix and generalized spasm is a solution of magnesia. It is used in the form of droppers. Magnesium sulfate helps to relax the muscles as well as calm the nervous system. The solution lowers blood pressure, improves urine output, which is used for gestosis. The appointment is contraindicated for bradycardia, low baseline blood pressure and severe kidney disease.

The choice of other drugs depends on the concomitant pathologies that could cause a deterioration in the condition.

After discharge from the hospital, women are prescribed "Magnesium B6" in the form of a tablet medicine. This is necessary to improve the state of the fetoplacental complex. At home, a pregnant woman can do breathing exercises that help calm down during stressful situations. Some do yoga for pregnant women, but these should be light asanas, excluding raising the arms and straining the abdomen. Nutritional recommendations remain the same as in the previous trimester.

From 7 months

At this time, the uterus also responds to the introduction of magnesia. But the number of receptors in it increases, which can be influenced with the help of the drug "Ginipral". It belongs to the group of sympathomimetics and is able to reduce the tone and contractility of the myometrium. Available in the form of tablets and solution. But most often the drug is used in hospitals for tocolysis - relieving contractions during premature birth or during complicated labor.

Pregnancy is an almost magical state, well, at least definitely miraculous. Naturally, at this time, a woman simply has to 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?

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

If during pregnancy, but before the onset of labor, the uterus begins to contract, they say that the tone of the uterus during pregnancy is increased. It is worth making a reservation here: since the process of muscle contraction is natural, it is not always at all that the uterus is in good shape 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, as well as indicative of serious violations. There is a share of common sense in this reasoning, because even in the process of sneezing or laughing, almost all muscles, including the uterus, contract. The same goes for the ordinary orgasm. Affects the state of the uterus and the psychological state of the pregnant woman. Very often, the tension of the muscles of the uterus is observed precisely during a gynecological examination.

However, the peculiarity of the tone of the uterus in all these cases lies in its short duration. Yes, and usually this state does not give unpleasant sensations. Another thing is if the uterus is in good shape for a long time. The constant tone of the uterus during pregnancy is fraught with the most unpleasant consequences for the fetus, and for the preservation of pregnancy too.

Why is uterine tone dangerous?

The consequences of uterine hypertonicity can be very dire, up to spontaneous miscarriage, if we are talking about the tone of the uterus in the early stages of pregnancy, before premature birth, if we are talking about the tone of the uterus in the second or third trimester of pregnancy.

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

Sometimes there is a tone of the uterus before childbirth, in which case it is customary to talk about training contractions. They are generally not dangerous. Thus, the uterus prepares for the process of childbirth, roughly speaking, 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 squeeze the vessels of the umbilical cord, the fetus may receive less oxygen, which entails the development of hypoxia. If, for the same reason, the baby does not receive additional nutrients, then hypotrophy and growth arrest are possible.

Causes of uterine hypertonicity

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

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

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

There are other hormonal disorders, the consequence of which can be the same diagnosis. In particular, excess of some male hormones. That is why it is very important during pregnancy to closely monitor the hormonal background of a woman.

Severe toxicosis also affects the condition of the uterus. Especially if accompanied by profuse and often vomiting. During vomiting, many muscles in the body contract, in particular the abdominal cavity. Affects this process and the uterus. Unfortunately, toxicosis in the early stages cannot be removed at all, you can only alleviate the woman's condition a little, but it also makes sense to do this.

Hypertonia, as well as miscarriage in general, may be associated with the presence of abnormalities in the development of the uterus: the uterus can be bicornate or saddle-shaped, as well as have other disorders. 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, the woman is aware of all her problems, and throughout the pregnancy, the woman should be under constant medical supervision. All anomalies in the development of the uterus will make themselves felt at the earliest stages of pregnancy.

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

Some infectious diseases and inflammatory processes of the genitals or in the uterine cavity also cause an increase in the tone of the uterus. Usually, infections are accompanied by other symptoms, such as: a change in the nature of the discharge, pain, itching, and so on.

Excessive stretching of the uterus can become the cause of the tone. This condition is observed 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 on psychological problems, tension and stress, which also affect the state of smooth muscles.

