Tone in pregnant women what to do. Increased tone of the uterus - a danger that does not tolerate delay
We will start talking about the tone of the uterus with a brief summary of the anatomical foundations. The uterus is an unpaired muscular hollow organ of the female reproductive system, in which the embryo is born, and then the fetus. Despite the sounded name “muscular”, the structure of this organ is not so simple, the wall of the uterus consists of three layers: endometrium (mucous membrane, the innermost layer), myometrium (muscular, the most massive membrane) and serous (peritoneal) membrane or perimetrium.
The myometrium has a complex structure, and in turn, consists of three layers, each of which is a smooth muscle fiber:
1. longitudinal layer includes circular and longitudinal muscle fibers
2. circular layer (or vascular), it includes many vessels
3. The submucosal layer consists of longitudinal fibers and is the most vulnerable of all layers.
Muscle tone, and in particular, the tone of smooth uterine muscles (uterine hypertonicity) is a state of contractile activity, increased muscle tension.
Like any structure that has muscle tissue in its structure, the uterus "has the right" to be in good shape. Outside of pregnancy, the uterus is in increased tone during menstruation, thus, blood and sloughing parts of the endometrium (uterine lining) are expelled from the cavity. If the uterus does not contract enough, then there may be problems with insufficiently complete excretion of secretions from the body. Therefore, menstruation is often accompanied by a feeling of sipping in the lower back and lower abdomen. This is a normal condition, but during pregnancy, everything is completely different.
The uterus during pregnancy is a fetal place, and it should maximally contribute to ensuring that the embryo is first safely implanted (attached to the wall of the uterus and begins to receive nutrition), and then grows and develops until the due date of delivery. To accomplish these tasks, with the onset of pregnancy, a significant hormonal restructuring occurs in the woman's body. Most often, when it comes to hormones, pregnant women hear the word “progesterone” and rightly so.
Progesterone is a female sex steroid hormone, the concentration of which increases significantly during pregnancy. Progesterone has a relaxing effect on all the smooth muscles of the body. Under the action of progesterone, the smooth muscles of the uterus are in a relaxed state, it is soft, the volume of the cavity is normal, and the fetus is not threatened with premature expulsion from the uterine cavity. In addition to the smooth muscles of the myometrium, progesterone also relaxes the muscles of the esophagus and stomach (possible heartburn), intestines (constipation), muscles that make up the vessels, primarily veins (varicose veins of the lower extremities and small pelvis, the appearance of hemorrhoids). As we can see, the action of progesterone is very powerful, but not selective. However, all these problems are temporary and solvable, and the main thing for a woman is to safely endure the desired pregnancy. By the way, here too progesterone plays a favorable role, acting on the central nervous system, the hormone creates a “protective inhibition” and does not allow the pregnant woman to worry too much.
Norms of uterine tone by gestational age
Normally, the uterus is in a normal tone (that is, in a relaxed state) up to the term of a full-term pregnancy, that is, up to 37 weeks.
As already mentioned, the uterus is a muscular organ and it can respond with increased tone to many stimuli (laughter, coughing, sneezing, a sharp rise from bed, sexual contact, rapid breathing, fear, gynecological examination on the chair, fetal movements). It is perfectly normal if the uterus in response to these irritants comes into tone, BUT (!) The key points here are SHORT-TERM and PAINLESS.
That is, the tone for several seconds - minutes, which does not cause pain (primarily pain in the lower abdomen and lower back), is not accompanied by pathological secretions (read more about this in the article "Discharge during pregnancy"), which does not change the nature of the movements fetus (if we are talking about tone after 16-20 weeks), passing at rest, should not cause panic in a pregnant woman.
The episodes of hypertonicity should be reported at the next appointment with the doctor, depending on the ultrasound findings, obstetric examination data, as well as on the basis of the anamnesis data (missed pregnancies, spontaneous miscarriages, premature births, abortions and operations on the uterus, gynecological and endocrinological diseases), management of your pregnancy will be chosen.
Periodic increased tone in the period of full-term pregnancy is a normal phenomenon, most often manifested in the form of irregular, short-term, painless, weak contractions. Such fights are often called "training", this definition, in fact, is correct. Thus, the uterus is rebuilt to a new mode and is preparing for intensive work on the expulsion of the fetus (that is, for childbirth).
