Almost every pregnant woman is faced with a mysterious phrase - uterine tone. Doctors also call this condition hypertonicity.
Disputes about the tone do not fade away. Modern doctors believe that it is not worth treating and hospitalizing a pregnant woman with such a diagnosis, and doctors of the old school prefer to play it safe. In most cases, the tone of the uterus does not threaten the pregnant woman and the child, but exceptions occur 1.
The tone of the uterus - a side view
To begin with, it is important to understand what the uterus is and how it functions. It is worth imagining a hollow organ, similar in shape to a vessel, the walls of which are muscle tissue.
The body consists of three layers:
- Outer serosa.
- Internal mucous membrane.
- The central muscle tissue is the myometrium.
We recall from the school anatomy curriculum that the main task of muscles is contraction.
The myometrium is responsible for contractions, which is the main function of childbirth. In theory, during rest, the myometrium should not contract. As the fetus grows, the uterus gradually stretches, providing the fetus with proper comfort. If contractions are observed before the onset of labor at any stage of pregnancy, then they speak of uterine tone. An obstetrician or an ultrasound diagnostician, regardless of the condition of the pregnant woman, can make a diagnosis of hypertonicity 2.
Some doctors believe that short-term uterine contractions are quite common, and the unborn child is not threatened. In Western medicine, there is no concept of uterine tone at all, there is hypertonicity, which actually portends the onset of labor. Short-term uterine tone can be provoked by stress, sex, and even going to the gynecologist 1 .
The real danger of uterine tone
Any pregnant woman immediately understands when she has a prolonged uterine tone. If it is accompanied by general malaise, unusual discharge and other unusual symptoms, then you should immediately consult a doctor. In addition, you need to know the real threats of prolonged hypertonicity:
1. In the early stages of pregnancy (first trimester), hypertonicity can cause fetal death. Hypertonicity really poses a danger in the earliest period of pregnancy, when the embryo has not yet fixed on the walls inside the uterus.
2. In the later stages (second and third trimester), hypertonicity can provoke premature birth.
3. The tone of the uterus in a pregnant woman threatens the child with hypoxia, since the compressed uterus partially blocks access to oxygen and nutrients. The growth and development of the child is suspended.
4. Starting from week 32, regular uterine contractions (which, however, do not cause pain or severe discomfort) are the absolute norm. Thus, the uterus "trains" before childbirth. Nevertheless, regular medical supervision during this period is very important. In the event that, along with increased uterine activity, there is an "adverse" obstetric history (termination of pregnancy, complications of childbirth), it is important to treat any manifestations of increased uterine tone with great caution, and carefully evaluate each situation. 3
Causes of uterine tone
If symptoms of uterine tone occur during pregnancy, expectant mothers immediately ask the question: “what is the reason”? However, it is worth considering that the tone of the uterus is not an independent disease. Uterine tone or hypertonicity is a symptom of another disease or problems developing in the body during pregnancy, and there are a lot of possible problems 4.
The main task after diagnosing the tone of the uterus is to find the cause of the tone and the impact on this cause. In parallel, it is necessary to deal with the tone itself and prevent its protracted course.
It is almost impossible to list all the possible conditions of the body in which the tone of the uterus is formed. But the main ones are:
1. Stressful state. The most common cause of tone is the usual stress. Any experience of a pregnant woman is reflected in the tone of the uterus. That is why the tone of the uterus is so often diagnosed during examination by a gynecologist or during a routine examination in the ultrasound room. Unfortunately, not all doctors understand that such a condition is caused by stress, and after examination, everything quickly returns to normal.
2. Lack of pregnancy hormones, which is a hormonal disorder. The body is provided with a similar hormone by the remnants of the egg after fertilization. Progesterone relaxes the myometrium and allows the fetal egg with the future embryo to gain a foothold inside the uterus. The lack of progesterone provokes hypertonicity, the organ may begin to contract, preventing the fetal egg from attaching, which leads to the obvious and sad ending of pregnancy.
3. Inflammation and infection. Everyone knows that before pregnancy it is extremely important to heal all the "sores" and ailments. But this is not always possible, then such diseases can become the cause of uterine tone in a pregnant woman. However, in this case, hypertonicity is accompanied by symptoms characteristic of this disease, which facilitates diagnosis and further treatment.
4. Toxicosis. A common but unpleasant condition that accompanies pregnancy, especially its first half. Severe toxicosis causes vomiting and the urge to vomit, which in turn affect uterine contractions. In this case, funds are needed that reduce the symptoms of toxicosis.
5. Rhesus conflict. A different Rh factor in mother and father is always a risk for the unborn child. If an embryo develops in the womb that has inherited the Rh factor from the father, then the woman’s body will reject it with all its might, which ultimately results in prolonged hypertonicity.
6. Previous abortions. After an abortion, synechiae (unions) form on the walls of the uterus. Further pregnancy always proceeds with various threats, including uterine tone.
7. Problems with the intestines. Gas formation, disturbances in bowel contraction and the process of defecation has a physiological effect on the uterus, as does toxicosis.
8. Medicines. Taking medication during pregnancy is associated with risks. It is necessary to clearly know about all the side effects and contraindications of the drugs used. Self-administration harms a pregnant woman, an unborn child and can cause uterine tone.
9. Physical changes in the uterus. They can cause polyhydramnios, multiple pregnancy, or simply a large fetus and its sharp growth. The uterus, in turn, reacts with a tone of 5.
Symptoms and diagnosis of uterine tone during pregnancy
As a rule, a pregnant woman herself understands when she has a uterine tone, such sensations are hard to confuse. Depending on the period, the symptoms of uterine tone in a pregnant woman may vary slightly:
- 1 trimester - back pain and pulling pain below the abdomen.
- 2nd trimester - the symptoms described above are accompanied by a feeling of heaviness and tension in the abdomen.
- 3rd trimester - the tone can not only be felt, but also felt, the stomach becomes as dense as possible, its usual shape may change 5.
It happens that a pregnant woman ignores such symptoms or gets used to them, then the tone of the uterus is easily detected on an ultrasound scan or at a gynecologist's appointment. For a more accurate diagnosis, additional tools are used, such as a tonometer.
But as already mentioned, it is important not only to diagnose the tone itself, but to determine the cause of the appearance. Sometimes outpatient monitoring of a pregnant woman is not enough, and hospitalization is required.