There are also completely prosaic reasons. So, the tone of the uterus often develops due to the intestines, more precisely, due to strong gas formation and altered intestinal perelsatics.

The main thing that needs to be understood and remembered from this section: the tone of the uterus is a symptom, therefore 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 in good shape?

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

Symptoms of an increase in the tone of the uterus in the early stages of pregnancy are heaviness in the lower abdomen, pulling pains, as with menstruation, sometimes these pains are given to the lower back or to the sacrum. Symptoms of uterine tone in the second and third trimesters are practically the same, in addition, at such periods, hypertonicity can be noticed even visually: the abdomen contracts, becomes hard, the uterus "turns to stone". In general, every woman will easily understand how the tone of the uterus feels during pregnancy.

In some cases, the tone of the uterus is manifested by spotting bloody discharge. These are very alarming symptoms, you need to immediately call an ambulance, 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, a woman may not feel them.

Diagnostics of the tone of the uterus

There are several ways of medical diagnosis of uterine hypertonicity. It is often noticeable even with a simple gynecological examination. However, the most common diagnostic method is ultrasound. An ultrasound scan shows the condition of the muscles of the uterus. In particular, it is ultrasound that shows such pathologies as the tone of the uterus along the back or front wall of 1 or 2 degrees. 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 exactly the tone of the uterus. However, they are not very widespread due to the fact that the diagnosis of this problem does not leave any difficulty. It is much more difficult to determine the cause of the 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 occurs during pregnancy, as well as on what caused it. If the situation is not associated with a serious risk, the treatment of uterine tone during pregnancy is carried out on an outpatient basis.

A woman is recommended to stay in bed, prescribe 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 funds should only relieve the tone of the uterus during pregnancy, in addition to this, you will probably be prescribed other medications that should cure the cause of the appearance of the tone.

So, if we are talking about a lack of progesterone, then a woman is prescribed a drug with its content. If the reason for the tone of the uterus is an excess of male hormones, then their antipodes are prescribed. With toxicosis, they do everything necessary to alleviate this condition, and if the cause is intestinal problems, it is necessary to reduce gas production. There is a treatment of its own in the case of Rh-conflict, and for any other diagnosis.

If the tone of the uterus cannot be removed for a long time, or the situation is initially very serious, doctors will insist on hospitalization and further treatment in a hospital. In a hospital, the patient will not be able to systematically break bed rest, as women usually do when at home: cleaning, cooking and other household chores haunt the hostesses. In addition, only in the hospital will doctors be able to more closely monitor the condition of the mother and child, as well as to bring down the increased tone in a timely manner, so as not to allow premature birth to begin.

Here it is worth making a small digression, in which we will talk about why, starting from the 28th week, they talk about preterm birth, although the baby is clearly not full-term. 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 the doctors will do their best to stop it. For this, tocolytic therapy is carried out, that is, the uterus is relaxed in every possible way with the help of appropriate schemes and drugs. And it is very important to start on time, since the child most likely will not survive at this time. That is why doctors in hospitals are fighting for every day of maintaining pregnancy. Still, the tone of the uterus at 36-38 weeks of gestation is not so risky, although it threatens the condition of the fetus. Therefore, after 28 weeks, first of all, they try to preserve the pregnancy.

Should I agree to hospitalization?

Very often, women have a question: how necessary is hospitalization? Usually, this question is asked by those who have older children or those who fear losing their jobs due to a long absence, they say, the child needs to be fed, money needs to be earned, but no-shpu and papaverine can be taken at home.

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

How to remove uterine tone at home?

In some cases, the tone can really be removed at home, and not only with medications, although you should not refuse them too hastily. How to remove uterine tone at home?

The best way to do this is with uterine toning exercises. For example, "Cat". You need to get on all fours, raise your head and bend 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 muscles of the uterus is facilitated by the relaxation of the muscles of the face. That is why the second exercise recommended for the tone of the uterus is associated with the face. You need to lower your head and relax all the muscles of the face and neck as much as possible. In this case, you only need to breathe through your mouth.