Causes of violation of the tone of the uterus during pregnancy:
1. Hormonal
As mentioned above, progesterone is the main hormone that preserves pregnancy. And most of cases of uterine hypertonicity is due precisely to hormonal causes. Progesterone deficiency directly affects the tone of the uterus, smooth muscles become much more excitable, react to less powerful pathogens, and the tone persists for a longer time.
There are several diseases of the female genital area, one of the symptoms of which is a deficiency of progesterone.
Hyperandrogenism syndrome is a symptom complex that includes elevated level androgens (male sex hormones), a relatively low level of female sex hormones, including progesterone. Manifestations of this syndrome are detected even during the collection of anamnestic data. In women, menstrual irregularities, excessive hair growth on atypical locations for women (stomach, chest, back, face), problematic skin (excessive greasiness of the skin, acne), the condition of which worsens before the next menstruation, increased greasiness of hair are revealed.
Often, women with this problem cannot become pregnant for a long time, and then from the early stages there are signs of a threatened abortion (uterine hypertonicity, pulling pains in the lower abdomen, spotting). Most often, hyperandrogenism is due to PCOS (polycystic ovary syndrome) or diseases of the adrenal glands. The diagnosis is established on the basis of blood tests for sex hormones, ultrasound of the pelvic organs and adrenal glands, and other highly specialized studies.
There is evidence that pregnancy, accompanied by a Rh conflict, often occurs against the background of uterine hypertonicity. If the mother has a Rh negative factor, and the father of the child has a positive factor, then it is likely that the fetus will have Rh factor - positive blood. In this case, the child is perceived by the mother's body as a foreign body and it is rejected at the immunological level. A manifestation of this process is the hypertonicity of the uterus.
5. infectious process
Acute inflammatory diseases the female genital area or exacerbation of chronic inflammation are accompanied by the production of inflammatory mediators (substances that regulate the course of the inflammatory process). Inflammatory process changes local metabolism and may be accompanied by increased uterine tone.
Acute infectious diseases(ARVI, food poisoning) can also be complicated by uterine hypertonicity, as the body experiences stress, body temperature rises, and general intoxication increases. Timely treatment helps to prevent complications of pregnancy.
6. Overstretching of the walls of the uterus (polyhydramnios, multiple pregnancy)
Overstretching of the walls of the uterus is a mechanical factor that provokes the contractile activity of the uterus.
7. Secondary causes (increased intestinal motility, constipation with excessive accumulation of feces, acute urinary retention with overdistension of the bladder and compression of the uterus)
8. Mechanical impact (rough sexual contact, abdominal trauma, fall).
9. Stress. During stress, the level of adrenaline and cortisol rises, which indirectly provokes an increase in the tone of the smooth muscles of the uterus.
Symptoms of increased uterine tone during pregnancy
In the I and II trimesters, you should worry about uterine hypertonicity if there are complaints of pulling pains in the lower abdomen and lower back, sacral region. At the end of the II and III trimester, the nature of pain with hypertonicity is approximately the same, and you can also visually determine the increase in the tone of the uterus, the stomach seems to “shrink”, it becomes hard to the touch, in thin pregnant women you can observe how the uterus contours (its contour becomes clearer and highlighted).
There is no decreased tone during pregnancy, since the norm (normal tone) is a relaxed state. Reduced tone may be of further importance if there is a tendency to overwear (pregnancy lasts more than 41 weeks, but spontaneous labor is not observed), during childbirth (weak labor). Management tactics in all cases is determined individually, after examination and history taking, and is carried out in an obstetric hospital.
Diagnostics
1. Medical examination. An obstetrician-gynecologist examines a pregnant woman, performs an external obstetric examination (4 receptions according to Leopold), "by touch" determines the tone of the uterus and, if necessary, counts contractions, their strength, duration and regularity.
According to the indications, an internal obstetric examination is performed on the chair, which determines the length of the cervix, the condition of the external uterine os and other parameters indicating the threat of interruption in combination with uterine hypertonicity.