To treat or not to treat uterine tone during pregnancy?
An obvious question with an unobvious answer. It all depends on certain factors, such as the duration of pregnancy, the frequency and duration of the tone, and most importantly, the cause that causes this tone. If the tone threatens the unborn child, then naturally it must be treated, but only a gynecologist can make such a decision.
If the tone is accompanied by pronounced pain or unusual discharge, you should immediately consult a doctor.
With hospitalization and severe hypertension, doctors will try to cope with it promptly. For this, electrophoresis with magnesia and other types of electrical stimulation are used. With severe toxicosis, provoking hypertonicity, endonasal galvanization is used.
If the doctor determines that the expectant mother is able to cope with the tone of the uterus herself, outpatient treatment is prescribed. Most often, doctors prescribe mild sedatives and antispasmodics. With a lack of progesterone, hormonal agents are prescribed. A naturally pregnant woman is recommended complete rest, bed rest and the absence of any stressful situations 5 .
The two most important tips, which are also the basis of tone prevention:
- Before pregnancy, it is important to cure all diseases and give up all bad habits, and during gestation, monitor your health and respond to any changes in the body.
- "Calm, only calm" is the basis of life philosophy for expectant mothers. The absence of stress is the key to successful childbirth.
In addition, it is worth getting used to a healthy diet and the normalization of water balance. It is necessary to abandon any heavy physical exertion. Wear loose clothing and go outside more often. During pregnancy, try to lead a healthy lifestyle, because the health of the unborn child depends on it.
- 1. Berezovskaya E. 9 months of happiness. Desktop guide for pregnant women / E.P. Berezovskaya. – M.: Eksmo, 2015. – 576 p.
- 2. Gasparyan N. Modern ideas about the mechanism of regulation of the contractile activity of the uterus / N. D. Gasparyan, E. N. Kareva // Russian Bulletin of the Obstetrician-Gynecologist. - 2003. - No. 2 (3). – 21-27 p.
- 3. Bakhmach V. Changes in the uterus and cervix during pregnancy and on the eve of childbirth / V. O. Bakhmach [et al.] // Saratov Journal of Medical Scientific Research. - 2011. - No. 2 (7). – 396-400 s.
- 4. Enikeeva G. Prevention of violations of the contractile activity of the uterus in childbirth and the early postpartum period / GK Enikeeva [et al.]// Tez. I All-Russian congress of obstetricians-gynecologists and pediatricians. - Chelyabinsk, 1992. - 49-50 p.
- 5. Sidorova I. Guide to obstetrics / I. S. Sidorova, V. I. Kulakov, I. O. Makarov. – M.: Medicine, 2006. – 848 p.
Throughout life, a person is in good shape. This is the so-called activity. It can be high or low. Today's article will tell you about what tone is. It turns out that this activity is not good in all cases. Sometimes its reduction is required, for example, during pregnancy.
What is tone?
Tone is a long and persistent excitation of muscles, tissues and nerve receptors of the human body. You can often hear such a thing as "skin tone". What does it mean? When the skin is in good shape, we can say that it is in perfect condition. The dermis is hydrated, it is elastic and full of vitality. Outwardly, this is manifested by a beautiful color, smooth surface, and the absence of any defects.
What is the tone of the human body? This is the ability to maintain a certain posture and position in space. A person always strives to increase his tone. The concept is determined by a combination of characteristics: mood, muscle condition, sanity, and so on.
improve tone
What can you do to improve your tone? If we are talking about the body, then you can activate the muscles and the work of all organs with the help of physical exercises. Athletes visit gyms in order to improve their tone. During physical exertion, blood circulation improves (the tone of the heart muscle and blood vessels), the work of the muscles is activated), and so on.
You can also increase the tone with the help of food. Now on many food products it is indicated that they increase tone. Separately, we can say about energy drinks. When they are used, the work of the whole organism is activated. But doctors say that this way to improve tone is not the most correct. Women are always looking to improve their skin condition. Many cosmetics indicate that they help to increase tone.
Uterine tone
Separately, the tone of the reproductive organ is considered. During the entire menstrual cycle, it changes, it depends on the production of hormones. During menstruation, the uterine organ is actively reduced (high tone). Some women experience pain during this.
In the middle of the cycle, the uterus is in normal tone. If pregnancy occurs, then certain hormones are produced that relax the muscular organ. This is necessary for normal attachment and further development of the embryo.
High norm or pathology
If the uterus is constantly in tension, then this condition is not normal. In early pregnancy, the corpus luteum and adrenal glands secrete the hormone progesterone. This substance relaxes the uterus. If it is not enough, then there is a tone. One or all of the walls of the reproductive organ thicken and tighten, contraction occurs. If this condition is not corrected in time, then detachment of the membranes will begin. A hematoma forms between the wall of the uterus and the embryo, the tissues are not fully nourished, and blood circulation is disturbed. In the future, a miscarriage or spontaneous abortion will occur.
At long gestation periods, tone can lead to premature birth. Therefore, it is necessary to inform the gynecologist about it. Note that at the time of contractions, the uterus is always in a tense state. This is fine. In some cases, reduced tone during delivery requires stimulation. For this, obstetricians and gynecologists use drugs (for example, Oxytocin). The drug contributes to the contraction of the uterus and the speedy opening of the birth canal. Every expectant mother needs to know how the tone manifests itself at different periods of gestation.
Symptoms and signs
What are the symptoms of tonus during pregnancy? Much depends on the gestational age. In the first weeks, the tension of the uterus can not be felt at all. But the higher the tone, the more noticeable it is. In this case, the woman experiences pulling pains in the lower abdomen. Sometimes they can give to the lower back. With a high tone, bloody discharge from the vagina can be observed.
For longer periods of pregnancy, the symptoms of tone look a little different. There is still pain in the abdomen. Only now it is spreading throughout the uterus. The expectant mother may notice abdominal tension. The abdominal wall becomes hard and seems to shrink. During increased tone, fetal movements can cause discomfort. In addition, the child during this period is especially active, thereby trying to get more oxygen.
Constant increased tone during pregnancy (the symptoms you already know) can have consequences: lack of nutrition for the baby and intrauterine growth retardation. Therefore, in the presence of the described signs, it is necessary to consult a gynecologist. The doctor will prescribe drugs that improve blood circulation and therapy aimed at reducing uterine tone.
