How to determine the uterus is in good shape or not. Increased uterine tone: what you need to know. What causes the uterus to tone up

Like other muscular organs, the uterus is in a state of physiological tone. It can increase or decrease depending on the phase of the menstrual cycle and a number of other reasons. Increased uterine tone during pregnancy indicates the presence of a hidden disorder in the female body. It can be detected only with the help of hardware diagnostics. Also, the tension of the muscles of the genital organ is a signal of the need for a thorough assessment of the condition of the placenta, the fetus. Uterine tone only in 25% of cases decreases on its own: often a woman needs hospitalization.

Hypertonicity is a common complication of pregnancy, regardless of its order in a particular woman. This is a condition in which the muscle fibers of the uterus are tense, which contributes to the hardening of the reproductive organ. The compaction of the texture of the myometrium is fully palpable during a gynecological examination. Due to the tension of the uterine muscles, the blood supply to the placenta and fetus is disturbed. This can lead to irreversible consequences for the development of the child.

Symptoms

A condition in which a woman has an increased uterine tone is characterized by five main symptoms. These include:

• Pain. Unpleasant sensation covers the lower abdomen, lumbosacral back; makes it difficult to get into a comfortable position.
• Nausea. It is often explained by the development of toxicosis.
• Spasms. In addition to pain in the lower abdomen, which is similar to discomfort during menstruation, a woman feels short contractions in the suprapubic region.
• An increase in body temperature to low numbers.
• Vaginal discharge - bloody, spotting, bright or dark. Vaginal secretion is preceded by an increased, perceptible contraction of the uterus.

Additional signs accompanying the hypertonicity of the female reproductive organ are caused by general anxiety and fear. Against the background of a deterioration in well-being, a woman develops insomnia, a decrease in appetite, and a decrease in pressure.

Causes

All factors causing uterine overstrain are divided into 2 types. The first includes those that depend on the tactics of a woman - the characteristics of her behavior, lifestyle during pregnancy, the nature and quality of nutrition. Type 2 causes are processes that occur directly in the body of the expectant mother. They can begin both before pregnancy and during childbearing. It is with 2 types of factors that they often encounter in gynecology when identifying the causes of uterine hypertonicity.

Decreased amount of progesterone

The condition is determined exclusively by the laboratory method. Before undergoing a blood test, it is difficult to establish that a pregnant woman has a reduced concentration of progesterone. The signs of this phenomenon resemble the symptoms of many other diseases, which greatly complicates the diagnosis. The leading cause of a decrease in progesterone in the blood is the presence of cysts inside the ovaries. The tension of the uterine muscles against the background of a deficiency of this hormone in the blood in the absence of timely medical care ends in a miscarriage.

Toxicosis

A debilitating condition that is caused by a sharp hormonal change that occurs in the female body after fertilization. Signs of toxicity:

• Nausea, repeated vomiting
• Dizziness
• Decreased blood pressure
• Pallor
• Insomnia
• Increased salivation
• Disorientation in space, time
• Bad taste in the mouth
• Lack or decreased appetite
• Panic attacks
• Mood change
• Tremor (involuntary trembling) of hands and feet

The cause of uterine hypertonicity in toxicosis is the regular, intense tension of the abdominal muscles during the urge to vomit (they can be repeated even 30 times a day).

Elevated prolactin levels

Sometimes the condition develops before pregnancy. The reasons are polymorphic: from being in a stressful environment to hereditary predisposition. The main sign of a violation is the release of colostrum from the nipples. Hyperprolactinemia has a direct effect on uterine tone, increases it, and contributes to the development of painful contractions. An increase in the concentration of prolactin in the body is detected only through laboratory diagnostics.

Pathology of the thyroid gland

Diseases of the endocrine system always negatively affect the course of pregnancy. Especially if a woman's body lacks or has an increased content of hormones that the thyroid gland produces. These biologically active substances significantly affect the state of the reproductive system.

With a significant deviation of iodine-containing hormones in the body of a pregnant woman, the blood supply to the placenta, and hence the child, is disturbed. This leads to fetal hypoxia and even to its fading. The growing tone of the uterine muscles is an indirect sign of hormonal imbalance. Which substances in the female body exceed or do not reach the norm are determined by the laboratory method.

Anomalies in the development of the uterus

The structure of the reproductive organ is of key importance in the issue of the full bearing of the child. If the shape of the uterus is characterized by features (for example, it is bicornuate, saddle-shaped), complications may arise as the gestational age increases. The most common of them is the detachment of the fetal egg (the first phase of a miscarriage), since it cannot be kept on the wall of an organ with a problematic structure for a long time.

Rh-conflict of the blood of parents

The discrepancy between these indicators activates protective processes in the woman's body. As a result, the immune properties of the pregnant woman recognize the embryo as a foreign body and reject it. It is the process of the onset of detachment of the fetal egg that causes uterine hypertonicity. The inconsistency of the Rh factor in the blood of the child's parents is found out during the passage of laboratory diagnostics.

Infectious diseases

Regardless of which organ undergoes an infectious and inflammatory process, the circulation of a pathogenic microorganism in the blood adversely affects the condition of the uterus. An increase in the tone of the reproductive organ is observed even with ARVI, which is directly related to the state of the woman's immune system. To avoid complications for the intrauterine state of the fetus, hypothermia is contraindicated during its gestation. Also, a pregnant woman should increase the protective properties of the body.

Pathologies of the placenta

Improper location, structure, blood supply of the placenta causes problems in the state of the uterus. For a long time, these violations may go unnoticed. An increase in the muscle tone of the genital organ is the primary manifestation of the problematic state of the placenta. To identify a violation and clarify its criteria, it is enough for a woman to undergo an ultrasound scan.

uterine fibroids

A benign tumor can appear both before pregnancy and during gestation. The reason is the abrupt changes in the state of the hormonal background, which not every woman can endure without consequences. Initially, the neoplasm progresses asymptomatically, then the following signs of fibroids appear:

1. Drawing pain in the lower abdomen
2. Aching and aching sensations in the sacral region
3. Constipation and urination disorders caused by tumor compression of the intestines and bladder
4. Pain during examination on the gynecological chair

If fibroids occurred before pregnancy, during menstruation, a woman could notice the release of large clots from the vagina, and increased bleeding after their discharge. Additional signs are pain during intimacy, difficulty in assuming a comfortable body position. Myoma tends to grow rapidly, and the period of pregnancy creates a favorable condition for this. The reason is significant hormonal fluctuations. Myoma interferes with the development of the child, because as it grows, it takes up more and more space inside the uterus. Therefore, an increase in the tone of the reproductive organ in pregnant women with fibroids is a sign of the impact of an enlarged tumor on the fetus.