2. Ultrasound examination of the uterus with dopplerometry. Ultrasound is performed to determine the degree and prevalence of uterine tone, to identify possible detachment of the fetal egg and the formation of a retrochorial hematoma (sometimes local hypertonicity is due to a hematoma starting to form). Doppler is performed to determine the state of blood flow in the uterine vessels and fetal vessels, which allows you to more accurately determine the prognosis of the fetus.
3. Cardiotocography. In a period of more than 30 - 32 weeks, a tensometric sensor of the CTG apparatus is used to determine uterine hypertonicity (read more about this research method in the article “Cardiotocography (CTG) during pregnancy”). The sensor is superimposed on the right corner of the uterus and reflects the contractile activity of the muscles of the uterus, the presence, number, duration and regularity of contractions.
Complications of increased uterine tone during pregnancy
In a period of more than 22 weeks, uterine hypertonicity is dangerous for the onset of premature birth. The shorter the gestation period, the less chance of a successful outcome in nursing a premature baby. There is also an increased risk of obstetric bleeding.
Prolonged, frequent uterine hypertonicity contributes to periodic circulatory disorders, and hence the nutrition of the fetus. The baby does not receive oxygen and nutrients, the risk of malnutrition (malnutrition) of the fetus increases.
Treatment of uterine hypertonicity during pregnancy
1. Hormonal preparations.
The main treatment for uterine hypertonicity, as a manifestation of a threatened abortion, is currently progesterone preparations.
Dufaston (dydrogesterone) is available in 10 mg tablets, the maximum daily dose is up to 30 mg, taken orally. The drug is taken under the supervision of a doctor up to 20 - 22 weeks. The start of taking the drug can be with pre-gravid preparation, if infertility is being treated.
Utrozhestan (natural micronized progesterone) is available in capsules with a dosage of 100 mg and 200 mg, oral or vaginal. The maximum daily dose is up to 600 mg, divided into 3 doses. The drug is taken starting from preconception preparation (if infertility treatment is being carried out) and up to a maximum of 34 weeks of pregnancy with dose adjustment. AT different dates pregnancy daily dose varies. Therefore, the drug should be taken under the supervision of an obstetrician-gynecologist.
Utrozhestan is an original drug, generics (analogues) are Prajisan and Iprozhin in the same dosages.
2. Sympathomimetics.
To stop the increased tone of the uterus, the drug Ginepral (hexoprenaline) is used. It is administered intravenously in an individual dosage, the drug is administered very slowly (the standard dose is administered in about 4 to 6 hours) and only in a hospital setting. After stopping an acute situation, it is possible to prescribe ginepral in tablets.
3. Osmotic therapy(magnesium sulfate intravenously, magnesium tablets)
Magnesia therapy (intravenous administration of magnesium sulfate 25%) is performed during pregnancy up to 37 weeks, in a day or round-the-clock hospital. The dose of the drug is selected individually.
Magnesium preparations in tablets (magneB6-forte, magnelis B6, magnistad) 1 tablet 2 times a day, taken from 1 month, then the duration is regulated by the attending physician, are used from early pregnancy, are well tolerated and show nice results in the prevention of uterine hypertonicity. For the relief of an acute condition, these drugs are not used.
4. There are also recommendations on observing the regime of work and rest, optimal stay in the fresh air, rational nutrition (especially the exclusion of excessively hot and spicy foods), taking herbal sedatives (valerian 1 tablet 3 times a day for a long time).
Forecast
Situations that provoke uterine hypertonicity are very diverse. But most of them are quite manageable situations that are subject to successful treatment under the supervision of a doctor. Comprehensive treatment always increases the chances of a successful course and completion of pregnancy.
Your task is timely registration (up to 12 weeks), regular monitoring and compliance with the recommendations of your obstetrician-gynecologist. Look after yourself and be healthy!
Obstetrician-gynecologist Petrova A.V.
The concept of uterine tone is known, perhaps, to most women who have given birth and even never been pregnant women - if not in practice, then by hearsay.
What are the sensations with the tone of the uterus?
Often, it is possible to recognize and determine the tone of the uterus on its own, since it is clearly felt as pulling pains and heaviness in the lower abdomen and in the lower back, as during menstruation. Pain in the tone of the uterus is accompanied by petrification of the abdomen - it is easy to feel by slightly pressing on it with your hand.