Diagnosis of the tense state of the uterus
What is tone and what symptoms does it have for women - described above. But how can a specialist determine this condition? Diagnosis is quite simple. The doctor may note the tension of the uterus during a routine gynecological examination. It is worth noting that in some cases the examination itself provokes tension in the reproductive organ.
You can determine the increased tone with the help of ultrasound. On the monitor, the doctor will see a thickening of the uterine walls, which indicates their tension. In early pregnancy, the tone of the uterus is reported by the deformation of the fetal egg. In the third trimester, pathology can be detected during cardiotocography (CTG).
Features of treatment: drugs
In order for the tone to be reduced with the threat of abortion, it is necessary to conduct appropriate therapy. First you need to find out what caused the contractions of the uterus. This may be physical activity, sexual contact, nervous tension, a hot bath, eating certain foods or taking medications. After that, the cause of the pathology is excluded. Next, conservative treatment is carried out, the scheme of which directly depends on the duration of pregnancy.
In the first trimester, women are prescribed progesterone-based drugs (Dufaston, Iprozhin). Antispasmodics are also prescribed (tablets or injections "Noshpa" and "Drotaverin", suppositories "Papaverin"). Be sure to use sedatives ("Valerian", "Motherwort"). In the later stages, hormonal drugs are not prescribed. Instead, they use "Ginipral", "Partusisten". Also, expectant mothers can be prescribed a medication containing magnesium and B vitamins. These drugs have a positive effect on the muscles and nervous system.
It must be said that treatment is indicated only with a constant tone of the uterus and a negative effect on the fetus. In late pregnancy, tone may periodically appear and pass on its own. If this condition does not cause any discomfort to a woman, then it is not necessary to correct it. For more detailed information, it is better to check with your gynecologist, since a lot depends on the individual characteristics of the body.
Prevention of hypertension during pregnancy
Has controversial opinions about the concept of "tone". Reviews of doctors say that this is a normal condition. But during pregnancy, it is better to reduce the contractility of the uterus and not provoke its tension. For the prevention of tone, observe the following rules:
- avoid physical activity;
- refuse sexual intercourse (according to indications);
- stick to proper nutrition;
- monitor the regularity of the chair, avoid constipation;
- do not wear tight clothing (especially in the beginning and later);
- do not take any medications on your own (even conventional painkillers);
- rest and walk more;
- get positive emotions and avoid stressful situations.
If you sometimes experience tone, then tell your doctor about it. Perhaps, depending on your characteristics, the specialist will give individual recommendations.
Summarize
Tone - is it good or bad? It is impossible to answer this question right away. Everything depends on the situation. Skin tone allows a person to look good and well-groomed. If it is lowered, then the body becomes flabby and ugly.
The tone of the uterus during pregnancy, on the contrary, can be dangerous. But it does not always require treatment and the use of medications. It should be remembered that each case is individual.
In women after 35 years, increased tone is much more common due to past illnesses and abortions. The causes of hypertonicity during pregnancy also sometimes lie in strong gas formation and altered intestinal motility.
Complications during pregnancy
These may include placenta previa, Rhesus conflict and severe toxicosis. Therefore, hypertonicity during pregnancy is not eliminated by itself, but the causes and the local focus of the problem are searched for, after which they are treated.
Preventive actions
If you successfully read this article before you received a positive test result, you can prevent possible hypertension or start treatment in advance.
What can be done to avoid suffering from hypertension later? For starters, go to the doctor for an examination and determine the possible risks. Most likely, he will advise:
- check for infections in the pelvic organs and, if present, begin to treat them;
- will give a referral to a gynecologist, endocrinologist;
- start taking care of your diet, healthy habits, the rhythm of life;
- You may need to consult a psychologist (under stressful conditions).
During pregnancy, you need to reduce the amount of psychological and physical stress.
How to help the body cope with the problem?
Successful treatment will largely depend on you. The doctor will give you the right recommendations and prescribe therapy, but you are the person who is responsible for your and your baby's health.
- Be less nervous. If a spasm overtakes you, try to breathe deeply, calmly and think about neutral and good things as much as possible.
- No physical activity. You will even have to walk less.
- We need more fresh air - in sunny weather, sit on a bench, go out onto the balcony, in cloudy weather - ventilate the room.
- You can not stay on your feet for a long time, ride in public transport.
- Take less baths and showers.
- Sexual life will also have to be postponed until the birth of the child.
- No housework.
To unload the spine and distribute the burden, doctors prescribe to wear a prenatal bandage.
Uterus Relaxation Exercises
You can try to do a few things yourself. Sit in a comfortable position for you. Tilt your head slightly, relax your neck and face. Breathe as calmly and deeply as possible.
There is an effective exercise "Kitty" - the deflection of the spine in a position on all fours. Get down on all fours and bend for a while, while raising your head up. Now arch your back with a hump and tilt your head. Do a few approaches, then take a lying position on the couch and rest for about an hour.
What is usually prescribed?
If doctors have already managed to determine the hypertonicity of the uterus during pregnancy and the situation is serious, then most likely they will prescribe you bed rest. It is rarely allowed to be carried out at home, it is usually provided in a hospital.
If there is such an opportunity, then you should not refuse it. No matter how good it is at home, you may be drawn to equip your life or start cleaning, and in a hospital, nurses will look after and monitor you. You will be treated with control of heart rate, blood sugar and pressure.
- Sedatives - tincture of motherwort or valerian. They do not harm the body of the expectant mother. This is necessary because even the presence of a disease is a stressful situation and exacerbates muscle tension.
- Antispasmodics, for example, No-shpu (in tablets or intramuscularly), Papaverine.
- If hypertonicity appeared during the first weeks of pregnancy due to problems with the hormonal background and progesterone deficiency, they should be treated accordingly - with Dufaston and Utrozhestan preparations (do not be afraid of hormonal drugs, the harm from modern drugs is much less than before).
- A solution of magnesium sulfate, administered with a dropper.
- Only from the second half of pregnancy can Partusisten, Brikanil or Ginipral be prescribed. But they have quite a long list of side effects.
Uterine hypertonicity: treatment, symptoms, causes, how to get rid of, what is dangerous
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Every expectant mother will certainly meet such terms as increased uterine tone, uterine hypertonicity, uterus in good shape.