Inflammatory processes of the reproductive organs

This includes adnexitis, endometritis, vaginitis - inflammation of the appendages (ovaries and fallopian tubes), uterus, vagina. Diseases progress in acute or chronic form. The cause of uterine hypertension during pregnancy in 90% are the first 2 pathologies.

Factors causing the development of these diseases:

1. hypothermia
2. Poor hygiene practices
3. Frequent abortions
4. Displacement of the installed intrauterine device
5. Frequent douching, which disrupted the natural microflora of the vagina
6. Taking hormonal medications
7. Unreasonably frequent use of vaginal tampons during menstruation

If adnexitis and endometritis are not eliminated before pregnancy, they can significantly complicate the process of bearing a fetus, provoke an increase in uterine tone. The reason is the reaction of the reproductive organ to the pathogenic microflora present in the blood during inflammation of the uterus and appendages.

Polyhydramnios

The volume of amniotic fluid surrounding the baby during fetal development increases as the gestational age increases. But there is a condition in which the amount of amniotic fluid is much more than the permissible norm. A common reason for the development of this is hidden infectious processes in the organs of the urogenital system. The reason for the increase in uterine tone with polyhydramnios is an intense load on the walls of the reproductive organ, which causes their response in the form of involuntary muscle compaction.

Obesity

The presence of excess weight creates difficulties in the process of bearing the fetus - hypertrophied fatty tissue compresses the uterus. The response of the reproductive organ is an increase in tone, which becomes noticeable already in the early stages of pregnancy. The best solution is to reduce body weight even at the stage of planning the birth of a child. This minimizes the risk of developing uterine hypertension during gestation.

Possible Complications

All the consequences of overexertion of the uterine muscles during pregnancy are associated with the potential risk of losing a child. Hypertonicity can provoke such complications:

• Placental abruption
• Fading pregnancy
• Premature birth
• Miscarriage

Also, with each of these conditions, the development of dangerous vaginal bleeding is possible, in which the risk of death increases. In this case, the woman needs emergency help from gynecologists.

Which doctor to contact

In 97% of cases, an immediate visit to a specialist is required. In all cases of pain and contractions in the lower abdomen, you need to notify the observing gynecologist or call an ambulance. If, after examination and diagnosis, problems are identified that require monitoring of the patient, hospitalization in the hospital department will be required. This will allow you to be under the control of doctors so that gynecologists can provide timely, competent assistance aimed at maintaining pregnancy.

Diagnostics

If there are complaints of intense contractions and pain in the lower abdomen, the pregnant woman needs to go through:

• Inspection. The doctor determines the boundaries of the location of the uterus; establishes whether the size of the reproductive organ corresponds to the gestational age.
• Unscheduled ultrasound of the uterus (with or without Doppler). Conduct an ultrasound examination of the genital organ, including its blood supply.
• Tonusometry (hardware determination of the degree of tension of the uterine muscles).

Additional types of research directly depend on the characteristics of the clinical case. A woman may be prescribed a blood test to determine the concentration of hormones.

Treatment

Since almost all medications are contraindicated during pregnancy, it is important to refrain from using medications before visiting a doctor. Conditions that cause uterine hypertonicity are eliminated with antispasmodics. Of the drugs that are safe for fetal development, No-Shpu is used. Antibiotics, non-steroidal drugs, most analgesics and even some vitamin complexes during pregnancy can provoke malformations in the child. A woman with an increased tone of the uterus is prescribed synthetic analogues of natural hormones - mainly in the form of suppositories.

The therapeutic benefit of drugs in this group is higher than the possible risk of developing complications of intrauterine development of the child. At the time of treatment, the patient is prescribed a diet and bed rest. To prevent even greater tension of the uterine muscles, sexual activity is contraindicated during pregnancy. To facilitate well-being, the use of a heating pad is contraindicated - exposure to high temperatures can provoke serious consequences, up to lethality.

Prevention

To prevent the development of conditions that lead to uterine hypertonicity, a woman should:

• Avoid increased physical activity, give up sports training, hard work.
• Take daily walks in the fresh air, with limited mobility due to bed rest - ensure regular ventilation of the ward.
• Refuse to use spices, spices, coffee, cocoa, hot sauces.
• Stay away from sources of toxic exposure, including cigarette smoke.
• Limit yourself from stressful factors, sleep at least 8 hours a day.
• Diversify the diet, do not oversaturate it with heavy food, which is digested for a long time, can provoke the development of constipation and increased pressure on the uterus.
• Avoid exposure to high temperatures.

Other preventive measures are to perform hygiene procedures in full, to prevent hypothermia.

The tone of the uterus during pregnancy increases due to a wide range of reasons - from inflammation and anomalies in the development of the organs of the reproductive system to emotional stress. In all cases, the prospect of full-fledged gestation is at risk. To avoid the loss of a child, you should consult a gynecologist with the primary symptoms of tension in the muscular layer of the uterus.

Video: What you need to know about uterine tone

With the onset of pregnancy, a woman pays increased attention to any manifestations that may indicate trouble. And this is right, because most often it is enough to see a doctor on time to cope with the deviation. During this period, physical stress and excitement are contraindicated for a woman, as they can cause a miscarriage or premature birth. Increased uterine tone during pregnancy is a common phenomenon that can be encountered in any week. You need to know what to do if this situation arises.