Therefore, there are usually no questions about how to feel the tone of the uterus - such discomfort can hardly be overlooked and overlooked.
How else can you determine the tone of the uterus?
If you observe such, you need to seek medical help. To confirm the diagnosis, a woman undergoes a vaginal examination and an examination of the abdomen, sometimes an ultrasound may be required.
In addition, there is a special apparatus that measures the force of contraction of the uterine myometrium. However, it has not received wide distribution, because the tone of the uterus is already determined quite simply.
How to tone up?In order not to lose precious time, you can take a no-shpy pill on the way to the doctor. Doctors in these cases usually prescribe vitamin B6 preparations, as well as sedatives - motherwort, Magne-B6. Sometimes calcium blockers, as well as anti-inflammatory drugs, are additionally prescribed.
In addition to drug treatment, a woman is shown physical rest, good sleep, a lot of fresh air, positive emotions, a normal mode of work and rest. If outpatient treatment does not help, a woman may be offered treatment in a hospital - "to save". In the hospital, under the close attention of doctors, it will be possible to learn more about the causes in order to eliminate them.
The uterus is an organ made up of muscles. In a calm, balanced state, the muscles are relaxed, the uterus is not tense. Muscle tension can often be observed during pregnancy, but especially during childbirth. This state of tension is called tone. Can there be uterine tone without pregnancy? Of course, yes, because muscle contraction can occur in any state.
The uterus is a hollow organ riddled with muscles. It consists of three parts: the outer serous membrane (perimetrium), the inner mucous layer (endometrium) and the muscular layer (myometrium). Muscle fibers in the last layer are located unequally. In the outer part - the arrangement is vertical, in the middle part - in a spiral. The inner part is distinguished by a circular arrangement of muscle fibers. Muscles are subordinate to the autonomic, nervous system, hormonal fluctuations. Muscles tend to contract and be in constant motion - tone.
In pregnant women, the tone of the female organ is a fairly common phenomenon, but if there is no pregnancy, and the uterus is in good shape, this is a reason to visit a doctor.
Symptoms
With a balanced state of the uterus, its abdominal wall is soft, the muscles are relaxed. This can be felt by pressing on the lower third of the abdomen. If the tone is increased, the abdominal wall is firm, and the muscles are tense.
Muscle contractions are accompanied by pain in the lower abdomen, which radiate to the lower back. Pain is aching and pulling. They can be felt when bending over, walking, squatting. Sometimes there may be spotting.
Diagnosis Methods
The tonic (excited) state of the reproductive organ can be determined in three ways:
- Probing with fingers - palpation. The doctor makes a diagnosis by independently feeling the woman's abdomen and conducting a vaginal examination;
- Ultrasound method;
- Tonusometry, using a special apparatus.
The reasons
A number of reasons that a woman does not even know about can affect the tone of the uterus without pregnancy:
Operations on the cervix
One of the significant causes of tone are operations on the cervix. The cervix is a dense frame with numerous muscle fibers. The cervix is connected to the uterus through the cervical canal, which prevents infection from entering the reproductive organ itself. Sometimes surgery is needed to treat certain conditions.
There may be several indications for operations: removal of polyps, amputation, treatment of erosion, prolapse and prolapse of the uterus, accompanied by lengthening of the neck, background and precancerous conditions.
Operations can be plastic - when the organ is preserved, and radical (the neck is removed). In some cases - biopsies from the cervix, accompanied by bleeding - suturing is not required. Bleeding is stopped with a tight gauze swab moistened with a solution of hydrogen peroxide.
For suturing the cervix, catgut or semi-synthetic threads are used. The area of the seams is smeared with iodine and a cotton swab is inserted into the vagina for a while. In the first one or two days after suturing, a woman experiences pulling pains in the lower abdomen. They may be accompanied by spotting, which indicates that the uterus is in good shape. A woman is given drugs that relax the reproductive organ and relieve tone. As pain relief, you can take anti-inflammatory drugs such as diclofenac, ibuprofen. Allocations can last up to 20 days.
During childbirth, the cervix may rupture, which will also require suturing the tears. The process is painless, as the uterus loses sensitivity after childbirth. Stitches are applied either separately, when each thread is fixed with a separate knot, or continuously, when the seam is tied at the beginning and at the end of the row. Such seams do not need special care, and they do not cause any particular inconvenience. But the painful sensations that accompany the tone of the female organ will persist for some time.