Sometimes, in order to get rid of the unpleasant sensations and symptoms of hypertonicity that have appeared, it is enough just to stand in such a position so that the uterus is in a suspended position: that is, again, on all fours, with an emphasis on the elbows.

By combining this simple set of exercises with sedatives and antispasmodics, the tone of the uterus can be removed 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 is eaten up to relieve, or the discomfort increases, you will still have to agree to hospitalization.

Prevention

Prevention of hypertonicity is a very simple matter. The main thing is to avoid unnecessary physical exertion and stress. It is also useful to eat right and observe the daily routine: go to bed and get up at about the same time. Good rest and healthy sleep are very important at this time.

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

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

I like!

Often this symptom of the threat of termination of pregnancy remains unnoticed by the expectant mother, which leads to more serious consequences.

Have you ever played sports? Lifting weights? Clench your hand into a fist that is strong. Look at the muscles of the arm: they have increased, began to be clearly contoured, thickened - they have come to tone. Just as the activation of skeletal muscles occurs, the muscles of the uterus (myometrium) also tone up. The only difference is that the processes of tension-relaxation of the muscles of the arms, legs, back are subject to your desires, since their work is controlled by the central nervous system. With the uterus, things are more complicated, nothing depends on your will.

Uterus in good shape: symptoms

What symptoms can tell us about tone of the uterus? This is primarily a pulling, monotonous, prolonged pain in the lower abdomen, without clear localization. “Somewhere below, like during menstruation,” patients often say. Pain can be given to the lumbar region, sacrum, perineum. In the second and third trimesters, placing her hands on her stomach, the expectant mother independently determines a dense uterus with clear contours. Often, bleeding from the genital tract may appear. It is important to remember that any non-light discharge - beige, brown, pink, streaked with blood, scarlet, abundant, smearing - is regarded as blood. They are dangerous during pregnancy and require immediate medical attention.

Diagnostics: hypertonicity of the uterus

A woman's uterus is a hollow muscular organ located in the middle of the pelvic cavity. Like any smooth muscle tissue, the myometrium has inherent properties - excitability, tone, stretching, plasticity and elasticity. Normally, the uterus should be relaxed during pregnancy. It is in this case that favorable conditions are created for the attachment of the ovum, the formation of the placenta. In the uterus, the growth and development of the fetus takes place, extra-fetal structures are formed - the placenta, amniotic fluid, umbilical cord, membranes.

For a number of reasons, the myometrium can become toned - the muscle thickens, becomes dense. During the examination of a woman on a chair in the first trimester of pregnancy, the obstetrician-gynecologist very clearly determines the increased tone with his hands. The thickening of the wall of the uterus is seen during the examination by the doctor conducting ultrasound diagnostics. At the same time, in the conclusion, he usually designates the problem with the following terms: "myometrial tone is increased" or "myometrial hypertonicity".

The consequences of hypertonia

Every expectant mother should understand that, no matter how the tone is determined - at the appointment when examined by an obstetrician-gynecologist, by herself or during an ultrasound examination, - this is the threat of termination of pregnancy. The tone of the uterus requires close attention of both the woman and the doctor leading the pregnancy.

The tone of the myometrium in the first trimester leads to detachment of the ovum, chorion (this is the name of the future placenta) and, as a result, spontaneous miscarriage occurs. Often, abortion does not occur, but due to the large area of ​​detachment, the pregnancy freezes, stops in its development due to malnutrition and oxygen delivery. At the same time, often a woman is not bothered by bleeding, only periodic pulling pains in the lower abdomen appear. And with screening ultrasound at 11-13 weeks, it turns out that the pregnancy is not developing, frozen at a period of 6-7 weeks, a large retrochorial hematoma is visualized (accumulation of blood when the ovum separates from the chorion, the precursor of the placenta).

In the 2nd and 3rd trimester, the tone of the myometrium rarely leads to placental abruption, only if it is abnormally located (low placentation) or if the placenta overlaps the area of ​​the internal pharynx.

But there is another danger. The uterus compresses the fetal bladder with the baby and amniotic fluid, of which there are already a lot after 20 weeks (600-1500 ml at term). The pressure on the lower segment, the internal pharynx, increases. The fetal bladder, under the influence of the tone, begins to work like a wedge, the cervix opens and premature birth occurs. It happens that amniotic fluid leaves with a preserved cervix. But the result is one - termination of pregnancy.