Sometimes tension in the muscles of the uterus is a completely normal process, for example, if it occurs when sneezing, laughing, changing body position. This condition occurs if a pregnant woman is anxious or worried. But we are not talking about a physiological increase in tone, which is short-lived and does not cause discomfort.

A prolonged increase in tone, which does not depend on the will and mood of a woman, but is caused by any pathologies, is dangerous, as it leads to impaired development or death of the fetus. Depending on which part of the organ is tense, total hypertonicity is distinguished (the walls and bottom of the uterus are tense), as well as local (on one of its walls - anterior or posterior). In this case, they talk about pathology of 1 or 2 degrees of severity.

What is the danger of the state

In the early stages (up to 12-16 weeks), the increased tone of the uterine muscle makes it impossible for the embryo to implant into the endometrium. There is a detachment of the fetal egg or its complete rejection, in which a miscarriage occurs. If the increased tone has arisen after the fetal egg is fixed in the uterus, it becomes the cause of malnutrition of the fetus, oxygen starvation. In this case, the pregnancy freezes, the fetus stops growing and developing. A miscarriage does not occur, but the fetus dies and must be removed by uterine scraping.

At later stages of pregnancy (more than 16 weeks), an increase in the tone of the uterus is dangerous because tense muscles disrupt the blood supply to the fetus, pinching the blood vessels located in the umbilical cord. In this case, placental abruption occurs, fetal hypoxia, leading to impaired development or death of the child, to the so-called "late" miscarriage.

On the eve of childbirth, an increase in tone indicates that the maturation of the fetus has completed. He has reached such proportions that "training" fights begin.

Video: What is uterine hypertonicity. The reasons for its appearance

Causes of increased tone

The reasons for the increase in uterine tone at the beginning of pregnancy can be:

1. Hormonal disorders - lack of progesterone. After fertilization of the egg, thanks to this hormone, the endometrium is loosened, which helps to fix the fetal egg in it. When progesterone production is normal, the smooth muscles of the uterus are relaxed. If the hormone is not enough, the tone rises. Uterine hypertonicity also manifests itself when the content of the male sex hormone testosterone is exceeded in the body of a pregnant woman.
2. Congenital malformation of the uterus. In the presence of a "bicornuate uterus" or its bend, pregnancy can proceed without complications, but quite often a woman cannot bear a child due to an increase in the tone of this organ.
3. early toxicosis. This condition is experienced by most women at the beginning of pregnancy. During severe vomiting, compression, spasmodic contraction of the muscles of the uterus occurs.
4. Rhesus conflict. The mismatch of the Rh factor in the blood of the mother and father of the unborn child often leads to the death of the fetus. At the same time, the tone of the uterus automatically increases.
5. The presence of scars or adhesions in the uterus after suffering inflammatory diseases, abortions, operations, as well as damage or stretching of the muscles of the organ during previous births.
6. Polyhydramnios or multiple pregnancy. Under the influence of ever-increasing gravity, the uterus is stretched, spasms occur in it. Most often, the birth of twins occurs a few weeks ahead of schedule.
7. Intestinal bloating, constipation.
8. Heavy lifting, harmful working conditions, severe emotional stress, active sexual contact.

To provoke a spasmodic contraction of the uterus and an increase in its tone can be too active fetal movement. If the spasms are painless and short-lived, there is nothing dangerous in them.

Sometimes the pathological tone of the uterus occurs during pregnancy in women with thyroid disease. Often, tone is observed during the development of infectious processes in the genitals.

Note: The risk of tone is increased in pregnant women younger than 18 and older than 30, as well as those who have had several abortions and have weak immunity. Often, symptoms of hypertension occur in smokers or drinkers during pregnancy.

Symptoms of increased uterine tone

Often a woman can guess the appearance of such a condition. If it occurs at an early stage (before the 16th week of pregnancy), then heaviness in the lower abdomen, aching pains in the sacrum and lower back (as during menstruation) appear.

At later stages of pregnancy, when the size of the abdomen increases, you can notice that the uterus is in good shape by changing the elasticity of the muscles. There is a feeling of a "stone" abdomen. If the uterus is “in good shape”, it tenses and contracts.

Advice: In order to independently check whether the uterus is in good shape or not, a woman should lie on her back and relax, and then gently feel her stomach with light movements. If it is soft, there is nothing to fear. But if it is elastic, the muscles are tense, it is necessary to report your condition to the doctor who monitors the course of pregnancy.

Signs of increased tone in the 1st trimester

The risk of miscarriage during this period is greatest, so the following signs should not be ignored:

• pain in the lower abdomen, radiating to the lower back;
• spotting spotting from the vagina;
• tension of the muscles of the abdomen, a feeling of spasm in his muscles.

Increased tone in the 2nd trimester of pregnancy

You can assume the presence of pathology by the presence of spotting discharge and back pain. Most pregnant women experience mild discomfort in the lower back due to the fact that the fetus becomes heavier, the uterus increases in volume, the ligaments that hold it are stretched. But if the tension is pathological, then the pain becomes severe. This requires urgent medical attention, which will help prevent the loss of a child.

Increased tone in the 3rd trimester of pregnancy

During this period, uterine contractions periodically appear in every pregnant woman. Since there is less and less free space in the uterus, it is more difficult for the unborn child to change its position, its thrusts into the wall of the organ become more noticeable, which leads to muscle contraction. Therefore, recognizing a state of increased tone is not as easy as before. However, "training" uterine contractions do not cause increased pain in the back and in the lower abdomen, moreover, they occur irregularly and for a short time. There is no hemorrhagic discharge.

A sign of an increase in the tone of the uterus during pregnancy may be the occurrence of pain during the movement of the fetus, when the hardening uterus begins to squeeze it. The long-term absence of movements (more than 12 hours) also speaks of trouble.

Diagnosis of increased tone

Each woman undergoes individual changes in her body during pregnancy. They can be unexpected even for a doctor, so it is not always possible to diagnose hypertonicity only according to the patient's sensations and by palpation of the abdomen. To clarify the condition of the uterus, an ultrasound is performed. This study allows you to identify a violation of the shape of the uterus, that is, to recognize the presence of tone in the region of its bottom, posterior wall or anterior, as well as determine the degree of contractions (1 or 2).

