Pregnancy, belly is in good shape, what to do. Regulation of labor

With the onset of pregnancy, every woman may face a number of previously unknown diagnoses. One of them is the tone of the uterus in early pregnancy. Sounds terrifying, doesn't it?

What is uterine tone? Why is it rising? Should I be afraid of such a diagnosis and is it possible to cope with this condition on my own?

What kind of diagnosis is this - uterine tone?

According to statistics, 6 out of 10 pregnant women hear the phrase from their gynecologist: “You have increased uterine tone during pregnancy”! This is followed by a list of prohibitions and referral to a hospital. But doctors prefer to keep silent about what it is.

Their only explanation is that in this moment the uterus is tense, and this, in their opinion, should not be the case at all, since such a condition can provoke a miscarriage.

Of course, we are used to trusting doctors and following all their recommendations. And then friends and acquaintances can tell their “ horror stories”, so it’s no surprise that you immediately start listening to your body.

And there really is something tugging, you can feel the tension.

That's all. In such a frightened state, all reason disappears somewhere, you pack your bag and go to the hospital.

What happens to the uterus during pregnancy?

In fact, the uterus is nothing more than a hollow organ consisting of muscle tissue. And any muscle in our body tends to contract. And this is normal, especially if there are extraneous factors that affect it! Therefore, you should calm down and figure everything out in order.

Know! The doctor may mistake minor inflammation of the organ wall for the tone of the uterus in the first week of pregnancy.

But it turns out that this is the body’s physiological reaction to implantation. ovum. Moreover, if at the place of its attachment there is local inflammation, then this is good sign that the placenta begins to form.

Uterine tone in the 1st trimester of pregnancy can also be a consequence increased anxiety mothers (read about this period and changes in the body of mother and baby in the article 1st trimester of pregnancy >>>). After all, it’s not every day that you learn about such a condition.

Therefore, naturally, you worry and listen to yourself more. In response to such attention, the uterus can actually become tense.

Important! The uterus can respond with muscle contractions to the ultrasound procedure itself, in particular the pressure of the sensor on abdominal wall. However, doctors prefer to make a “terrible” diagnosis and prescribe therapy to the woman.

How can you feel the tension of maca?

Often, women whose doctor has detected increased uterine tone are at a loss. After all, they don’t experience much pain. So how does uterine tone manifest during pregnancy?

Symptoms of uterine tone during pregnancy in the 1st trimester are: pulling sensations lower abdomen. Women often compare these sensations to those they experienced during their periods;

In the last trimester, this can even be determined visually - the stomach becomes hard and may change its shape somewhat. In this case, you may not feel anything.

• To determine if your uterus is tense, lie on your back with your knees bent;
• In this position, the anterior abdominal wall relaxes as much as possible and you can feel the location of the uterus above the pelvis;
• If the abdomen is “stone-like” in this place, then the walls of the organ are probably tense at the moment;
• It is worth noting that during the second pregnancy, the tone of the uterus is felt less frequently.

Separately, only the posterior or, conversely, only the anterior wall of the uterus can be tensed. This is due to the fact that discomfort often occurs only in a specific place in the abdomen. And on an ultrasound, the doctor will detect a deflection of one of the walls of the organ.

Why do you feel the uterus?

If you notice any unusual sensations in the uterine area, this does not mean that it is in good shape. There can be many reasons for this condition. Among them it is worth highlighting:

1. Growth of the uterus. Starting from week 5, it begins to grow rapidly. As a result, the ligaments that support the organ are stretched, which leads to tingling sensations. They may get worse when you sneeze, move quickly, or turn your body sharply;
2. Abdominal muscle adaptation. Gradually, the abs lose their shape, and the abdominal muscles stretch, adapting to the growing uterus. As a result, discomfort may arise at the moment sudden movement, but it passes quickly;
3. In the second trimester, the uterus already reaches a certain size and can put pressure on neighboring organs. The gastrointestinal tract is especially affected. In this case, the unpleasant sensations are physiological and this condition does not require treatment;
4. After 35 weeks, the uterus begins to gradually prepare for upcoming birth. Therefore, now it can periodically tense, and the cervix smoothes and softens. This results in a tingling sensation in the lower abdomen.