Causes of hypertonia

There are many reasons for the appearance of uterine tone during pregnancy. Rarely can you single out one, more often they are combined: stress, lack of sleep, hard physical labor, hours of work, sports, air travel, long distance travel, sex life up to 12 weeks of pregnancy, colds. An important role is played by bad habits - smoking, alcoholism, but there are other factors that lead to an increased tone of the uterus.

Infections... First of all, these are sexually transmitted infections: chlamydia, mycoplasma, ureaplasma, viruses, etc. They cause inflammation of the pelvic organs, including the uterus. The synthesis of anti-inflammatory cytokines is enhanced - these are biologically active substances that provide an inflammatory response in the body and adversely affect the course of pregnancy and fetal development. These include interleukins, interferon, which increase the tone of the myometrium. In addition, in this case, the likelihood of intrauterine infection of the baby is high.

Hormonal disbalance... Lack of progesterone is an equally rare cause of increased myometrial tone. Progesterone is especially important in the first trimester of pregnancy. It relaxes the myometrium, contributes to the normal processes of implantation and formation of the placenta. In the first trimester, this hormone is synthesized by the corpus luteum of the ovary, with its insufficient function of progesterone, little is produced, and pregnancy proceeds against the background of hypertonicity of the uterus, which leads to the threat of termination of pregnancy. By 16 weeks, the placenta takes over the synthesis of hormones, and the risk of miscarriage decreases.

In addition to progesterone deficiency, there are a number of hormonal disorders, as a result of which pregnancy proceeds with the threat of termination: hyperandrogenism (increased levels of male sex hormones), hyperprolactinemia (increased levels of the hormone prolactin in the blood), thyroid pathology - hyper- or hypothyroidism, autoimmune thyroiditis.

At-risk groups... After surgical interventions in the uterus (abortion, diagnostic manipulations), childbirth, complicated by the inflammatory process, adhesions can form - intrauterine synechiae. In such cases, pregnancy proceeds against the background of an increased tone of the uterus, with the threat of termination, with bleeding.

Endometriosis, fibroids(especially such an arrangement of the tumor, when it protrudes into the uterine cavity, deforming it) - all these are the circumstances accompanying an increase in the tone of the myometrium during pregnancy.
In women with disorders in the hemostasis system (a complex of body reactions aimed at preventing and stopping bleeding), with changes in the indicators of the coagulation or anticoagulation systems of the blood, the presence of antibodies to cell phospholipids, pregnancy proceeds with an increased tone of the uterus, starting from the shortest terms.

Multiple pregnancy, pregnancy, complicated by polyhydramnios, oligohydramnios, often passes against the background of the tone of the uterus and is complicated by premature birth.

Patients with chronic diseases, with severe somatic pathology (for example, bronchial asthma, diabetes mellitus) who have had colds, viral diseases during the current pregnancy, very often have uterine tone.

How to treat uterine hypertonicity

The tone, of course, needs to be removed, the uterus needs to be relaxed, otherwise this condition may result in spontaneous miscarriage.

If the expectant mother is not included in any of the risk groups, everything is in order with her health, this is the first pregnancy, which came without any problems and proceeded safely until the present moment, there was no bleeding from the genital tract during the entire period of gestation, but with In this case, the woman is worried about minor pulling pains in the lower abdomen and, according to the doctor, the tone of the uterus is increased or the uterus is excitable on palpation - outpatient treatment can be carried out, but with the obligatory observance of bed rest. Therefore, it is important to remember that there can be no talk of any kind of work, even routine, around the house!

In this case, antispasmodics are prescribed (NO-SHPA in tablets, CANDLES WITH PAPAVERIN), vitamins, MAGNE B6, sedatives (VALERIANA, PUSTYRNIK), perhaps the appointment of gestagenic drugs - DUFASTON, UTROZHESTAN. Dosages and treatment regimens are prescribed individually for each patient by a doctor.