Increasing the tone of the muscles of the back wall

It is more difficult to diagnose such a condition, since there are often no obvious symptoms that could cause a feeling of discomfort in a woman. In this case, muscle tension in the posterior wall is detected during a planned ultrasound scan and subsequent tonusometry (using a sensor applied to the uterus).

When hypertonicity of the 2nd degree appears, the pain in the lower abdomen and lower back intensifies, it is especially felt when walking, it can be given to the rectum, perineum, vagina. If such a pathology is detected, the woman is hospitalized and treated to prevent miscarriage or premature birth.

Increased muscle tone of the anterior wall

This complication of pregnancy is accompanied by more pronounced symptoms: spotting, severe pain in the lower abdomen and perineum. Diagnosis is established by palpation of the uterus through the vagina.

The stage of increasing the tone is determined.

At the "initial" stage, changes in the shape of the organ are insignificant, the neck has normal dimensions.

At the “development” stage, the neck shortens and partially opens.

At the “final” stage, the cervix opens completely, which leads to termination of pregnancy or premature birth.

Treatment

Treatment, depending on the degree of tension of the uterus and the threat of complications, is carried out at home or in a hospital.

First of all, a woman needs bed rest. She is advised to avoid worries and stress, sexual intercourse, and be more attentive to her diet (refuse coffee, eat foods containing fiber to normalize bowel function). Antispasmodic drugs are prescribed, such as papaverine or no-shpa to relax the muscles, as well as sedatives (valerian or motherwort tincture).

Medical treatment

After finding out the cause of this condition, the corresponding pathologies are treated. If progesterone deficiency is detected, duphaston or other drugs based on it are prescribed. Excess testosterone is eliminated with the help of estrogen-containing agents. To alleviate the manifestations of toxicosis, Benedictine or other antiemetics are prescribed.

Preparations containing magnesium are also prescribed, which helps to relax the muscles of the uterus, intestines, and also reduces the excitability of the nervous system. In a hospital, a woman is given magnesium and vitamins intravenously.

A warning: In no case should you take any drugs during pregnancy without a doctor's prescription, since any of them have serious side effects. Medicines can cause irreparable harm to the health of the baby and mother.

Special exercises

At home, tension in the uterus is relieved in the absence of serious symptoms with the help of physical exercises. For example, you can weaken the tone by standing on all fours. Then the uterus appears as if in limbo. Bend your back and stand like this for 10-15 seconds. Additionally, antispasmodics should be taken. After completing the exercises, you need to lie down for an hour.

Yoga classes help a lot.

Video: Exercises to reduce the tone of the uterus

Measures to prevent increased tone of the uterine muscles

It is possible to reduce the likelihood of such a complication of pregnancy. It is necessary to regularly visit a gynecologist, undergo the necessary examinations, follow all the doctor's recommendations. This will allow you to notice infectious diseases and other pathologies in time.

Hygiene plays an important role. Good rest and sleep, normal daily routine, short walks in the fresh air, limitation of physical activity, as well as emotional peace are the most important conditions for a normal pregnancy. It is necessary to eat regularly and properly, stop smoking and drinking alcohol.

Almost 60% of pregnant women hear the diagnosis of "uterine tone" already at the first visit to the gynecologist in order to confirm their position and register. This seemingly harmless condition carries certain risks associated with the bearing and development of the fetus. How to understand that the uterus is in good shape, we will tell in our article. Be sure to dwell on the symptoms and causes of this condition, possible methods of its treatment and prevention.

uterus?

During pregnancy, brief contractions of smooth muscle tissue are normal. This is a completely natural condition, which usually does not cause any discomfort to a woman. So, the uterus contracts during sneezing, laughter, worries, gynecological examination and ultrasound. As soon as the action of the stimulus stops, the myometrium again assumes a relaxed state.

Throughout pregnancy, the uterus tenses quite often. Up to 12 weeks, muscle contractions are the least intense, which is related to physiology. At this time, the body works to keep the pregnancy and prevent miscarriage. Gradually, the number of contractions increases, and by 20 weeks they may be accompanied by short-term pain. This is due to the preparation of the woman's body for childbirth.

In European countries, such a physiological process does not require special attention from the doctor, unless it is accompanied by symptoms that cause discomfort and indicate serious disorders in the body. In order not to miss them, it is important to know how to understand that the uterus is in good shape. First of all, a woman should be alerted by the fact that the muscular organ is in tension for a long time. This is a dangerous signal that pregnancy and the normal development of the fetus are in jeopardy.

The danger of increased tone during pregnancy

Constant tension of the myometrium can have negative consequences for the expectant mother and fetus. That is why it is important to understand in time that the uterus is in good shape. Both in the first and in the last trimester of pregnancy, the risks of premature termination of pregnancy are quite high.

The danger of increased tone is as follows:

• violation of the implantation of the fetal egg;
• anembryony;
• spontaneous abortion;
• premature birth;
• hypoxia;
• hypotrophy.

Most often, uterine tone occurs in the early stages of pregnancy. During this period, the tension of the muscular organ can cause rejection of the fetal egg during its implantation. As a result of this, its development will stop and spontaneous miscarriage will occur.

In late pregnancy, uterine tone is usually not a concern. As a rule, it is associated with training bouts of Braxton-Hicks. The uterus is just preparing for childbirth. This explains the periodic muscle contractions.

The tone can not only cause discomfort to the mother, but also lead to a lack of oxygen and nutrients for the fetus. In the first case, hypoxia occurs, and in the second - malnutrition or stunting of the child. All this occurs due to clamping of the vessels of the umbilical cord by the uterus, which is constantly in tension. That is why it is so important to diagnose such a condition in a timely manner.

Symptoms of increased uterine tone during pregnancy

Many women doubt whether they can self-diagnose muscle tension. In fact, this is not at all difficult to do, although the symptoms of uterine tone during pregnancy at 14 weeks and at 38 are significantly different. It is important to familiarize yourself with them as early as possible.