After the 30th week of pregnancy, it is worth starting preparations for childbirth, which will include both working through fears and preparing the body for the upcoming birth.

Detailed preparation plan for natural childbirth, you will receive the Five Steps to a Successful Childbirth >>>

Most often, such sensations are short-lived and quickly pass if you rest and lie down for a while. However, when the pain continues for more than 1 hour, it is better to consult a doctor.

You should also visit your gynecologist if the pain is accompanied by:

• bloody discharge;
• disturbance of general well-being;
• increased body temperature;
• vomiting or upset stool.

What increases the tone of the uterus during pregnancy? Her condition can be affected by:

1. psychological problems and stress;
2. physical activity and sports;
3. long trips;
4. lack of sleep;
5. poor nutrition (read the current article: Nutrition in early pregnancy >>>);
6. fetal position;
7. multiple pregnancy;
8. large fruit size.

What to do at home?

Every woman expecting a baby can experience unpleasant sensations. At the same time, it is important to know how to relieve uterine tone during pregnancy at home?

Having studied the reasons for this condition, it becomes clear that, first of all, you should calm down and relax:

• To do this, you need to lie down and close your eyes;
• You can turn on calm music or use aromatherapy (articles

Almost every woman who is expecting a child, sooner or later, is faced with the appearance of uterine tone. This condition causes real panic in many first-time mothers. It is very simple to explain the appearance of uterine tone, because this issue has been well studied by doctors. But when the stomach is toned during pregnancy, not all women know what to do.

No one is immune from the occurrence of uterine tone. Any woman who is expecting a child, regardless of the stage of pregnancy, may encounter a similar problem. Due to the fact that the uterus is one of the muscular organs, it can turn to stone different dates carrying a child.

The uterus may be in calm state and be completely relaxed, or may begin to tense during the occurrence of spasms - muscle contractions. In later stages of pregnancy, uterine tone may occur due to the fact that the body has begun to actively prepare for the upcoming birth. In addition, from about 34 weeks of pregnancy, the baby begins to gradually descend, which can provoke sinking sensations reminiscent of contractions.

When the stomach begins to harden, the tone of the uterus appears, then similar condition Doctors call it Braxton Hicks training contractions. This condition cannot be controlled; it is characterized by a rather sharp tension of the uterine muscles. The duration of training contractions can reach 2 minutes, and the frequency is approximately 4 times per hour. At the same time, you can feel a slight pressure on the stomach.

The stomach is toned during pregnancy, what should you do if this happens in the second trimester of pregnancy? In this case, you should immediately contact the doctor who is caring for your pregnancy. Due to too high tone of the uterus, the condition of the fetus worsens. First observed oxygen starvation, which can turn into acute or chronic hypoxia. The fruit stops receiving not only required amount oxygen, but the blood supply is also disrupted. As a result of all this, serious pathologies in the development of the baby can occur. You can find cases where the tone of the uterus led to damage to the central nervous system, as well as to the appearance of very serious pathologies in the physical development child.

Uterine tone during pregnancy: actions

Uterine tone can occur even when you do nothing. In this regard, it is advisable not to sleep on your back for too long, and do not bend your legs at the knees. If similar problem occurs exclusively during the day, then in most cases it is enough to lie down and relax for the uterus to return to normal. Don't forget about breathing correctly, which will not only help remove tone, but will also be useful directly during labor activity.

If rest does not help get rid of discomfort or any other symptoms that frighten you appear, you should immediately consult a doctor. These symptoms include the following:

• Contractions do not stop even after rest and are accompanied by painful sensations in the area of ​​the lower spine.
• Diarrhea appeared, watery discharge appeared from the vagina, bloody issues.
• Dizziness, loss of consciousness, and hyperemia of the whole body occurred.
• Uterine tone and contractions occur more often than 4 times in one hour.
• The fetus does not move or its activity is too weak.
• In the later stages of pregnancy, the tone of the uterus can turn into regular contractions, which can become the beginning of labor.

The stomach is toned during pregnancy: what should the doctor do?