If the increased tone is short-term, there is nothing to worry about. It is enough to lie on your side, drink warm tea, take a warm bath, watch a pleasant movie. In this case, the symptoms pass very quickly. If they go into the pathological stage, you can not do without the intervention of a doctor. When the diagnosis is established, the doctor decides to hospitalize the woman in a hospital. This is how, under the supervision of specialists, the treatment is faster and more correct.
Although pregnancy is considered one of the most beautiful periods in a woman's life, when she enjoys her position, she needs to be attentive for all 9 months, monitor changes, and respond quickly to them. One of the most unpleasant symptoms that pregnant women often experience is uterine tone or hypertonicity.
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Signs of tone vary slightly depending on the duration of pregnancy. How to determine yourself in the first trimester:
- feeling of heaviness in the lower abdomen
- drawing pain, similar to those that occur during menstruation
- pain that radiates to the lower back or sacral spine
In the 2nd and 3rd trimesters, the signs are almost the same, except that hypertonicity can also be visually noticed. In a pregnant woman, the belly shrinks noticeably, it becomes very hard. Therefore, it will be easy for any woman to notice this phenomenon. Sometimes this condition can also be manifested by bloody discharge. You should definitely call an ambulance immediately, and at the same time, see a doctor. To determine whether the tone is definitely increased or not, and whether it is dangerous, an examination by a gynecologist, as well as an ultrasound examination, will help.
They may be different. Sometimes these are natural causes associated with hormonal changes, physical activity, emotional state, etc. For example, the uterus is often in good shape during a gynecological examination, because the patient is a little tense and embarrassed at this moment.
What causes the uterus to tone up:
- Lack of progesterone in the early stages. At hormonal failure, tone may occur due to an overabundance of male hormones. Therefore, all 9 months it is necessary to monitor the hormonal background.
- Toxicosis- Another reason, especially if it is accompanied by severe nausea and vomiting. At this point, the abdominal cavity contracts, and the uterus may also be involved. With severe toxicosis, it is recommended to go through, in which the blood is cleansed and toxins are removed from the body. To do this, a woman is drip-injected with special solutions that do not harm either her or the baby, a course of 3 procedures, then at the discretion of the doctor and based on the condition of the pregnant woman. After that, the expectant mother becomes much easier, often the signs of toxicosis go away completely.
- Anomalies in the structure of the uterus are also one of the reasons. Therefore, it is better for a woman to be examined in advance, even before pregnancy, in order to be aware of such problems. Anomalies of the uterus can greatly interfere with the normal bearing of the fetus, or not allow it at all.
- Rhesus conflict often causes hypertension. It occurs if a woman has a negative blood type, and her partner has a positive one. It may happen that her body will reject the fetus, mistaking it for something foreign.
- Infections, inflammation in the pelvic organs- another reason. There will be other signs expressed in a change in the amount and type of discharge, the occurrence of itching and burning.
The reasons why there may be an increased tone of the uterus during pregnancy, great amount and it would take a long time to list them. One of them is uterine distention, for example, if the child is very large or the pregnancy itself is multiple. The tone increases due to gas formation in the intestines.
It is not the tone of the uterus itself that should be treated as some kind of separate disease, it is only a symptom, you need to look for the cause and eliminate it.
This means that the muscles of the uterus are tense. Normally, they should be relaxed. They strain only during childbirth to help the fetus be born. If the muscles of the uterus are tense, and the pregnant woman and her baby feel uncomfortable, then it is worth fighting this condition.
Why is hypertension dangerous?
There is nothing wrong with it if the tone passes quickly. If such symptoms become permanent, there is a danger to the health of the fetus and, in general, there is a threat of termination of pregnancy. With hypertonicity, the fetus may suffer from a lack of oxygen.
What to do if the tone is increased?
The question that worries almost all expectant mothers: what to do if the uterus is in good shape during pregnancy? You need to take a little look at your condition. If there is no acute pain, bleeding, and this condition itself quickly passes, there is nothing wrong with that, perhaps these are just training fights. If the hypertonicity is of a prolonged nature, a doctor's consultation is necessary, and possibly hospitalization, or complete rest. In some cases, the doctor recommends undergoing an additional examination to determine the possible risks and causes of the pathology.