If the expectant mother at home or at work feels characteristic pulling pains in the lower abdomen, and there is no way to contact the attending doctor, you need to drink NO-SHPU at a dosage of 0.04-0.08 g, you can enter rectally a CANDLE WITH PAPAVERIN and take 2 VALERIANA tablets ...

If the expectant mother is at risk, bleeding has appeared,
various pains in the lower abdomen - immediate hospitalization is required. Inpatient treatment will depend on the duration of the pregnancy and the clinical picture.

In the 1st trimester, intramuscular injections of PAPAVERIN, NO-SHPA, PROGESTERONE, vitamins, sedatives (sedatives), UTROZHESTAN or DUFASTON are usually prescribed. These drugs have a different mechanism of action, but the result of taking them is the same - relaxation of the uterine muscles. In the case of bleeding, it is necessary to prescribe hemostatic (hemostatic) drugs - SODIUM ETHAMSILATE, DICINON, TRANEXAM.

After 16 weeks, the arsenal of drugs for reducing the tone of the uterus expands, and, at the same time, there is no need to use hormonal drugs. At this time, they usually begin to be gradually canceled, in the absence of indications for a longer admission.

Additionally, physiotherapeutic treatment can be prescribed to help relax the uterine muscles. These methods include:

Endonasal galvanization is the use with a therapeutic purpose of a continuous direct current of low strength and low voltage, supplied to the body by contact through electrodes.

Electrophoresis with magnesia is the effect on the body of a direct current and particles of a medicinal substance, magnesia sulfate, introduced through the skin or mucous membranes.

Electroanalgesia - pain relief using weak electrical discharges through the skin, which block the conduction of pain impulses to the brain.

Electro-relaxation of the uterus - the effect on the neuromuscular apparatus of the uterus with an alternating sinusoidal current to suppress the contractile activity of this organ. With the threat of termination of pregnancy from 15–16 weeks, electro relaxation is a preferable method over other methods of therapy for the threat of termination, since there is no side effect of medications, and the effect occurs already during the procedure.

Electro-relaxation of the uterus can be used to provide emergency care in the event of a threatened abortion.

In the 2nd and 3rd trimester, intravenous drip administration of GINIPRAL, SULFURIC MAGNESIUM is possible.

Also shown are injections of antispasmodics - PAPAVERIN, NO-SHPA. The recommended drugs are calcium channel blockers (NIFEDIPIN, CORINFAR). These drugs block calcium channels in the myometrium, calcium is not transported, while the muscle cannot contract and relaxes.
To enhance the antispasmodic effect, add tablet forms of drugs that reduce the tone of the uterus - GINIPRAL, NO-SHPU in tablets, as well as CANDLES WITH PAPAVERIN.

Be sure to include vitamins in the treatment regimen: in injectable form - intravenously, in tablet form in order to improve metabolic processes, normalize the activity of the central nervous system.

Sedatives are also prescribed in tablet form or in the form of tinctures. It is necessary to use drugs that improve uteroplacental blood circulation (KURANTIL, PENTOXIFILLIN, EURHILLIN, Trental), drugs that improve metabolic processes (ACTOVEGIN, COCARBOXYLASE, RIBOXIN, OROTAT POTASSIUM, PANTOPENATE CALCIUM antipyretic drugs, LYOXYNATE antibiotics) to a lack of oxygen - INSTENON, PIRACETS), hepatoprotectors (substances that improve liver function - HOPHITOL, ESSENTIALE).

The increased tone of the muscles of the uterus is not a reason for emotions, but for a more attentive attitude towards oneself. Therefore, if the doctor diagnosed the expectant mother with uterine hypertonicity, she needs not to get upset, but just pay a little more attention to herself and her condition and listen to the advice of the attending physician.

Today in the article you can find out what it means: the uterus is in good shape? Women hear this diagnosis quite often, but why is it dangerous? What to do in this case?

To begin with, let's deal with the concept of “toned uterus”. What does it mean? From doctors you can hear another name for the diagnosis - uterine hypertonicity. It most commonly occurs during early pregnancy. As you know, during childbirth, the uterus contracts, helping the baby to be born. But in some cases, these muscle contractions occur much earlier than expected.