If the gynecologist has sufficient quantity experience, then just a superficial examination of the pregnant woman will be enough for him to understand what to do, as well as to determine the severity of the problem that has arisen. Typically, the doctor uses special device— sensor-tonusometer. It is applied to a woman’s abdomen to determine the strength of the muscle tone of the uterus. After this, the expectant mother can be sent for an ultrasound to conduct additional diagnostics, more accurately determine the cause of uterine tone.

When the results of the examinations are ready, the doctor decides: it is worth starting to develop labor and relieve hypertension with the help of medications. To completely relax the uterine muscles, the gynecologist prescribes medications that contain a lot of magnesium. It is these drugs that will help keep the fetus in the uterus until the moment when physiological labor can occur.

How to eliminate uterine tone using folk remedies

The stomach is toned during pregnancy - what to do to eliminate this unpleasant problem with the help folk remedies? First of all, you need to lie down and try to relax your face as much as possible. This technique not only helps to remove the tone of the uterus, but is also useful directly during labor. Remove all thoughts that may disturb you. Gently pat the belly and talk to the baby. From the second trimester of pregnancy, the baby hears the mother's voice perfectly and feels all the same emotions as a pregnant woman. Therefore, it is important to first calm down, relax to the expectant mother, and then help the child do the same.

There are also others traditional methods, which are considered very effective if the stomach is toned during pregnancy, but you don’t know what to do.

• Relaxing bath. If you notice that your stomach is starting to harden, and rest does not help solve the problem, then fill the bath with warm water. It is important that the water is not hot, as this will only worsen the situation. Warm water will help a pregnant woman relax, calm down, and completely relieve tension. Make sure that the bathroom is not stuffy, as this can lead to dizziness and poor health.
• Use aromatic oils. If you are leaving home, take a small container filled with aroma oil with you. To eliminate the tone of the uterus during pregnancy, the scent of valerian, jasmine, chamomile, lotus, geranium, myrrh, geranium, and vanilla is perfect.
• At home, a container with aromatic oil can be replaced with an aroma lamp. Warm baths with the addition of a few drops of your chosen aromatic oil are also considered very effective.
• Soothing tea helps eliminate the “stoniness” of the stomach. To prepare it, you need to mix several components: 2 teaspoons of lemon balm, 2 tablespoons of mint, one teaspoon each of valerian, motherwort. Brew the resulting mixture and drink warm with a small amount of honey.

If you feel the tone of the uterus while walking, you should immediately sit down on a bench.

When you rest a little, the muscles of the uterus will gradually begin to relax. You can also take antispasmodic or sedative medications. This could be no-spa, tincture of peony, valerian, motherwort. These medications should always be carried with you to avoid uterine hypertonicity.

Do not put unnecessary stress on the uterus during pregnancy.

Don't worry, keep it to a minimum physical activity. In some cases, you need to stop playing sports altogether, even if the exercises are designed for pregnant women. If your stomach is toned too often during pregnancy, then you should abstain from sex, because orgasm leads to severe tension in the muscles of the uterus.

To minimize the risk of uterine tone during pregnancy, it is worth reviewing your diet.

The foods that a pregnant woman eats should contain a lot of magnesium. This substance is considered essential for the full functioning of muscles. A macroelement such as magnesium helps eliminate tone and prevent its occurrence in the future. Experts emphasize that during pregnancy daily norm magnesium increases significantly. It is 400 mg. The expectant mother's diet should include hazelnuts, almonds, bran bread, buckwheat, oatmeal, beans, green vegetables. These foods contain the most magnesium.

In almost all cases, gynecologists recommend taking vitamin complexes with magnesium from the first trimester of pregnancy.

Such drugs help to quickly and effectively eliminate muscle spasms and improve the functioning of the nervous system of a pregnant woman.

The abdomen is toned during pregnancy - what to do when it lies on preservation

If the methods that we listed above did not bring desired result and the tone of the uterus has not been eliminated, then you should immediately visit a doctor. Most likely he will offer to lie down for safekeeping. At the hospital, specialists will be able to carry out everything necessary examinations so that the condition of the pregnant woman’s uterus can be reliably assessed.