Signs of uterine tone in early pregnancy are as follows:

• heaviness in the lower abdomen;
• drawing pains as during menstruation;
• discomfort in the lower back and sacrum.

In the second and third trimesters, signs of hypertonicity can be as follows:

• involuntary contractions of the abdomen, during which it becomes hard, literally "stone";
• pulling pains in the lower abdomen and lower back.

Pain in the lower abdomen is usually cramp-like.

The above symptoms at any stage of pregnancy may be accompanied by spotting. This sign of muscle hypertonicity requires emergency medical attention. But first you need to try to calm down. In most cases, with timely medical care, pregnancy can be saved.

Changes in the intensity of fetal movements in comparison with previous weeks should be added to the symptoms of uterine tone during pregnancy in the 2nd trimester and in the third. A woman should also be alerted to the discomfort that occurs during fetal movements, which may be due to a decrease in space for him in the uterus. All suspicions should be immediately reported to the gynecologist.

In medical practice, there are cases when the tone of the uterus is asymptomatic. In this case, the condition can be diagnosed using a gynecological examination or ultrasound.

Causes of the condition

If you listen to the symptoms described above, it is easy to understand that the uterus is in good shape during pregnancy. As with other pathologies, the causes of this condition can be varied. First of all, they are associated with the physiological processes that occur in the body during the period of gestation. But most often it is pathological changes and problems that cause the appearance of symptoms of uterine tone during pregnancy. The reasons for this condition are as follows:

1. Lack of progesterone in the body. In the early stages, a deficiency of the main female hormone responsible for a favorable pregnancy outcome can lead to a disruption in the process of implantation of the fetal egg and spontaneous miscarriage. Similar effects can occur in the presence of other hormonal changes in the body.
2. Severe toxicity. Vomiting often provokes contraction of the muscles of the abdominal cavity and uterus. In this case, it is important to do everything necessary in order to alleviate the condition of the woman.
3. Anomalies in the development of the uterus. In rare cases, this organ may have a bicornuate or saddle shape, as well as other disorders. All of them interfere with the normal bearing of the fetus or even make it impossible.
4. Rhesus conflict. It occurs when the mother has a negative blood type, and the fetus has a positive one. In this case, the woman's body rejects the child as a foreign body. At this time, hypertonicity occurs.
5. Inflammatory and infectious processes of the genital organs or in the uterine cavity. In this case, hypertonicity is often accompanied by other symptoms: discharge, itching, etc.
6. Severe distension of the uterus. This condition occurs with multiple pregnancy, polyhydramnios, large fetal sizes.
7. Psychological problems. Stress has a direct impact on the condition of smooth muscles.
8. Change in intestinal motility. With the onset of pregnancy, changes affect not only the reproductive organs, but also other body systems. So, increased gas formation may well cause tension in the uterus.
9. Miscarriages and abortions in the past. Unfavorable outcome of previous pregnancies can adversely affect the state of the present. Women who are at risk need constant monitoring by a gynecologist.

Diagnosis of hypertonicity

It is possible to make a correct diagnosis and understand that the tone of the uterus during pregnancy, as with any other changes in the body that are not related to physiological processes, is possible after a preliminary history taking. Medical diagnosis of this condition is carried out in different ways:

1. Gynecological examination. It is carried out by a gynecologist only in the early stages of pregnancy. After 20 weeks, palpation is done through the anterior abdominal wall. In this case, the woman lies horizontally on her back with her legs bent at the knees. This position allows you to relieve tension in the abdominal wall and feel the seal.
2. Ultrasound procedure. This method allows not only to diagnose hypertonicity, but also to establish its degree, as well as which wall of the uterus it affects.
3. Tonusometry. Diagnosis is carried out using special sensors that measure the tone of the uterus. This method is used much less frequently than the previous ones, since in most cases it will not be difficult to identify hypertonicity. It is much more difficult to determine the cause of this condition.

It is possible to reveal that the uterus is in good shape, and independently. But this should be done in the second trimester of pregnancy, when the uterus is located above the level of the navel. How to understand if there is a tone of the uterus? To do this, take a horizontal position on a flat surface, bend your knees and try to relax. After that, with gentle movements, palpate the surface of the abdomen. A hard, especially "stone" stomach will indicate hypertonicity. This is a signal that you need to see a doctor.

How to understand that the uterus is in good shape on ultrasound?

To diagnose hypertension, it is enough for a doctor to conduct an examination according to the gestational age. But to confirm their assumptions, the gynecologist most often appoints an ultrasound scan. This is an additional examination that helps to assess the degree of thickening of the muscle layer and the condition of the cervix. According to the results of the ultrasound, the doctor sees whether there is a threat of termination of pregnancy.

The advantage of this method of examination is that it allows you to identify local tone, that is, in certain areas of the uterus. It is his woman who most often does not feel, while the danger of an unfavorable outcome of pregnancy remains.

If the ultrasound reveals that the uterus is in good shape at the 36th week of pregnancy, and the symptoms that bother the woman (pain, spotting) increase, this may indicate the onset of labor. In this case, the pregnant woman needs emergency help.

Treatment of increased tone in a pregnant woman

Regardless of how muscle tension was detected - during an ultrasound scan or on your own, consultation and examination by a gynecologist are mandatory. Only a doctor can determine how strong the symptoms of uterine tone during pregnancy are. Treatment will depend on this, as well as on the reasons that caused it.

A woman who is diagnosed with uterine tone is assigned to bed rest. If stress does not pose a risk to the mother and fetus, treatment is carried out on an outpatient basis.

Traditional therapy includes taking the following medications:

• "No-shpa";
• "Papaverine";
• "Magnesium B6";
• motherwort tincture.

All these remedies will help relieve muscle spasm, but they will not eliminate the reason why the tone of the uterus occurred during pregnancy (2nd trimester). The symptoms will reappear after a while. In addition, toxicosis usually lets go by the beginning of the 2nd trimester, which means that it cannot cause a spasm of the muscles of the abdominal wall. Therefore, by the end of the 13th week, a woman must pass all tests to detect hormonal disorders and blood to determine the Rh factor.