What does increased uterine tone mean? Sometimes women feel a pulling pain in the abdomen or lower back. In other cases, the diagnosis is made by ultrasound examination. What does it mean - the uterus is toning, what are the reasons? There are an incredible number of them. After all, this female organ is able to respond not only to stretching (it occurs as a result of fetal growth), but also to nerve impulses. The latter include the conditions caused by:

  • excitement;
  • fear;
  • joy and so on.

Do not ignore the pain in the abdomen during pregnancy, immediately seek the help of a specialist. He will prescribe adequate treatment that can save the baby's life. The consequences can be the most dire, up to and including termination of pregnancy.

Uterus before childbirth

First, let's talk about why the uterus is in good shape before giving birth. What does this diagnosis mean just before the baby is born? Let's start with the features of this stage:

  • reaching the maximum size of the uterus;
  • with the correct presentation of the baby, the mother's belly has the correct oval shape;
  • just before childbirth, the belly drops.

Is hypertonia always observed before childbirth? It is worth remembering that just before the contractions, you can observe the uterus in good shape. What does it mean? Before childbirth, some changes occur in a woman's body, and hypertonicity is a normal reaction of the body, indicating that labor has begun. During this period, the placenta and pituitary gland produce hormones that can strengthen the muscular structure of the uterus. This is necessary to prepare for the strongest tension in order to expel the fetus. Hypertonicity in the forty-first week is quite normal, the body signals to us that labor activity has begun, and soon mom will be able to hug her long-awaited baby.

What is uterine tone?

But what does the uterus mean during pregnancy before the intended birth? To begin with, we are talking about the smooth muscle genital organ, which consists of three layers:

  • perimetry;
  • myometrium;
  • endometrium.

The myometrium is the muscular membrane, which is characterized by contraction. As a result of this, the concept of "uterine tone" arises. Her normal state is relaxation. If the muscles contract, then the myometrium contracts, forming pressure in the uterine cavity.

The most dangerous is hypertonicity in the first trimester, as it can cause fetal death.

The danger

In this section, you will learn what an increased uterine tone during pregnancy means, and what are the consequences of its occurrence. In case of hypertonicity, you need to urgently consult a doctor, because the consequences include:

  • spontaneous miscarriage (the most dangerous consequence that can be avoided if you seek medical help in a timely manner);
  • the tone of the uterus can negatively affect the health of the baby (a violation of the blood supply that occurs as a result of this disease can lead to oxygen starvation of the baby).

You should not stay idle, because prolonged hypertonicity can lead to premature birth, if it occurs in late pregnancy. With this disease, children are often born weak and small, because the clamped umbilical cord does not deliver the required amount of oxygen and nutrients to the child.

Cause

We figured out the question, what does the uterus mean during pregnancy? Now we propose to talk in more detail about the causes of this unwanted and dangerous disease.

Natural causes include:

  • strong laughter;
  • sneezing;
  • orgasm;
  • doing any physical work, and so on.

In addition, there are pathological factors that increase the tone of the uterus, which means their correct treatment. Now we will figure it out. Among them:

  1. Deficiency of progesterone, a hormone that prepares the endometrium for implantation. He must relax the muscles of the uterus and maintain a normal tone.
  2. The production of male hormones in large quantities. This is due to hormonal disruption, in which case the uterus is actively contracting to reject the embryo.
  3. Saddle and two-horned uterus. These anomalies are congenital and are quite common. Some women find out about this feature only during the first ultrasound scan during pregnancy.
  4. Severe toxicosis. This can be explained quite simply: during vomiting, all the muscles of the abdominal cavity contract. Toxicosis can cause hypertension only if it causes weight loss and constant poor health in a woman. In this case, urgent hospitalization is required in order to stabilize the woman's condition. If the expectant mother eats well, gains weight, and toxicosis does not bother her much, then hospitalization is not needed.
  5. Rhesus conflict. This problem is relevant for women with a negative Rh factor, if the dad has a positive one. There is a chance of conceiving a child with a positive Rh, like a father. Then the mother's body perceives the fetus as a foreign body, the uterus begins to actively contract, which prevents the ovum from implanting in its cavity. As a rule, the first pregnancy goes well, as the female body produces a small amount of antibodies. With subsequent pregnancies, everything is much more complicated.
  6. Diseases of the female reproductive system. This problem is accompanied by a host of additional symptoms, including pain, discharge, itching, and so on.
  7. Distension of the uterus (large or giant fetus, twins, polyhydramnios).
  8. Tumors in the uterine cavity.
  9. Stress.
  10. The transverse position of the fetus at the end of pregnancy.
  11. Diseases of the gastrointestinal tract, since with increased gas production and impaired intestinal motility, the uterus is strongly strained.