Let's look at what uterine hypertonicity means, what are the reasons for its appearance and how to deal with them.
How is uterine hypertonicity manifested?
Everyone knows that the uterus is a hollow muscular organ, consisting of various layers:
- perimetry (serous membrane), enveloping the body of the uterus from the outside;
- myometrium - the most powerful, muscular uterine layer;
- endometrium - mucous, inner membrane.
As you know, muscles contract.
It is the contraction of muscle tissue that tells us about the state of tension (tonus) of the uterus. During pregnancy, the uterine muscles relax and then they talk about the normal state, normotonus. When excited, the muscle layer of the uterus contracts, muscle fibers react to internal and external stimuli, intrauterine pressure increases, and then we can talk about hypertonicity (increased tone) of the uterus.
The uterus during pregnancy grows, increasing in size, and by the time of delivery it already occupies all the free space in the abdominal cavity. The growth of the uterus occurs due to an increase in the volume and mass of muscle fibers. For example, one individual muscle fiber becomes five times thicker and twelve times longer!
Uterine tissues are saturated with calcium, glycogen and trace elements. The synthesis of actomyosin is growing, there is an increase in the number of enzymes responsible for contractions of muscle tissue. So the uterus is prepared for the process of future childbirth.
Hypertonicity of the uterus in pregnant women is of great interest to specialists: they need to know how to identify this pathology and how to get rid of it.
The tone is able to rise throughout the entire muscle layer or manifest itself locally, in a certain area. Local hypertonicity of the uterine wall can be detected during an objective, instrumental examination of a pregnant woman.
With local changes in tone, a woman may have complaints. This becomes especially noticeable when local hypertonicity of the anterior wall of the uterus is manifested, which is a characteristic sign of a complication during pregnancy.
Be sure to pay attention to the following signs of uterine hypertonicity:
- drawing pains in the lower back;
- pain like menstruation;
- heaviness and tension in the lower abdomen.
Hypertonicity of the uterus during pregnancy, although it cannot be called a disease, nevertheless, it requires special attention and attention. The treatment is not aimed at combating the tone, but at the causes that cause it, since this indicates trouble in the body of the expectant mother.
What to do with moderate hypertonicity of the uterine wall in the early stages? In this case, a pregnant woman is prescribed a home regimen with getting rid of emotional and physical stress. Perhaps the appointment of sedatives, vitamin and mineral complexes, antispasmodics.
Local hypertonicity of the posterior wall of the uterus requires the following appointments:
- papaverine in candles;
Hypertension of the uterus during pregnancy
It is customary to call hypertonicity pulling pains in the appendages that appear in a pregnant woman before the expected date of the onset of labor. Painful sensations resemble pain during menstruation, and are also similar to the onset of labor.
Hypertonicity is not a disease, therefore it is not treated - in order to normalize the condition, they are trying to establish the causes of its occurrence and eliminate them. The greatest danger of uterine hypertonicity during pregnancy is the threat of spontaneous miscarriage.
Causes of uterine hypertonicity
Spontaneous abortion occurs just because of the premature onset of uterine contraction (uterine hypertonicity). There can be many reasons for this condition.
- hormonal and endocrine disorders (insufficient function of the ovaries or placenta, disruption of the adrenal glands, which leads to an excess of male sex hormones);
- inflammatory diseases of the pelvic organs, infectious diseases in the pelvic organs and in the fetal egg;
- disruption of the immune system;
- anomalies and malformations of the uterus, underdeveloped genitals of a woman;
- tumor processes;
- isthmic-cervical insufficiency (the cervix is not able to withstand the increasing load, which is why it opens long before the expected date of birth);
- somatic diseases (diseases of the kidneys, heart, etc.);
- depression and anxiety states (self-doubt, internal tension, hysteria, etc.).
Consequences of uterine hypertonicity
If uterine hypertonicity during pregnancy occurs in the first trimester, this can lead to the death of the fetal egg, spontaneous miscarriage or non-developing pregnancy. In the second and third trimesters, this phenomenon can provoke spontaneous abortion and premature birth, while contributing to the development of isthmic-cervical insufficiency.
The fetus also suffers from uterine hypertonicity in the mother: the blood supply to the placenta worsens, which threatens the child with intrauterine hypoxia, that is, oxygen starvation, as a result of which growth and development are retarded. When the uterus contracts, the placenta does not shrink, but exfoliates, which also increases the risk of spontaneous abortion and the birth of a premature baby in the last weeks of pregnancy.
Treatment of uterine hypertonicity during pregnancy
Despite everything, hypertonicity in most cases is not capable of bringing a serious threat to either the child or the mother, therefore, treatment is not required. Nevertheless, a pregnant woman should be constantly under the supervision of a doctor, and also inform him of unusual changes in her state of health.
If the symptoms of uterine hypertonicity during pregnancy do not return to normal, the lower back continues to pull, there are pains in the lower abdomen and unusual vaginal discharge, you need to see a doctor as soon as possible. It is also very important to monitor the behavior of the baby in the stomach - maybe he is too restless or unusually quiet.
Be sure to see a doctor if irregular cramping pains occur with hypertonicity. The specialist will be able to determine whether there is a threat of termination of pregnancy: he will listen to the fetal heartbeat, refer him to an ultrasound scan and, if necessary, prescribe treatment with safe drugs, the main purpose of which is to relax the muscles of the uterus.
If a threat of miscarriage is detected, a woman can be sent to a hospital to maintain her pregnancy. It is better not to give up this, so as not to harm the child, because with hypertonicity, the blood vessels of the placenta are compressed, the baby suffers from a lack of oxygen and important nutrients.
Hypertonicity of the uterus during pregnancy in the second trimester can be accompanied not only by painful contractions of the uterus, but also by shortening of the cervix and a tendency to open it. In this case, to relieve the tone, you need treatment in a hospital and strict bed rest.
If the tone continues to develop in the third trimester, then in combination with a change in the hormonal background and preparation of the cervix for childbirth, painless contractions can gradually develop into labor.
Timely treatment of hypertension almost always allows you to extend the pregnancy as long as possible, at least up to 34-35 weeks. At this time, the baby's lungs have already formed - in case of premature birth, he will be able to breathe on his own.