If there is a risk of hypertonicity, then special therapy is immediately carried out. Doctors prescribe sedatives and antispasmodics. In some cases you still need to restore normal balance hormones. In the hospital, a pregnant woman will have constant bed rest, which will also have an extremely positive effect on her well-being and the condition of the uterus.

Bandage during pregnancy against uterine tone

To reduce the load on the uterus during pregnancy, especially in later stages, you can use a special bandage. You can replace it with comfortable trousers that could support your stomach. It is very important to choose right size. Clothes should not be tight. You will soon notice that when your stomach is supported at least a little, the muscles practically do not tense. Many experts emphasize that a special bandage is an excellent prevention of uterine hypertonicity.

A toned belly during pregnancy: what it can lead to

The tone of the uterus is very dangerous phenomenon, which can threaten the child’s life and its proper development.

• Tone can cause different degrees fetal hypoxia - the child will not receive enough oxygen.
• Placental abruption.
• Termination of pregnancy or premature birth depending on the period.

The stomach is toned during pregnancy, you need to ask your doctor what to do, especially if you are encountering a similar situation for the first time. You should not self-medicate, and even if you want to try traditional methods, you must get the approval of the gynecologist who is monitoring your pregnancy. Otherwise, the situation may only worsen and then the child will have to be saved due to the development of uterine hypertonicity.

Expectant mothers are often diagnosed with “uterine tone during pregnancy.” Those who are carrying their first child do not recognize this danger and often do not understand how everything can end. But even more “experienced” pregnant women are usually afraid of tone in the 1st trimester and mistakenly believe that later nothing bad will happen anymore.

Why does uterine hypertonicity occur, how to recognize it, why pain cannot be tolerated, what medications can be taken to get rid of it? You will find answers to these and other questions in our article.

Female organ reproductive system– uterus – consists of outer and inner mucous membranes, between which there is a muscular layer (myometrium). Like all other human muscles, the myometrium has the ability to contract and relax. But while a woman can “control” the muscles in her arms and legs, she cannot control the muscular layer of the uterus. For example, the uterine muscles contract when a woman laughs, coughs or sneezes.

This process occurs unnoticed and painlessly, but until the woman becomes pregnant. When the fertilized egg begins to grow inside the uterus, female body tries to reject it as a foreign (as it seems to him, completely unnecessary) body. The myometrium contracts, and the expectant mother experiences pain at this moment. This is called hypertonicity of the uterine muscles.

Painful sensations can be weak or strong, last a few seconds or minutes, appear a couple of times or bother you constantly. If a woman does not yet know about her pregnancy, she often does not understand the danger that threatens her and the baby. And if the gynecologist knows and has already managed to scare her that there should be no pain during pregnancy, she begins to worry, and thereby only makes things worse.

In a woman who was absolutely healthy before conceiving a baby, during pregnancy the uterus becomes toned for the following reasons.

1. “Sedentary” work or the need to stand on your feet for several hours, travel on public transport.
2. Stressful situations.
3. Failure in work hormonal system in the 1st trimester: deficiency (it is produced by the ovary to relax the myometrium; in the 3rd trimester, this task is performed by the placenta) or excess of male hormones.
4. Toxicosis, which is accompanied severe vomiting(in the 1st trimester). Increased myometrial tone occurs because the muscles of the organ tense during gagging. Toxicosis is considered normal occurrence in the first trimester. But if a pregnant woman constantly feels nauseous just by looking at food, if she loses weight, the baby will not receive the necessary nutrients. Is not in the best possible way will affect its development.
5. Fetal movement in the late term (in this case, hypertonicity of the uterine muscles should not be feared).

Expectant mothers who have:

• harmful (tobacco smoking, addiction to alcoholic beverages);
• a large number of abortions;
• multiple pregnancy. A large load is created on the walls of the uterus. In some cases, she has to stretch to enormous sizes;
• special structure of the reproductive organ (bicornuate, saddle-shaped, children's uterus);
• negative Rh factor. If a pregnant woman has a blood type with negative Rh factor, and the biological father of the child is positive, the mother’s body tries to reject the fertilized egg, as foreign body. But the first such pregnancy usually proceeds well;
• dysfunction thyroid gland;
• polyhydramnios;
• viral and infectious diseases, including those that are sexually transmitted (ureaplasma, chlamydia, mycoplasmosis, viruses);
• myoma;
• diseases of the gastrointestinal tract. Hypertonicity of the uterus appears with severe gas formation.