At home, the expectant mother is recommended to observe bed rest. She should avoid strong physical exertion, emotional experiences. Antispasmodics are prescribed. Usually, with uterine tone, this is No-shpa or. Magnesium B6, motherwort, and other drugs may be prescribed, depending on the identified cause. All actions should be aimed at eliminating the underlying cause that caused the increased contraction of the uterus.
You can remove the tone not only by medication, but also by performing special exercises. One option for how to relieve uterine tone during pregnancy is the Cat exercise. A woman should get on all fours and bend her back, stay in this state for a few seconds, and then straighten her back back. You need to repeat 7-8 times, then lie down on the bed and lie down for at least one hour.
If at home it is not possible to remove the increased tone, you should contact your doctor. He may prescribe hospitalization to prevent preterm labor and maintain a healthy pregnancy for the rest of the term. Sometimes, even if the expectant mother has the opportunity to relieve symptoms at home, she simply does not follow all the doctor's prescriptions. After all, there are many things to do at home: which can never be redone, so it is not always possible to relax calmly. More often, because of this, doctors recommend strongly to go to the hospital, at least for a day, so that the woman regains her strength.
What the doctor advises with increased uterine tone, see the video:
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If the future woman in labor begins to feel a strong tension in the muscles of the "press" or pain in the lower abdomen, she needs to inform the gynecologist as soon as possible.
These manifestations are normal, but do not exclude the development of a syndrome called increased uterine tone during pregnancy. Often this phenomenon is simply called tone, which is fundamentally wrong, since tone is a physiologically necessary state for a muscular organ, which is the uterus.
Abnormal uterine tension, if left untreated or preventive action, can progress to more severe complications, endangering childbearing. Read about the symptoms and risk factors for increased uterine tone during pregnancy and how to fix this problem.
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Classmates
To imagine what the tone of the uterus is during pregnancy, let's remember the muscle layer of this organ - the myometrium. It consists of 3 layers of smooth muscle, elastic fibers and connective tissue. Myometrium has a contractile ability (tonus), which is actively manifested during labor and ensures the exit of the fetus from the uterus.
In certain situations - with any tension of the press, whether it be physical activity or coughing - the uterus, even without pregnancy, enters into tone, which is a normal reaction to contraction of the abdominal muscles. It is clear that before the onset of labor, intensive contractile activity of the myometrium is undesirable.
When the excitability and tension of the uterus are increased, this means that it has entered into an increased tone and does not allow the fetus to develop calmly, receive nutrition and breathe.
The symptomatic complex, when the myometrium of the uterus is compressed and tense, is called increased tone. Some clinicians (especially ultrasound specialists) define this condition as hypertonicity, but this term is not used in obstetrics. The hypertonicity of the uterus is spoken only in relation to labor.
If we talk about increased tension of the myometrium shortly before childbirth, for example, at 38 weeks, such uterine tone can be attributed to the so-called "training contractions", these periodic muscle contractions are safe for the fetus.
When tension in the uterus increases out of time - in the initial or middle period of pregnancy - and is characterized by increased intensity, this provokes an increase in pressure in the uterine cavity and threatens the course of gestation.
Uterine tone
Increased tone of the posterior or anterior wall
There are 2 degrees of uterine tone during pregnancy in accordance with which part of the muscular membrane is excited:
- 1 degree - when the posterior wall of the uterus is in increased tone;
- Grade 2 - tension of the myometrium, when the uterus comes into tone along the front wall.
It is believed that 1 degree of uterine tone is less dangerous for pregnancy, although it requires obstetric supervision. The 2nd one implies the tension of the entire myometrium, which becomes noticeable from the side of the anterior wall and is characterized by tangible clinical manifestations.
Could it be early?
High uterine tone is able to manifest in any period of pregnancy, including. This is not necessarily a signal of a pathological course of pregnancy, rather, on the contrary. The uterus that took into its bosom fertilized egg, can react differently to its qualitatively new state, including quite tolerable pain. About physiologically justified pain during pregnancy says their nature:
- they are not localized in a certain part of the abdomen, but migrate to different points;
- do not progress, do not increase in strength, do not become more frequent;
- often given to the lower back or felt in the lower abdomen.