Prevention of uterine hypertonicity
Experts say that the prevention of uterine hypertonicity should be dealt with even before conception and planned pregnancy. To do this, it is necessary to undergo an examination to identify infectious diseases of the pelvic organs. It is also recommended to consult with a gynecologist-endocrinologist and a psychotherapist (if necessary).
During pregnancy, the expectant mother must observe a sparing regimen, reduce not only physical, but also mental stress, and also master relaxation techniques, which are very necessary during this period. The slightest signs of an increase in the tone of the uterus are a reason to consult a doctor.
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Hypertonicity: what is it?
Hypertonicity manifests itself as pulling pains in the appendages
If we speak in a simple, understandable language, avoiding complex medical terms, then uterine hypertonicity is pulling pain in the appendages that appear before the calculated date for the onset of labor. In order to understand what these symptoms look like, it is enough to remember the pains in the period immediately before or during menstruation, and for those women who have already given birth, these pains can be compared with the sensations during contractions.
Hypertonicity is not a disease, but this does not mean that there are no reasons to see a doctor. The increased tone indicates some troubles, which, unfortunately, take place in the body of the expectant mother.
Causes, or what the increased tone indicates
Hypertonicity is a signal indicating the need for a visit to the doctor. It is very difficult to establish the causes of increased tone, because there are too many of them. A list of 10 reasons will now be given, but this is only part of a rather long list. So, the causes of hypertonicity include:
- inflammatory diseases of the small pelvis;
- infectious diseases in the fetal egg, as well as in the pelvic organs;
- dysfunction in the immune system;
- hormonal disorders, including endocrine disorders.
An example is insufficient function of the placenta, ovaries, malfunction of the adrenal glands, which inevitably leads to an excess of male sex hormones;
- previous pregnancies, cases of artificial termination of pregnancy;
- tumor formations (myomas);
- pathology of the uterus (anomalies and defects);
- insufficient development of the female genital organs (from a medical point of view, this is genital infantilism);
- diseases that are not directly related to the female reproductive system, that is, somatic. These diseases include disorders of the kidneys, heart and other organs;
- depression, which outwardly manifests itself as uncertainty in decisions, mood swings, nervousness, hysteria, tension, etc.
In case of inaction
Increased uterine tone may indicate serious illness. And this is the first reason for the impossibility of inaction. The second reason is that hypertonicity itself, despite the fact that it is not a disease, can lead to serious consequences.
The consequences of inaction are reflected in the fetus
An increased tone in the first trimester can lead to the death of the fetal egg or to an undeveloped pregnancy. Spontaneous abortion is also possible. If we talk about the second and third trimesters, then an increased tone can lead to late spontaneous abortion, as well as premature birth, which contributes to the formation of isthmic-cervical insufficiency (the cervix, due to an ever-increasing load, cannot withstand and, as a result, opens long before due date).
Other serious consequences are also possible. Increased tone entails impaired blood supply to the placenta, which consistently and often inevitably leads to intrauterine hypoxia - oxygen starvation. In addition, hypertonicity entails a delay in the growth and development of the fetus.
So, we have identified the symptoms and causes, the consequences too, now we should move on to treatment. But in order to determine a specific direction of treatment, it is always important to conduct a diagnosis.
Diagnostic studies
There are several different ways to diagnose uterine hypertonicity. First of all, this is a routine gynecological examination. Indeed, often hypertonicity can be detected by a gynecologist even during a routine examination. However, another method of diagnosis is more common - ultrasound. During an ultrasound examination of the uterus, the state of its muscles is shown. So, ultrasound makes it possible to detect some pathologies, for example, the tone of the uterus on the anterior or posterior wall of I and II degrees. How is this possible? The reason is that the tone of the walls of the uterus is outwardly expressed in a change in their shape.
Reference: The degree of tone is an indicator that depends on which of the walls of the uterus the fetus is attached to.
In addition to ultrasound, there are other diagnostic methods, the implementation of which becomes real due to the presence of special devices that measure specifically the tone of the uterus; however, these devices are not widely used, since, as a rule, it is not difficult to identify hypertonicity. Much more difficulties arise later, when it is necessary to determine the true cause of hypertonicity.
And now, after the diagnosis, treatment is prescribed.
How is hypertension treated?
What should be done after it has been established that the uterus is in good shape? First of all, it is important to listen to the advice of a doctor. He will establish what exactly caused the tone and how strong it is. If it is determined that there is no serious risk, then the treatment of tone will be carried out on an outpatient basis.
In such cases, the doctor, as a rule, gives the following recommendations:
- compliance with bed rest;
- taking antispasmodics (usually papaverine or no-shpa);
- appointment of magnesium B6;
- taking sodalite drugs (in particular, motherwort).
Medications and bed rest
It should be noted that all of these funds are aimed solely at removing the tone of the uterus during pregnancy. At the same time, other medications are prescribed, the action of which is designed to eliminate the cause that caused the tone.
What drugs are we talking about? It all depends on the specific reason. For example, in cases where hypertonicity is caused by a lack of progesterone, drugs containing it are prescribed. When a tone appears against the background of an excessive content of male hormones, treatment involves the appointment of their antipodes.
Treatment of hypertonicity in toxicosis is aimed primarily at alleviating the condition of a woman. If the cause of the tone lies in problems with the intestines, then the primary goal is to reduce gas formation.
Peculiar treatment and in the event that there is a Rhesus conflict. Their features are also observed when other causes are eliminated.
If the treatment for a long time does not bring the desired result, or there is a complicated situation, then, alas, there is a need for hospitalization and subsequent inpatient treatment. The fact is that often women do not comply with the bed rest prescribed for them, because they are constantly distracted by household chores: this is cleaning, washing, cooking, and much more. And in a hospital, a woman will not have the opportunity to violate the regime. Moreover, only in the hospital is it possible to ensure constant monitoring of the general condition of the mother and child. Finally, in a hospital, doctors can quickly detect an increase in tone and bring it down to prevent the possibility of premature birth.