As you can see, there are many reasons. That is why you should not self-medicate, consult a specialist. He, in turn, must deal with the cause of hypertension, only after that he will prescribe the correct treatment for you.

Symptoms

You have learned what is dangerous and what the tone of the uterus means during pregnancy. The symptoms of this ailment are our next question, which we will try to deal with right now.

A woman can independently, without the help of a doctor, determine that her uterus is in good shape. The first signal is a pulling pain in the lower abdomen, it is similar to those that a woman experiences before menstruation. In addition, discomfort in the lumbar region may be felt. Perhaps the manifestation of pain that women experience at the time of the contraction. In this case, the uterus can be "stone".

There is also the following way to independently determine tactilely whether the uterus is in good shape. Lie on your back, try to relax as much as possible. Feel the stomach, if your assumptions are wrong, then it will be soft, otherwise it will resemble a thigh in elasticity.

If hypertonicity occurs in the second or third trimester, then you can notice:

  • contraction of the abdomen (determined visually);
  • bloody discharge from the genital tract.

In addition, the doctor may notice during examination a shortening of the cervix and thickening of the anterior wall.

First trimester

Now we will talk about the danger of hypertonicity in the first trimester of pregnancy. It is important to note that in the first weeks (from the fourth to the twelfth) a woman should not experience any unpleasant sensations. This is due to the fact that it is during this period that the probability of termination of pregnancy is high. Ideally, if the doctor issues the following verdict: uterine tone n. What does "n" mean? In medicine, it is customary to denote a good state that does not threaten anything.

Any problem should be consulted with a doctor. If the situation is not serious, then you will be advised to take the No-shpy course on drink. Problems of a hormonal nature are solved by taking the drugs "Duphaston" and "Utrozhestan". If other serious violations are identified, then urgent hospitalization is necessary.

When you feel aching pain in the first trimester of pregnancy, you need to drink "No-shpu" and rest a little. Try to calm down, drive all negative thoughts away. If the pain persists, then call an ambulance. In the hospital, as a rule, progesterone injections are prescribed. When bleeding is used "Ditsinon", "Tranexam" and other hemostatic agents.

2 trimester

The tone of the uterus during pregnancy during this period is a fairly frequent phenomenon. The thing is that the body begins to train, to prepare itself for childbirth. Now the woman's body is undergoing hormonal changes, starting from the twentieth week of pregnancy, you can periodically observe small painless contractions.

If the situation is serious (pain, bleeding, and so on), then a doctor's supervision is necessary. Seek help from a medical facility urgently. Hypertonia in the second trimester can lead to fetal hypoxia. The doctor who leads your pregnancy must be sure to play it safe and prescribe the drug "Magne B6". He is able to maintain a normal state.

If you are indicated for hospitalization, then in the second trimester of pregnancy, doctors can instantly remove the tone of the uterus using the following means:

  • electropharesis with magnesia;
  • endonasal galvanization;
  • eletrorelaxation of the uterus.

These procedures are the safest when there is a threat of miscarriage. Since no drugs are taken, and the effect can be seen already during the procedure. In addition, droppers are possible:

  • Ginipralol;
  • sulphate magnesia.

Drugs are prescribed that partially block the calcium tubules. Due to this, the uterus cannot contract, the muscles relax. These drugs include:

  • "Nifedipine";
  • Corinfar.

Additionally, doctors prescribe special vitamin complexes for pregnant women.

Third trimester

What does the increased tone of the uterus mean in the third trimester of pregnancy? These manifestations are already quite frequent and strong. This is due to the fact that the baby can provoke himself, since he gets cramped in his mother's stomach, and he rests on his legs and arms.