Some diseases, such as sexually transmitted infections, can only be treated in the third trimester, since antibiotics must be taken. It is also impossible to refuse treatment: the placenta protects the child, but some substances can penetrate through it and negatively affect the development of the fetus.

Hypertonicity of the uterus manifests itself in different ways throughout pregnancy. In the 1st trimester this is:

• dizziness, nausea;
• a dull nagging pain in the lower abdomen, as during menstruation, in the lower back or perineum (it can be of equal strength or “roll up”, intensify, then weaken).

In the 2nd and 3rd trimesters, a “fossil” of the abdomen is added to them. A tense uterus can be felt by placing your fingers on your abdomen.

Another sign increased tone– bloody discharge from the genital tract. They may be copious or spotting, beige, brown, pink or streaked with blood. Normally only observed light discharge. In all other cases, you should immediately contact a gynecologist.

At a later stage, when there is little room for a large baby in the womb, you can see how the baby “stretches out.” At this moment, the muscles of the uterus tense, and the woman clearly feels the fossilization of the abdomen, sees how it changes its rounded shape (one side of the abdomen seems to sink in, while the other, on the contrary, begins to protrude more). This lasts literally a few seconds and does not pose any danger to either mother or baby.

Diagnostics

In order to understand whether the patient’s uterine muscle tone is increased, doctors use three methods:

• palpation (palpation with fingers);
• tonusometry.

In the 2nd trimester of pregnancy, the doctor can “grope” the tone of the uterus with his fingers through the front wall abdominal cavity. During the examination, the woman lies on her back and keeps her legs bent at the knees. In this position, the abdominal muscles relax, and the uterus, if it is dense, can be easily felt.

Ultrasound examination is used as helper method diagnostics The results obtained allow us to understand the degree of threat (complications, miscarriage) and the need for hospitalization.

During tonuometry, muscle tension is detected using special sensors. This method is rarely used because the other two provide comprehensive information.

Elimination methods

Increased uterine tone is treated in outpatient setting and in the hospital. The first option is chosen when the expectant mother is bothered by mild pain in the lower abdomen or lower back. However, she has no bleeding, and up to this point the pregnancy has been uneventful. Hospitalization is recommended in cases where the increased tone cannot be relieved for a long time.

At home, a woman should rest more, forget about sexual activity for a while, take antispasmodics (No-shpu, Drotaverine, Papaverine - solution for intramuscular injections or rectal suppositories), sedatives (motherwort, valerian) and gestagenic (Utrozhestan) agents, as well as Magne B6.

Medicines have contraindications. You cannot prescribe medications for yourself. The doctor must do this. He selects the dosage individually in each case.

• "Cat". It is performed as follows: kneel down, place your palms on the floor, carefully bend your back, then arch it. Repeat 5-10 times. After this, it is better to lie down for half an hour or an hour, especially if the exercise is performed in the 3rd trimester of pregnancy.
• Tense facial muscles can cause uterine contractions. By relaxing the facial muscles, you can eliminate uterine hypertonicity. To do this, a pregnant woman needs to get on all fours, lower her face down, and relax her facial muscles. Breathe through your mouth.
• Knee-elbow pose. This exercise is performed as follows: a woman needs to kneel and rest her elbows on the floor, stand like that for 1-10 minutes. In this position, the uterus will be in a suspended position and will be able to relax.

The exercises must be performed carefully, at a slow pace. If the pain intensifies, you need to stop, rest, lie down. In case of severe, persistent pain, it is better to call a gynecologist, get a consultation, or immediately call an ambulance.

If a pregnant woman’s high muscle tone cannot be relieved for a long time or bloody discharge appears, doctors will insist on hospitalization. In the hospital to the expectant mother You will have to stay in bed.

In the 1st trimester she will have intramuscular injections No-shpa, Papaverine, vitamins, sedatives, Utrozhestan. If there is bleeding, it will be stopped with Dicinon or Tranexam.

But all these remedies relieve symptoms and do not solve the main problem - eliminating the cause.