Their sporadic nature (irregularity) and dissimilarity to contractions also speak of the non-pathological nature of the pain. When there are too intense pain, and even more so - spotting, you need to rush to the doctor.
It is useful for women to find out how the increased tone of the uterus feels, so that by detecting it in a timely manner, measures can be taken to save the pregnancy. , and ?
How to determine yourself?
The future woman in labor is quite capable of independently determining the tone of the uterus, if she is attentive to her well-being. Symptoms vary in degree of pathology and are able to manifest both in the 1st trimester and in subsequent ones.
What are the signs?
The tone of the uterus of the 1st degree is usually not manifested by pathological signs, and the pregnant woman simply does not notice it. This condition is determined only with ultrasound, during which you can see a local thickening of the myometrium. Modern gynecologists generally tend to consider this situation normal, since:
- the zygote is usually attached to the back wall of the uterus;
- at the site of implantation, a reaction occurs in the form of a slight inflammation;
- this is accompanied by increased blood flow to the fetal egg;
- because of this, the posterior wall of the uterus thickens, which is quite logical, but is often interpreted by ultrasound doctors as an increased tone.
It is not rare that such a “diagnosis” (although this is just a symptom) is made for the purpose of reinsurance.
In the 3rd trimester, symptoms such as heaviness in the sacral area or pulling pain in the lower back may occur, which are quite tolerable. Despite the insignificance of the pain syndrome, a woman should still inform her doctor about these signs indicating uterine tone and, possibly, develop a sparing regimen for bearing a baby.
The tone of the uterus of the 2nd degree declares itself more pronounced, the symptoms of which occur in both the 1st and 2nd trimesters. Here are some manifestations that will help to recognize the tone of the 2nd degree:
- pain below and a noticeable induration of the abdomen, palpable tension ("fossil") in the muscle layer;
- spread of pain to the perineal area;
- a feeling of "bursting" in the external genital organs;
- spasm of the muscles of the rectum, the urge to empty the intestines;
- frequent urination or urge to it.
If a woman has previously suffered an injury to the cervical canal, a high tone is also manifested by contraction of the cervix, which cannot be determined independently, but is detected during an obstetric examination.
Symptoms by trimester
Symptoms of increased uterine tone do not correlate with the timing of pregnancy, its manifestations can open in the second and third trimester. The intensity of the signs correlates with the degree of tone tension.
If you do not get rid of the increased tone at the beginning of gestation, by the 3rd trimester the symptoms often worsen: at grade 1, back pain occurs, at grade 2, bloody discharge from the vagina, indicating an abnormal course of pregnancy and the danger of its failure.
The appearance of acute pain and traces of blood in the discharge, regardless of the gestational age, is a good reason for the hospitalization of a future woman in labor in a hospital.
The reasons
It is also necessary to understand why the uterus comes into tone during pregnancy, which prevents it from being in the normotonus necessary for rest and development of the fetus.
The most common cause of increased uterine tone during pregnancy, experts call a lack of progesterone. This hormone is responsible for the normal course of the gestational period, reducing the excitability of the nerve receptors of the spinal cord and myometrium, reducing its contractility. A high tone of the uterus, provoked by a lack of progesterone, can result in consequences such as fetal hypoxia, "miscarriage", miscarriage or premature birth. The origin of this condition during pregnancy is also associated with other pathologies:
- hyperprolactinemia - when increased prolactin production provokes blocking of progesterone production;
- hyperandrogenism - early termination of pregnancy due to excessive production of male sex hormones;
- endometriosis - pathological growth of the endometrium;
- genital infantilism - a state of abnormal developmental delay of the reproductive system
- myoma - a benign tumor of the myometrium;
- transferred to early dates inflammatory or viral diseases;
- a disorder of regulation of the central nervous system, manifested by a loss of the ability to maintain the optimal tone of the myometrium;
- thyroid diseases;
- genetic anomalies.
In addition to diseases, the tone of the uterus is influenced by external influences - harmful working conditions, daily duty, lack of sleep and other violations of the regime.
How to relieve muscle strain of the body?