| 05.09.2014 08:00 |
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The uterus is a hollow muscular organ designed for the development and bearing of the fetus. For nine months, she is a warm and cozy home for the baby. Stretching and increasing in size dozens of times during pregnancy, the uterus demonstrates excellent elasticity, which no other organ possesses. Pregnancy ends with the birth of a child, in which the uterus, which has a high contractility, is directly involved. As a rule, before the onset of labor activity, the uterus of expectant mothers is in a relaxed state, with the exception of training contractions that are characteristic of the second half of the gestational period. Under the influence of adverse factors, the contractility of the organ increases, which leads to the appearance of local hypertonicity of the uterus during pregnancy. Why does the tone of the uterus increase earlier than expected? What is the danger of local uterine hypertonicity during pregnancy, and how to prevent it? Increased local uterine tone during gestation - normal or problem?The wall of the uterus consists of sheets:
The myometrium is composed of smooth muscle cells capable of contraction. Along with the growth of the fetus, there is an increase in the size of the uterus, due to the development of myometrial cells. During the gestational period, each of the muscle fibers increases by more than 10 times. Due to the presence of a muscular system, the uterus contracts during childbirth, putting pressure on the fetus and contributing to its expulsion. The contractility of the uterus is influenced by the amount of actimiosin, a protein that is responsible for the work of muscle fibers. It has been proven that the uterus has partial automatism, that is, it is capable of reflex contraction, regardless of the connection with the brain. No matter how strange it may sound, the uterus contracts because it has such an ability. In response to any irritant, for example, a crowded intestine or bladder, stress, sexual arousal, the myometrium contracts, resulting in local uterine hypertonicity during pregnancy. The degree of risk with an increase in uterine tone depends on the gestational age and associated symptoms. At short periods of gestation, myometrial hypertonicity is often the cause of abortion, therefore it is regarded as a life-threatening condition for the fetus. An increase in tone in the second half of the gestational period causes a violation of blood supply in the uterus with the development of intrauterine fetal hypoxia. Toward the end of pregnancy, local uterine hypertonicity is not dangerous, as it is one of the harbingers of childbirth. Why does the uterus tone increase during pregnancy?
2. Gynecological diseases
3. Overstretching of the walls of the uterus (multiple pregnancy, polyhydramnios) 4. Emotional and physical stress
5. Infections (pneumonia, pyelonephritis, acute respiratory infections, influenza, etc.) 6. Smoking and alcohol consumption. Symptoms of local hypertonicity of the uterus during pregnancy.If the uterus is in an increased tone, the expectant mother will complain of pulling pains in the lower abdomen or lumbar region. On palpation, the uterus is elastic, "stone". The appearance of spotting spotting from the genital tract indicates the threat of termination of pregnancy. Local hypertonicity of the uterus during pregnancy of short terms can cause spontaneous abortion. Reduction of the myometrium leads to a partial detachment of the fetal egg and disruption of the blood supply to the embryo. Local hypertonicity of the myometrium is manifested by tension in a certain area of the anterior or posterior wall of the uterus. Signs of hypertonicity of the anterior (vesical) surface of the uterus during pregnancy:
Signs of local hypertonicity of the uterus during pregnancy on the posterior (intestinal) surface:
As a rule, the intensity of pain is similar to menstrual pain. It should be remembered that spotting during pregnancy in any amount is the main sign of a threatened abortion. The second half of pregnancy is characterized by an increase in uterine tone - the appearance of Braxton Hicks training contractions, which gradually prepare the uterus for childbirth. Training contractions are normal and are not accompanied by pain. Diagnosis of local hypertonicity of the uterus during pregnancy.One of the most reliable methods for diagnosing changes in myometrial tone is ultrasound. An increase in the tone of the uterus is determined as a total or local tension of the myometrium. During the gestation period, ultrasound of the uterus using a transvaginal probe is not performed. A woman may well assess the tone of the uterus at home. To do this, lie on your back and bend your knees. The muscles of the abdominal wall in this position are relaxed, which allows you to assess the tone of the uterus. With increased tone, the uterus is firm, protrudes in the form of a tubercle. Local hypertonicity of the uterus during pregnancy. Prevention and treatment.At the first signs of increased tone of the myometrium, you should immediately consult a doctor. Treatment of uterine hypertonicity should be carried out in a hospital setting. If it is not possible to seek medical help, you can try to relieve the tone of the uterus at home.
Horizontal position. Lie down on the bed and do not get up unless absolutely necessary. Before resting, empty the bladder, which also puts pressure on the uterine wall. As a prevention of a local increase in uterine tone during pregnancy, the following methods are used:
Local hypertonicity of the uterus during pregnancy is a condition familiar to many women. It should be remembered that the course of pregnancy largely depends on the woman's attentive attitude to her own health, as well as the early diagnosis of changes in the uterus. |
Uterine hypertonicity is not a disease, but a symptom that means increased tension of the myometrium (smooth muscles of the uterus). Outside of pregnancy, the myometrium goes through various phases of contractile activity every month, which depends on the menstrual cycle.
This process is regulated by many hormones and provided by the autonomic nervous system, which responds to their signals and "conducts" the activity of all internal organs, the tone of blood vessels and muscles.
But uterine hypertonicity during pregnancy is caused by other reasons, since other hormones command the functions of the uterus. The frequency and intensity of uterine muscle tension cause natural anxiety in pregnant women, as this can be a harbinger of serious problems for both the expectant mother and the child.
Causes of uterine hypertonicity
The specific causes of uterine hypertonicity can only be found out on the basis of a survey of a pregnant woman. To do this, doctors prescribe a blood test for hormone levels, autoantibodies to phospholipids, antibodies to human chorionic gonadotropin (hCG), ultrasound, etc.
It should be noted that in the absence of pregnancy, the contractile activity of the uterus also depends on the biosynthesis and action of hormones and prostaglandins, which cause uterine muscle contractions and rejection of its inner lining during menstruation.
But during pregnancy, the hormonal and neuroendocrine systems of a woman are rebuilt, and the production of many biologically active substances (including the neurotransmitters adrenaline and noradrenaline) decreases. In this case, the ability of the uterus to contract is blocked by progesterone. This hormone not only ensures the introduction of the fetal egg into the endometrium, but also, in parallel, stimulates beta-adrenergic receptors of myometrial cells, resulting in relaxation of the smooth muscles of the uterus.
So during pregnancy, the tone of the uterus is controlled, so the main causes of uterine hypertonicity lie in the imbalance of hormones.
Hypertonicity of the uterus in the early stages in many cases is due to the fact that the woman's ovaries produce too little progesterone. It can also be hyperandrogenism - excessive production of male hormones by the adrenal cortex. In addition, hypertonicity of the uterine wall in the initial period of gestation may indicate alloimmune disorders, that is, when the mother's body makes attempts to give an immune response to the presence of potentially foreign protein cells of the embryo.