In the 2nd trimester, a pregnant woman’s doctor may prescribe:

• electropheresis with magnesium;
• droppers with Ginipral;
• vitamin and mineral complex.

In the 3rd trimester, the same drugs are used to treat increased uterine tone. If, based on the results of the ultrasound, it becomes clear that the tone is strong and the child is receiving little oxygen and nutrients, the expectant mother is prescribed Curantil or Trental.

These drugs are allowed to be taken only as prescribed by a doctor. For example, Chimes can cause a severe headache. But if a woman takes several drugs, she will not be able to understand what exactly caused adverse reaction. You need to tell your doctor about your condition. He will decide which medication to remove.

Possible negative consequences and prognosis

Contraction of the uterus is a pain that cannot be tolerated in the hope that it will go away on its own over time. The tone carries a great danger, first of all, for the developing fetus.

In the 1st trimester, spontaneous miscarriage (detachment of the ovum) may occur. The pregnancy may not be interrupted, but may freeze due to the fact that the fetus did not receive oxygen and nutrients. In both cases, it is not possible to maintain the pregnancy.

In the 2nd and 3rd trimester, placental abruption does not occur, but another problem appears: the uterus, contracting, compresses the amniotic sac, as a result of which the cervix opens and premature labor begins. In some cases, even if the cervix is ​​closed. It is most often possible to save the baby if the gestational age is 36-38 weeks.

Prevention

To prevent increased uterine tone, pregnant women are recommended to follow a few simple rules.

1. Get tested to detect sexually transmitted infections at the stage of pregnancy planning.
2. Register in a timely manner, regularly go to “appearances” with the gynecologist, and follow his recommendations.
3. Sleep 8-10 hours a day.
4. Be sure to breathe fresh air, but from long hiking It's better to refuse.
5. Avoid stressful situations.
6. Do not create excessive physical stress for yourself.
7. Avoid drinking alcohol while still planning pregnancy.
8. Stop smoking.
9. Avoid lifting heavy objects, especially in the 3rd trimester.

A pregnant woman should eat properly. Her diet must include foods rich in magnesium:

• vegetables, greens (cabbage, basil, spinach);
• cereals (wheat, barley, buckwheat);
• dairy products (cheese, natural yogurt).

This trace element helps relax the smooth muscles of the intestines and myometrium (muscle tissue of the uterus). In addition, it has a beneficial effect on the central nervous system.

Conclusion

Uterine tone during pregnancy is a diagnosis that gynecologists make for 60% of women. Symptoms of hypertonicity are pain in the lower abdomen or lower back, “fossilization” of the abdomen, spotting. Muscle spasms can cause placental abruption (miscarriage) or premature birth.

There are many reasons for the appearance of increased tone, but you can prevent its occurrence if you do simple rules prevention: rest more, be less nervous, eat right and listen to the doctor’s recommendations. Self-medication can lead to dire consequences.

Pregnancy is a time associated not only with the happy anticipation of the baby’s appearance, but also a period of adaptation of the woman’s body to the state of pregnancy and the fight against gestational complications. One of these pathological conditions, which seems to be the most common during pregnancy, is increased uterine tone. In this article we will consider the problem of uterine hypertonicity during pregnancy, highlight the pathogenesis, clinical picture, we will present diagnostics and methods to combat this problem.

What is uterine tone?

The tone of the uterus is normal condition female reproductive organ, which is characterized by short-term contraction of the myometrium (middle muscular layer of the uterus) in response to various kinds impact. For example, motor activity embryo, and after 22 weeks - the fetus, filled bladder, increased peristalsis intestines. The tone of the uterus without pregnancy may increase before and during menstruation.

How to determine the tone of the uterus?

Uterine tone in mandatory must be present during pregnancy, as this muscular organ that and it should shrink. Otherwise, if the uterus did not come into tone, then it would not be able to perform such difficult task, as a rather long period of contractions - the first period of labor, as well as the second period - the period of pushing. During a normal pregnancy, uterine tone should be present, the symptoms of which should not cause any discomfort to the woman.

What is uterine hypertonus?