It is very difficult for doctors in this period to diagnose hypertonicity, as it can be preparatory contractions. Of course, gynecologists are reinsured by sending pregnant women to the CTG procedure as often as possible.

It is also important to note that in Europe, hypertonicity does not cause such a violent reaction in doctors. They believe that this is a normal condition of a pregnant woman. However, inpatient treatment is prescribed to women for whom this symptom causes a lot of discomfort or there is a possibility of miscarriage.

  • "Courantil";
  • "Euphyllin";
  • Trental.

They are necessary for hypertonicity, as they contribute to the normalization of blood circulation in the uterus. As a result of treatment, the tone returns to normal, the baby receives the required amount of oxygen and nutrients.

Hypertonicity should not cause panic in the mother, it is a signal that more attention should be paid to your health. Also relevant drugs in this case are:

  • lipoic acid;
  • Actovegin;
  • Riboxin;
  • Calcium Pantothenate;
  • Essentiale;
  • "Hofitol".

Diagnostics

We have already said enough about what the increased tone of the uterus means. Now let's talk a little about diagnostics. When contacting a medical institution, the doctor will advise:

  • examination of the abdomen;
  • examination in the gynecological chair;
  • ultrasound procedure;

With palpation and examination on the gynecological chair, the doctor will be able to assess the condition of the uterus and cervix. With the help of ultrasound, you can determine: is the tone increased throughout the muscles of the uterus or in certain areas? Do not self-medicate, immediately contact qualified specialists. Now you are responsible not only for your health, but also for the health of your baby.

Treatment

How is a toned uterus treated? What does this mean: tension of the myometrium? With this diagnosis, a woman is individually selected therapy that helps to relax the muscle fibers (that is, the myometrium).

Depending on the degree of danger and the cause, therapy can be carried out at home or in a hospital. If you are allowed to be treated at home, then you should follow all the doctor's recommendations, including mandatory bed rest. As a rule, women cannot fully comply with it, because there is always work around the house. Doctors recommend inpatient treatment. The most common drugs for eliminating increased uterine tone are:

  • "No-shpa" or "Drotaverina hydrochloride";
  • Magne B6;
  • "Valerian";
  • "Motherwort";
  • "Novo-passit";
  • "Duphaston";
  • "Utrozhestan" and so on.

Hospitalization: Yes or No?

What does the increased tone of the uterus mean? You have learned how the treatment is carried out in the hospital too. Now let's say a few words about whether it is worth going to the hospital, or it is better to choose treatment at home.

With hypertonicity, it is very important to observe bed rest, which is almost impossible for a woman to do at home. After all, it is necessary to clean up, prepare food, and it is not always possible to shift these responsibilities onto other shoulders.

If an increased tone is found for a period of twenty-eight weeks or more, then hospitalization is important for a woman. Modern medicine is capable of leaving such a baby, he has a chance of survival. Earlier than this date - the chances are extremely small. Therapy is aimed at stopping labor.

By force, no one will send a woman to the hospital, the mother herself must understand that the life of the future baby depends on this. If the threat of miscarriage is high, then you should immediately go to the hospital for treatment.

Disposal at home

Now let's talk about how to remove the tone of the uterus during pregnancy at home. Before contacting a medical facility, a woman can try the following methods:

  • relax;
  • drink a pill "No-shpy";
  • perform special gymnastics.

Exercises will help in the last paragraph:

  • "Kitty" (up to fifteen repetitions);
  • relaxation of the muscles of the face (the chin is lowered to the chest, and the muscles of the face and neck are as relaxed as possible);
  • deep breathing through the mouth;
  • take a knee-elbow position, linger a little, then lie down and relax.

What does the uterus mean in pregnant women: prevention

  1. Calm the nervous system.
  2. Rejection of bad habits.
  3. Sparing work schedule.
  4. Healthy, full sleep.
  5. Compliance with diet and daily regimen.
  6. Listen to relaxing music.
  7. Avoid contact with sick people.

These tips will help you avoid many health problems of the future baby and mother.

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