According to the results, the doctor will prescribe the necessary treatment. If the tone is associated with a lack of progesterone, it is eliminated by taking special medications, but if tension is formed due to an excess of male hormones, then it is corrected by antipodes. In case of Rhesus conflict, another, but no less effective therapy is prescribed. And it is also worth noting that the sooner a woman goes to the doctor, the sooner she will be prescribed the necessary tests and the cause of this condition will be found. Do not risk your own health and the life of your baby.

When is hospitalization needed?

If the tone continues for too long and cannot be removed on an outpatient basis, the doctor will insist on further treatment in the hospital. Despite the fact that most women try to negotiate with the gynecologist not to give them a referral to the maternity hospital, it is worth noting that hospitalization has its own advantages:

1. A pregnant woman will 100% comply with the bed rest prescribed for her. She will no longer be able to be distracted by household chores such as cooking, cleaning, washing, etc.
2. In the hospital, the woman will be under the supervision of doctors around the clock, who will be able to bring down the intensified spasms in a timely manner, if necessary. In addition, the pregnant woman will not have to guess and try to understand if the tone of the uterus, as she did at home. Systematic examinations of doctors will help to detect any changes in a timely manner.

After the causes and symptoms of increased uterine tone during pregnancy are eliminated, we can talk about continuing therapy at home.

And it is also worth noting why it is so important to go to the hospital on time. The fact is that childbirth that began after the 28th week of pregnancy is considered premature. And although the child is not yet full-term, you can try to save his life. Therefore, doctors will do their best to make it at least until this period, but even better if it can be extended. But if the tone of the uterus provokes the onset of labor at week 25, gynecologists will take all measures to stop it. Children born at such a period survive extremely rarely or have multiple developmental pathologies in the future.

Most women, especially in the case of re-pregnancy, do not rush to the hospital with pulling pains in the abdomen or lower back. Even if they already know how to understand if the tone of the uterus is increased and were able to independently identify its cause, as a rule, expectant mothers first try to remove it on their own. In addition to such medicines as "No-shpa" and "Papaverine", the following actions and exercises will help eliminate the discomfort caused by muscle spasm:

1. Complete rest and healthy sleep. According to reviews, the symptoms of uterine tone during pregnancy often appear after intense exertion (cleaning, lifting weights, a busy day). In this case, the woman needs to ensure a good rest. It is important to create conditions so that she can relax. Then the tone will be removed as if by hand.
2. Exercise cat. The pregnant woman needs to get on all fours, bend her back and raise her head up. After a minute, return to the starting position. Perform 3-4 sets, then take a horizontal position and rest for about an hour. After a while, you need to check that the tone of the uterus is not increased. How to understand this was described above.
3. with an emphasis on the elbows so that the uterus is in limbo. This will remove or reduce hypertonicity.
4. Lower your head down, relaxing the muscles of your face and neck as much as possible. At the same time, you need to inhale and exhale air only through your mouth.

Preventive actions

If you listen to your feelings, it will be difficult to miss the obvious symptoms of uterine tone. And to understand how to eliminate them, consultation with a gynecologist and strict adherence to his appointments will help. Well, in order to completely forget about the discomfort during pregnancy, prevention is needed:

• avoid excessive physical activity;
• try to resolve any conflicts peacefully, avoid stressful situations;
• adhere to the principles of proper nutrition and daily routine;
• ensure proper rest during the day and healthy sleep at night;
• give up alcohol and smoking even in small doses, it is advisable to do this at the planning stage;
• monitor your weight;
• refuse sexual intercourse in the last weeks of pregnancy;
• wear a prenatal bandage that will support the uterus and relieve muscle tension.

Such symptoms of uterine tone at 33 weeks of pregnancy, such as pain in the lower back and lower abdomen, are often associated with physiological processes and preparation for childbirth. But to exclude the possibility of complications and minimize the risk of premature birth, you should consult a doctor. In addition, regular visits to the gynecologist and constant gynecological control will help save the life of the unborn child.

Does the stomach “stiffen”, “stand up like a stake” and “shrink into a ball”? According to statistics, every second expectant mother faces unpleasant symptoms of uterine hypertonicity during pregnancy. Why does it arise? How dangerous is it? What to do? These questions are answered by our expert - Anna Romanovna PASTUKHOVA, obstetrician-gynecologist of the Zdravitsa Family Medicine Centers.

How is the uterus

To understand what happens in the body at the time of uterine hypertonicity, you need to imagine this organ. Simply put, the uterus is a sac of muscle, lined on the inside with mucous tissue. As the child grows, this "bag" increases, becomes more durable and resilient.

” Each muscle fiber lengthens 10-12 times, thickens 4-5 times and gains strength. In order to push out a child during childbirth, which is several times heavier than the uterus, the muscles contract with a force of 100 to 400 newtons (and this, for a moment, is close to the traction force of a small horse!)

So that all this “dormant power” does not manifest itself ahead of time, the body during pregnancy includes a “protective mode”, the so-called “dominant of pregnancy”. The most important thing for a woman is her condition and external stimuli that are not related to expectation fade into the background. This is necessary, among other things, in order not to provoke an involuntary strong and prolonged contraction of the muscles of the uterus, which, like any muscular organ, is sensitive to external influences and stress.

However, if the emotional stress is too strong, the woman has not established a favorable "pregnant" hormonal background, there is a Rhesus conflict or serious health problems, the increased tone of the uterus can take a pathological form and become a threat of termination of pregnancy.

Expert opinion

The so-called "tone of the uterus" is the contraction of the fibers of its muscle layer. The process of muscle contraction is natural, so tone is not always a problem. The uterus is a living organ that reacts to the movement of the fetus, to a change in body position, to a long-term static load. All this causes a contraction of the muscle layer and leads to some tension. But these are short-term and painless phenomena, almost imperceptible to the woman herself.

If the contractions are noticeable, cause discomfort, become painfully growing or long in time, you should consult a doctor, as they can lead to such consequences as spontaneous miscarriage (early - up to 12 weeks or late at 13-21 weeks), premature shortening cervix, opening of the cervix and premature birth.