Hypertonicity is pathological condition, which characterizes the presence of a diagnosis of threat of miscarriage up to 22 weeks, and after that - threat of premature birth.
How to distinguish uterine tone during pregnancy from hypertonicity? How do you understand that the uterus is toned and this condition is physiological in nature?

The most important differences in tone are:

• No pain.
• Absence long period keeping the uterus in good shape (no more than one minute).
• Feeling of uterine tone up to 5 times a day.
• Lack of productive contractions, which lead to shortening of the cervix, as well as to its wedge-shaped transformation. This point is the most important in diagnosing increased uterine tone.

Symptoms of uterine tone

An important point is the question “how to determine the tone of the uterus during pregnancy?” In order to understand when pregnancy is progressing physiologically, and when it is necessary to seek help medical care, you need to understand how to independently determine the tone of the uterus. Quite often, primigravida women cannot understand what it includes this state. Below we present the main symptoms that help you find out the answer to the question “how to understand the tone of the uterus.”

Diagnosis of uterine tone during pregnancy

When a doctor examines a pregnant woman, a uterus with increased tone is detected and is characterized by a dense consistency. At the same time, female reproductive organ is well controlled through the anterior abdominal wall and remains in this state for a long time. To diagnose hypertonicity, ultrasound is used, during which hypertonicity can be detected back wall uterus, as well as the anterior one. However, this sign may not always indicate a threat of termination of pregnancy. The uterus can become toned in response to the passage of an ultrasound wave through its wall. Also on ultrasound examination When performing cervicometry (measurement of the length of the cervix), isthmic-cervical insufficiency is diagnosed (shortening of the cervix, opening of its internal pharynx).

How does uterine tone appear on cardiotocography? (CTG)

Increased uterine tone can be determined by performing cardiotocography. The resulting film will graphically depict a curve parallel to the curve heart rate fetus, indicating hypertension.

Reasons for the appearance of tone in the first trimester

Uterine tone on early stages can be caused by various factors, among which 80% is attributed to congenital anomalies development. Women must be aware of this fact and, while maintaining pregnancy in a hospital setting, must give written agreement about maintaining pregnancy. Also, the tone of the uterus in early pregnancy can be caused by hormonal dysfunction in the form of progesterone deficiency and the impact of stress factors on the female body.

Reasons for the appearance of tone in the second trimester

In the second trimester, a woman may also experience increased uterine tone during pregnancy, the reasons for which lie in the low level of progesterone (the main hormone of pregnancy), which has a relaxing effect, and the presence of infection of various etiologies, disruption of the intestines in the form of increased peristalsis.

Reasons for the appearance of tone in the third trimester

Unfortunately, even in the third trimester, increased uterine tone occurs in pregnant women. Its reasons include low level progesterone, which can be aggravated by the development of placental dysfunction and its aging, because it is the placenta that produces the main amount of progesterone. When disturbances occur, its hormonal function also suffers. Polyhydramnios, multiple pregnancies, and infectious factors can serve as a trigger for the development of complications such as the threat of premature birth. Also, at any gestational stage, the cause of hypertension may be the presence of a pathology concomitant with pregnancy, such as uterine fibroids, endocrine diseases, hematological pathologies.

Why is uterine tone and hypertonicity dangerous?

Women quite often do not take increased tone seriously and do not take any measures to stop it. This happens due to the ignorance of the fair sex about the dangers of uterine tone. Dangerous complications of myometrial hypertonicity include:

Methods for treating uterine tone and preventing its manifestations

Due to development information technologies and on the Internet, many pregnant women begin to look for answers to the question “how to relieve uterine tone” on the forums. The most frequently discussed topic on such pages is the tone of the uterus, how to relieve this condition at home. This is the most basic mistake that can be fatal. Only obstetrician-gynecologists know how to relieve uterine tone during pregnancy, depending on the etiology, and only in a hospital setting.

How to remove uterine tone using drug therapy?

Preventive measures in the development of uterine hypertonicity are:

If any symptom of a pathological course of pregnancy occurs, you should immediately seek help from medical institution!