If the body of a pregnant woman makes it clear that the tone of the uterus is increased, and this is confirmed by instrumental and laboratory research, it is necessary to look for methods to combat this pathology. Doctors will take any action to remove the abnormal increase in tone and extend the pregnancy to 38 weeks.
But shpa
The main medicines used to relieve tense uterine tone are antispasmodics. The well-known antispasmodic drug No-shpa is often prescribed by doctors of antenatal clinics. The annotation for this medicine contains a warning about its use during pregnancy.
Despite the absence of embryotoxic and teratogenic effects in No-shpa, pregnant women are advised to use this medication with caution, comparing the likely risks to the fetus and the potential benefit to the woman. Usually, no-shpu is drunk at a dosage of 2 tablets per dose in order to remove a spontaneous increase in the tone of the uterus, if the woman has no contraindications prescribed in the annotation.
No-shpy tablet
Candles
Rectal suppositories, often prescribed for increased tone, also have an antispasmodic effect. The active substance of the suppositories is papaverine hydrochloride. According to the instructions, caution is recommended during pregnancy. The recommended dosage is 1-2 suppositories 2-3 times a day. The drug is injected into the anus after emptying the intestines, after cutting off the contour packaging around the perimeter of the candle with scissors.
Papaverine
Papaverine pills are recommended to be used with caution in uterine tone, that is, as prescribed by a doctor, since according to the annotation, the safety of this medication during pregnancy has not been established. Usually this antispasmodic is taken at a dosage of 1 tablet 3-4 times a day, unless otherwise prescribed by the doctor.
In urgent situations (with acute and radiating pain in the lower abdomen), papaverine and no-shpa solutions can be administered as injections. The dosage is determined by the doctor conducting symptomatic antispasmodic therapy.
Papaverine ampoules
What else can be done to reduce tone?
The main rule in the situation is what to do if a high tone of the uterus is found - to organize calmness and immobilization (immobility) for the pregnant woman, to warn the doctor. At acute pain and spotting- Call SMP.
Even with tolerable pain sensations, it is necessary to provide the woman with peace and medical assistance. If it turns out possible treatment at home, you should strictly follow all the appointments of a specialist.
To reduce tone, the treatment regimen includes:
- soothing medications (tinctures of valerian or motherwort) - they are designed to muffle the fear of losing a child, which exacerbates the increased excitement of the myometrium;
- with a deficiency of progesterone in the 1st trimester - medications Duphaston, Utrozhestan;
- antispasmodics described above.
A woman at home should be provided with a gentle mode of physical activity and a diet that excludes the possibility of constipation.
What is the dangerous condition?
The tension of the myometrium creates an unfavorable "environment" for the fetus inside the uterine cavity - it prevents the normal supply of oxygen and nutrition, inhibits growth. With 1 degree of uterine tone, the prognosis is usually favorable, timely action can suppress the increased tension of the muscular membrane. At grade 2, the risks of developing complications such as:
- oxygen starvation of the fetus;
- detachment of the placenta;
- spontaneous abortion at an early stage;
- out-of-term delivery in the 3rd trimester.
Knowing how dangerous the tense tone of the uterus is, a woman should in every possible way move away from unnecessary emotions, physical overwork and other dangerous influences that can provoke it. If the pathology has already been discovered, you should not hesitate to visit a doctor.
Danger of uterine hypertonicity
In what cases is treatment required?
Summing up what has been said, we note that the normal tone of the uterus is physiologically optimal for the muscular organ. If the condition is not characterized by obvious manifestations - pain, bleeding - no treatment is required.
Any discomfort and pain in the abdomen and lower back or spotting during pregnancy should alert future mother and forced to come for a consultation with a gynecologist. Even if the turnout is scheduled for a certain day, if there is characteristic features you should not wait for the appointed date, but go to the doctor in the near future.
Timely prescribed treatment for high uterine tone in most cases saves a pregnancy that is in jeopardy.
Conclusion
- Normally functioning muscles of a living organism are always in good shape, this is the norm for any muscle group, including the myometrium.
- Increased tension of the myometrium is called increased tone, which occurs both during pregnancy and without it.
- If this symptom complex poses a threat to pregnancy and fetal development, a sparing regimen is developed for the pregnant woman, the diet is adjusted, and, if necessary, medication is prescribed.
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