Among the most likely causes of uterine hypertonicity during pregnancy, experts also call: an abnormal shape of the uterus; a history of repeated abortions or uterine surgery; endometriosis (pathological growth of the inner layer of the uterine wall); myoma (benign tumor of the uterus); multiple ovarian cysts; late toxicosis; diabetes mellitus, problems with the thyroid gland or adrenal glands; unhealthy habits (smoking, alcohol).
Uterine hypertonicity in the second trimester is often the result of autonomic dysfunction (in the form of increased tone of the sympathetic nervous system), lipid metabolism disorders, stress, excessive physical activity, various inflammatory diseases of the genital area, and magnesium deficiency in the body. Due to the large size of the fetus, polyhydramnios, or if the woman is pregnant with twins, uterine hypertonicity may occur in the third trimester.
Although, as obstetricians-gynecologists say, after the 37-38th week of gestation, a periodic increase in uterine tone is not considered a pathology. Rather, on the contrary: there is a “training” of the uterus before childbirth. The fact is that by the end of pregnancy, estrogen production rises again, and this leads to the inevitable activation of the synthesis of oxytocin, the hormone of the hypothalamus. Before the onset of labor, this hormone accumulates in the pituitary gland. First, oxytocin is necessary for the normal course of childbirth, since it stimulates the smooth muscles of the uterus and thereby contributes to its contraction. Secondly, this hormone, acting on the muscle cells of the mammary gland, facilitates the flow of milk into the milk ducts.
Why is uterine hypertonicity dangerous?
hypertonicity of the uterus in the first trimester (up to the 13th week) can lead to the death of the embryo and miscarriage.
Uterine hypertonicity in the second trimester (until the 26th week) is a real threat of late spontaneous abortion. In addition, at such times, a frequent increase in the tone of the muscles of the uterus can cause persistent hypoxia of the fetus, which negatively affects its development. And uterine hypertonicity in the third trimester is fraught with premature onset of labor and the birth of a non-viable or premature baby. Or it can lead to the so-called isthmic-cervical insufficiency - the inability of the cervix to keep its cavity closed with an increase in the size of the fetus.
When a frequently recurring spontaneous local hypertonicity of the uterus is observed, the threat of premature separation (abstraction) of the placenta from the uterine mucosa increases many times over (since the placenta does not contract when the uterus contracts). And if a third of the placenta exfoliates, then the fetus may die. However, it should be borne in mind that short-term spontaneous local hypertonicity of the uterus often occurs only when examining a pregnant woman or performing an ultrasound scan.
Symptoms of uterine hypertonicity
The increase in tone differs in degree: uterine hypertonicity of the 1st degree and uterine hypertonicity of the 2nd degree.
In the first case, doctors mean partial hypertonicity of the anterior wall of the uterus or hypertonicity of the posterior wall of the uterus, and in the second, the tense state of the myometrium of the entire uterus.
In most pregnant women, hypertonicity of the posterior wall of the uterus does not manifest itself in any way: doctors detect thickening of muscle fibers on ultrasound. Although towards the end of pregnancy there are painful sensations in the lumbar region, as well as pulling pain in the sacral area.
The main symptoms of uterine hypertonicity, which affects its anterior wall, are the tension felt by the woman in the abdomen (the abdomen hardens); the symptom passes quickly enough in the supine position and with calm deep breathing. There may be pulling pains in the lower abdomen, capturing the perineum, as well as more frequent urination, rectal tension (similar to the urge to defecate).
The listed symptoms of uterine hypertonicity can have different intensity, but most often resemble the state before and during menstruation. Of particular concern and immediate medical attention should be the appearance of any discharge from the vagina, especially bloody ones.
Hypertonicity of the lower segment of the uterus, that is, the cervix, during pregnancy (before the onset of the physiological term of childbirth) is practically not observed. Unless when the neck was injured in a previous birth, or there is a significant deformation.
As a rule, the opposite happens: with the onset of pregnancy, the lower segment of the uterus becomes shorter, and its muscles become softer. But during childbirth, with cervical rigidity, hypertonicity of the lower segment of the uterus is quite possible.
Treatment of uterine hypertonicity
Symptomatic treatment of uterine hypertonicity during pregnancy consists in its removal with the help of appropriate pharmacological preparations. Therapy is also carried out taking into account the etiology of this symptom complex.
How to treat uterine hypertonicity in case of endogenous progesterone deficiency? Drug treatment of uterine hypertonicity in early pregnancy is carried out with the help of preparations containing hormones. Duphaston with uterine hypertonicity is prescribed in this case by almost all domestic gynecologists. This drug (another trade name is Dydrogesterone) is a synthetic analogue of the female sex hormone progesterone and helps to maintain pregnancy with its habitual miscarriage. The standard dosage is 20 mg per day (in two doses, according to the scheme prescribed by the doctor), the maximum is 60 mg. However, it must be borne in mind that Dufaston has side effects in the form of headache, weakness, abdominal pain, breakthrough uterine bleeding.
What is prescribed for uterine hypertonicity? First of all, drugs that relieve muscle spasms (antispasmodics). No-shpa with uterine hypertonicity is the most common appointment of obstetrician-gynecologists. The drug is well tolerated, rarely has side effects and is completely safe during childbearing. No-shpa (drotaverine hydrochloride) in tablets of 40 mg is prescribed for adults, one tablet three times a day. The maximum single dose of the drug is 80 mg, the daily dose is 240 mg.
What is prescribed for uterine hypertonicity caused by magnesium deficiency? Of course, magnesium preparations. The lack of magnesium in the body is often noted during pregnancy and is manifested by increased nervous excitability of cells - muscle spasms and convulsions. Magnesium contributes to the restoration of electrolyte neutrality of smooth muscle cells, significantly reduces the excitability of cellular neurons and normalizes the transmission of impulses of the sympathetic nervous system.
It has been established that the intake of magnesium preparations by pregnant women from the 4-5th to the 24-25th week of gestation reduces the risk of miscarriage by more than 60%, and the risk of preterm birth - by almost a third.