Uterine tone is not always a pathology

Doctors assure: a temporary slight increase in the tone of the uterus is the norm and does not pose any danger. However, many “beginning” pregnant women are afraid not only of the muscle contractions themselves, but also of the very possibility of increasing the tone of the uterus, listening to the sensations and being afraid to miss the “bad manifestation”. The good news is that the body of a pregnant woman is a very reliable thing, you can trust it. The main thing is to take care of yourself and listen carefully to your needs.

Causes of uterine hypertonicity
Hormonal disorders (they matter mainly in the first half of pregnancy)	insufficiency of progesterone (a female sex hormone, the most important function of which is to maintain pregnancy) or a violation of the ratio of the amount of estrogen (a female sex hormone produced by the ovaries) and progesterone; hyperandrogenism (increased levels of androgens - male sex hormones); hyperprolactinemia (increased levels of prolactin (the pituitary hormone that regulates lactation), in which there may be insufficient production of progesterone.
	genital infantilism (underdevelopment of the uterus); hypoplasia of the uterus; uterine fibroids (benign tumor of the myometrium - the muscular layer of the uterus); endometriosis (growth of the inner lining of the uterus beyond its limits); (inflammation of the lining of the uterus).
Muscle overstretching	multiple pregnancy (pregnancy with two or more fetuses); (increased volume of amniotic fluid); large fruit.
Causes associated with the work of the central nervous system)	heavy physical work; excessive psycho-emotional stress; with a sharp rise in body temperature.

Expert opinion

If there is no pathology, then preventing an increase in the tone of the uterus is a very real task. Lead the right lifestyle: get enough sleep, eat rationally, regulating bowel function. Limit physical activity. Keep stressful situations to a minimum.

Methods for the diagnosis and treatment of uterine tone

If hypertonicity nevertheless manifests itself more and more often, the stomach now and then “stiffens” and “shrinks” and all this is accompanied by pulling pains, then this is an absolute reason for an urgent visit to the doctor. Ultrasound diagnostics will help determine whether local or general uterine hypertonicity (the muscles of a separate section of the myometrium or the entire myometrium are tense), as well as to determine the degree of hypertonicity: minor, moderate, or severe. Also, the doctor will determine the cause of this condition and prescribe medication.

If the tone is really strong, be prepared for the fact that you will be recommended strict bed rest and a minimum of physical activity. In some cases, hospitalization is indicated. But more often, the symptoms of hypertension are relieved simply by good rest, the care of loved ones, and soothing herbal tea, which your doctor may recommend. Special gymnastics helps many to relieve stress - ask your doctor to show you a couple of exercises.

Expert opinion

The main component is the medical and protective regimen. Sometimes it is enough to free a woman from household chores and the symptoms of an increase in the tone of the uterus fade away.

As for drug therapy, different groups of drugs are used:

phytosedatives (motherwort, valerian, bromine tincture);

antispasmodic drugs;

combined preparations of magnesium with vitamin B6, which have a relaxing effect on the muscular layer of the uterus and a sedative on the nervous system of a pregnant woman;

hormonal agents that increase the level of progesterone (a hormone that maintains pregnancy);

calcium channel blockers (this is an emergency drug in case of a threatened abortion);

blockers of prostaglandin receptors (prostaglandins are physiologically active substances normally produced in human tissues, but during pregnancy leading to uterine contractions);

oxytocin receptor blockers (oxytocin is a hormone that causes uterine contractions).

It is important to understand that each case is individual and requires different treatment. There is no single drug that would equally help everyone, and only a doctor can prescribe the correct treatment for uterine hypertonicity.

Urgent help

If you feel a sudden strong cramp in your stomach, then the most important thing is not to panic, understand that this is just a cramp and everything will be fine. Try to get in a comfortable position. Breathe rhythmically and measuredly, try to inhale deeply, then hold your breath for a short while and exhale slowly and smoothly, relieving tension. If you have antispasmodics recommended by your doctor, take them. And, of course, be sure to consult your doctor.

Expert opinion

Relax, calm down, lie down if possible. Take an antispasmodic drug: No-shpy tablets or papaverine (rectal in suppositories), magnesium preparations are suitable. Be sure to see a doctor!

- a pathological condition, accompanied by increased contractility of the myometrium, which appears earlier than the established date of birth. Among the clinical signs, there is a visible tension of the anterior abdominal wall, pulling pains in the lower abdomen. To diagnose uterine hypertonicity, an objective examination of a woman and an ultrasound scan are used. Additionally, blood tests to determine hormones may be performed. Treatment consists in ensuring complete rest, prescribing sedatives, antispasmodics, vitamin therapy.

General information

Uterine hypertonicity is an increased excitability of the smooth muscles of the uterus, provoked by hormonal changes or negative psychophysiological factors. This condition is more commonly diagnosed in women under 18 and over 30 years of age. In the first case, the hypertonicity of the uterus is due to the underdevelopment of the genital area and the unpreparedness of the organ for bearing the fetus. As for patients over 30 years old, hyperexcitability usually develops against the background of frequent abortions, previous infections and other obstetric and gynecological pathologies. Uterine hypertonicity poses a real threat to the life and health of the baby, as it can provoke not only hypoxia, but also miscarriage, the onset of premature birth, and fetal death.

Causes of uterine hypertonicity

In most cases, uterine hypertonicity develops against the background of reduced production of progesterone, a hormone that ensures the normal course of pregnancy. Under its influence, there is a decrease in the contractility of the myometrium, the excitability of the receptors of the uterus and spinal cord, which together allows you to carry the fetus up to 38-40 weeks and give birth to a healthy baby. Progesterone deficiency with uterine hypertonicity manifests itself in the form of spontaneous miscarriages, fetal hypoxia, miscarriage or premature birth. Therefore, during treatment, the main goal should be to influence these etiological links of the pathological condition.

Uterine hypertonicity often develops when a woman has hyperandrogenism - a condition in which there is an increased production of male sex hormones. This diagnosis is also possible with genital infantilism. In this case, an underdeveloped uterus in response to an excessive increase may respond with increased hyperexcitability. Hyperprolactinemia is also a common cause of uterine hypertonicity. The condition is accompanied by increased production of prolactin, which blocks the production of progesterone and leads to an increase in the contractility of smooth muscles.

Often, uterine hypertonicity is due to hormone-dependent diseases that a woman suffered from even before conception. Among them are fibroids, endometriosis. Previously transferred inflammatory processes that spread to the uterine cavity and appendages also increase the likelihood of developing increased excitability of the myometrium. Uterine hypertonicity may be due to dysregulation of the central nervous system, which manifests itself in an increase in contractility, the inability to maintain optimal muscle tone. Women with multiple pregnancies, polyhydramnios, in the presence of a large fetus are more susceptible to such a pathology. These factors contribute to excessive overstretching of the myometrium.

The risk group for the development of uterine hypertonicity includes patients with genetic abnormalities, thyroid diseases, who have had viral infections in the early stages of pregnancy. When the expectant mother's body is exposed to negative factors (harmful working conditions, lack of sleep, daily work), the likelihood of this condition also increases. Often, uterine hypertonicity is due to psycho-emotional experiences, stress, and bad habits. Therefore, such factors should be excluded from the life of the patient.

Symptoms of uterine hypertonicity

Depending on which part of the myometrium is tense, in obstetrics, 1 and 2 degrees of uterine hypertonicity are distinguished. In the first case, only the posterior wall of the organ is reduced, which is most often not accompanied by pathological manifestations. In the third trimester of pregnancy, uterine hypertonicity of the 1st degree can be manifested by slight pulling pains in the lower back, a feeling of heaviness in the sacrum. There are usually no other symptoms.

Hypertonicity of the uterus of the 2nd degree implies tension of the myometrium of the anterior wall of the organ and is accompanied by a more pronounced clinical picture. The main symptom is pulling pains in the lower abdomen, similar to those that occur in women in the premenstrual period. Often, with hypertonicity of the uterus, the pain spreads to the perineum, there may be a feeling of fullness in the external genitalia. At the same time, there is an increase in urination, a contraction of the muscle fibers of the rectum, similar to the urge to defecate.

Visually, with hypertonicity of the uterus, the abdomen becomes dense, slightly rises, acquires more rounded shapes than usual. It is possible to determine the tension of the myometrium through the anterior abdominal wall by palpation. As for the lower segment of the penis, that is, the cervix, with uterine hypertonicity, its contraction is usually not observed, although such a symptom is sometimes present if the woman previously had cervical canal injuries, for example, during previous births.

Diagnosis of uterine hypertonicity

Uterine hypertonicity is an alarming symptom in obstetrics, which may indicate a possible likelihood of spontaneous abortion or premature birth. Therefore, the health and life of the fetus depends on timely diagnosis and treatment. An obstetrician-gynecologist can identify hypertonicity of the uterus with the help of a routine objective examination of a woman, which is carried out at each appointment. On palpation of the abdomen, tension of the myometrium will be felt, the intensity of such a sign may be different - up to a feeling of "petrification". In this case, patients often report discomfort and even pain.

Ultrasound scanning is used as an additional method for diagnosing uterine hypertonicity. With the help of this study, it is possible to determine the local or total contraction of the myometrium. At 1 degree of hypertonicity, a thickening of the muscular layer of the uterus is observed on one side. If a similar sign is detected in the area of ​​​​attachment of the placenta, then there is a high probability of its detachment. With uterine hypertonicity of the 2nd degree, the entire myometrium is thickened, there are corresponding clinical symptoms. Also, to determine contractility, tonusometry can be performed - measuring the tone of the uterus using a special sensor, which is placed on the anterior abdominal wall and records the level of tension in the muscle layer.

Treatment of uterine hypertonicity

With hypertonicity of the uterus, a pregnant woman, first of all, should be provided with bed rest. It is necessary to eliminate any negative factors (physical activity, stress) that can cause an aggravation of the pathological condition. If excessive contractility of the myometrium is not accompanied by severe symptoms, treatment can be carried out on an outpatient basis. Hospitalization of a woman is indicated for grade 2 uterine hypertonicity, especially if spotting from the vagina is observed. This symptom may indicate an early abortion, premature birth or placental abruption in the 2nd-3rd trimester.

Drug treatment of uterine hypertonicity depends on the etiology of the pathological condition. With a lack of progesterone production, progesterone preparations are prescribed. If uterine hypertonicity has developed against the background of magnesium deficiency, the patient is shown taking tablets based on this trace element or injecting magnesium sulfate in case of medical care in a hospital setting. Under the action of this component, there is a decrease in the contractility of the myometrium, the normalization of the transmission of nerve impulses.

Antispasmodics are prescribed as symptomatic therapy for uterine hypertonicity. They reduce the contractility of the myometrium and eliminate pain. The use of sedatives is also indicated. With uterine hypertonicity, mainly herbal preparations are used. Additionally, vitamin complexes are used. Until the 34th week of pregnancy, tocolytics are prescribed, which reduce contractions of the myometrium and suppress the onset of labor. With this diagnosis, specialists always try to prolong pregnancy management as much as possible and bring the fetus to 38 weeks.

Prediction and prevention of uterine hypertonicity

In most cases, the prognosis for uterine hypertonicity is favorable. With timely medical care, it is possible to suppress the increased excitability of the myometrium and prolong the gestation of the fetus until the expected date of birth. With the progression of uterine hypertonicity, the possibility of giving birth to a viable baby appears only for a period of 25-28 weeks. At earlier stages, the fetus simply will not be able to survive in environmental conditions.

Prevention of uterine hypertonicity should begin even when planning conception. It is important to timely detect and treat sexual infections, diseases of hormonal etiology. After the onset of pregnancy, the prevention of uterine hypertonicity is to reduce physical activity, the correct organization of the work and rest regimen. You should also completely eliminate emotional experiences and stress. If even minimal signs of uterine hypertonicity are observed, you should immediately seek medical help.