In a hospital, Magnesium sulfate or Magnesia is widely used for uterine hypertonicity. The drug in the form of a 20-25% solution of magnesium sulfate is administered parenterally (intramuscularly) in 5-10-20 ml. The specific dosage and duration of the course of treatment are determined by the doctor.
Tablets are recommended for oral administration: magnesium citrate, magnesium gluconate, magnesium orotate or magnesium lactate. Most magnesium in magnesium lactate - 48 mg in a tablet of 0.5 g. The daily dose is about 50 mmol. The doctor sets the frequency and duration of admission on an individual basis. In renal disorders, this drug is prescribed with caution.
To relieve uterine hypertonicity during pregnancy, Magne B6 (Magnelis B6) is prescribed. The drug is taken 1-2 tablets three times a day (during meals, drinking a glass of liquid). Side effects of Magne-B6 can be expressed as pain in the epigastric region, constipation, nausea, vomiting and flatulence. It must be taken into account that magnesium reduces the level of absorption of iron and can lead to anemia.
What can not be done with uterine hypertonicity?
If during pregnancy the tone of the uterus systematically increases, then in order to preserve the fetus, a pregnant woman should not: physically strain (including in terms of everyday household chores); lift heavy; long walk or stand; take car trips over long distances; fly by the plane; take a bath (or a too hot shower).
The concepts of sex and uterine hypertonicity are incompatible, so for some time you will have to do without intimacy: increased contraction of the uterus during intercourse can cause premature termination of pregnancy.
Often pregnant women face the problem of uterine hypertonicity. This condition is fraught with serious consequences for the fetus. What causes hypertonicity, what is its danger, how to get rid of the problem - we will find answers to these difficult questions.
What is hypertonicity
The uterus is a hollow organ, the walls of which consist of several layers. A fertilized egg is attached to the inner layer - the endometrium, when a new life is born in a woman's body. Of no small importance is the muscular layer - the myometrium. It is his contractions that are called increased tone or hypertonicity of the uterus.
The uterus also contracts in its normal state when a woman is not pregnant. These processes are influenced by hormones produced by the female body. But when fertilization occurs, the uterus must remain in a calm state. Then the egg is attached to the inner walls of the organ, begins to actively develop.
An ideal pregnancy passes without problems in the form of hypertonicity. But few women can boast of this. Most pregnant women already in the early stages experience discomfort due to constant or periodic pulling and in the zone. This is how hypertension manifests itself.
Symptoms
Girls are wondering how to determine hypertonicity during pregnancy. Any discomfort is a reason to see a doctor. There are certain symptoms of increased uterine tone:
- constant pulling pain in the abdomen;
- unpleasant pain in the lumbar region;
- spotting spotting.
If you see blood on your underwear, you need to see a doctor immediately. This is a reason for hospitalization in order to maintain pregnancy. In the early stages of pregnancy, the body is gradually rebuilt. A woman has to get used to new sensations. Minor pulling pains are considered the norm, but they should cause only mild discomfort, and not serious discomfort. Let your gynecologist know about what you are experiencing. He will prescribe drugs that reduce the pregnancy in order to prevent the slightest threat of termination of pregnancy.
Causes
There are several reasons why hypertension occurs:
- hormonal imbalance;
- stress, increased anxiety;
- an excess of calcium in the body.
To prescribe adequate treatment, you must first determine why the disease occurs. Modern diagnostic methods allow you to do this quickly. Be sure to a woman is assigned an ultrasound. With the help of ultrasound, you can see what state the walls of the uterus are in - relaxed or tense. It often happens that the tone manifests itself in a certain area - on the front or on the back wall of the organ. You can determine its localization by the nature of the pain. If in a woman, an increased tone is found along the anterior wall of the uterus. If the pain is felt in the lower back, then the hypertonicity of the back wall is manifested.
What is dangerous
In the early stages of gestation, hypertonicity leads to termination of pregnancy. Due to the constant contractions of the uterus, the fetal egg cannot properly attach to the walls of the organ, bleeding begins. Keeping a pregnancy in this case is not easy. Some women lose a baby without even knowing about it. Bleeding is perceived by them as the beginning of the next menstruation.
Hypertonicity in the second trimester leads to exfoliation of the placenta, fetal hypoxia. The baby is fed through numerous blood vessels that are adjacent to the placenta. If the uterus does not relax, is constantly tense, nutrition is disturbed. The child has a delay in intrauterine development.
Another consequence of increased tone is isthmic-cervical insufficiency. Due to spasm, the cervix cannot fully open. There is always a risk of preterm birth. Doctors often in such cases resort to suturing the neck. These sutures are removed before delivery. These procedures are always performed under general anesthesia. There is a good chance that the baby will be born by caesarean section. Even before birth, in such cases, the child undergoes 2-3 anesthesia. Sometimes such measures are indispensable. But after all, you can get rid of hypertonicity and prevent its appearance at a later date.
In the third trimester
After 26 weeks of pregnancy, her third trimester begins. If hypertonicity continues to bother a woman, the risk of premature birth is high. Modern medical technologies make it possible to nurse premature babies, but a certain imprint on the health of such babies still remains.
After 36-38 weeks, they no longer talk about hypertonicity. At this stage, the body is already preparing for childbirth. During labor, the uterus must contract so that the baby gradually enters the birth canal. Many women know what training contractions are. These sensations are comparable to pain with increased uterine tone.
How to fight
If the reason for the increased tone of the uterus is a violation of the hormonal balance in the body, it is advisable to identify this in the early stages of pregnancy. A blood test for the level of hormones in it gives a clear picture of what is happening. Insufficient - pregnancy hormone, can lead to tone. You can increase it by taking hormonal preparations in the form of suppositories or regular capsules.
If the tone is a reaction to stress, the woman is prescribed sedatives, sedatives. Sometimes it is advisable to check the blood for trace elements. An excess of calcium and a lack of magnesium is another cause of hypertonicity. Prescribed magnesium preparations solve the problem. Be sure to use antispasmodics. Medical treatment alone is not enough. A pregnant woman needs bed rest.
Women who periodically experience such a problem during pregnancy are prescribed regular ultrasound examinations. The screen shows not only the localization of the problem, but also the severity of the tone.
Uterine hypertonicity is a serious but solvable problem. You need to monitor your well-being, consult a doctor at the slightest sign of malaise, follow all his recommendations. Then you will be able to bear a healthy baby and give birth to him in a timely manner.