Consequences and complications of pregnancy with uterine hypertonicity

As can be seen from the above, the main consequences of increased uterine tone are conditions that aggravate the course of a given pregnancy and can lead to the death of both the fetus at birth with signs of extreme prematurity, and the death of the woman herself, if we're talking about about abruption of a normally located placenta or central presentation due to the occurrence of pathological tone of the uterus.

The tone of the uterus during pregnancy can have serious consequences, the symptoms of which every pregnant woman should know in order to protect herself and her unborn child from complications of this condition.

Often this symptom of a threatened miscarriage goes unnoticed by the expectant mother, which leads to more serious consequences.

Have you ever played sports? Did you lift weights? Clench your hand into a fist as hard as you can. Look at the muscles of your arm: they have enlarged, become clearly contoured, thickened and become toned. Just as skeletal muscles are activated, the muscles of the uterus (myometrium) also become toned. The only difference is that the processes of tension and relaxation of the muscles of the arms, legs, and back are subject to your desires, since their work is controlled by the central nervous system. With the uterus, things are more complicated; nothing depends on your will.

The uterus is toned: symptoms

What symptoms can tell us about uterine tone? It is, first of all, a dragging, monotonous long-term pain in the lower abdomen, without clear localization. “Somewhere below, like during menstruation,” patients often say. The pain may radiate to the lumbar region, sacrum, and perineum. In the second and third trimesters, placing her hands on her stomach, the expectant mother independently determines a dense uterus with clear contours. Bloody discharge from the genital tract may often appear. It is important to remember that any non-light discharge - beige, brown, pink, streaked with blood, scarlet, copious, spotting - is regarded as bloody. They are dangerous during pregnancy and require immediate medical attention.

Diagnosis: uterine hypertonicity

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

For a number of reasons, the myometrium may become toned - the muscle thickens and becomes dense. During an examination of a woman in a chair in the first trimester of pregnancy, the obstetrician-gynecologist very clearly identifies the increased tone with his hands. Thickening of the uterine wall is seen during the examination and the doctor conducting ultrasound diagnostics. At the same time, in conclusion, he usually refers to the problem using the following terms: “myometrial tone is increased” or “myometrial hypertonicity.”

Consequences of hypertension

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

The tone of the myometrium in the first trimester leads to detachment of the fertilized egg, chorion (the so-called future placenta) and, as a result, a spontaneous miscarriage occurs. Often, termination of pregnancy does not occur, but due to large area In the event of abruption, the pregnancy freezes and stops in its development due to disruption of nutrition and oxygen delivery. In this case, the woman is often not bothered by bleeding, only periodic nagging pain lower abdomen. And with a screening ultrasound examination at 11-13 weeks, it turns out that the pregnancy is not developing, frozen at 6-7 weeks, a large retrochorial hematoma is visualized (an accumulation of blood when the fertilized egg separates from the chorion - the precursor of the placenta).

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

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

Causes of hypertension

There are many reasons for the appearance of uterine tone during pregnancy. It is rarely possible to single out just one; more often they are combined: stress, lack of sleep, severe physical work, long hours of work, playing sports, air travel, moving long distances, sex life up to 12 weeks of pregnancy, colds. Play an important role bad habits– smoking, alcoholism, but there are other factors that lead to increased uterine tone.

Infections. First of all, these are sexually transmitted infections: chlamydia, mycoplasma, ureaplasma, viruses, etc. They cause inflammatory processes in the pelvic organs, including in the uterus. The synthesis of anti-inflammatory cytokines is enhanced - this is biological active substances, providing an inflammatory response in the body and adversely affecting the course of pregnancy and fetal development. These include interleukins and interferon, which increase myometrial tone. In addition, in this case there is a high probability of intrauterine infection of the baby.

Hormonal disbalance. Progesterone deficiency is an equally rare cause of increased myometrial tone. Progesterone is especially important in the first trimester of pregnancy. It relaxes the myometrium, promotes normal processes implantation and formation of the placenta. In the first trimester, this hormone is synthesized yellow body The ovary, with its insufficient function, produces little progesterone, and pregnancy occurs against the background of uterine hypertonicity, which leads to the threat of miscarriage. By 16 weeks, the placenta takes over the synthesis of hormones, and the risk of miscarriage decreases.

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

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

Endometriosis, fibroids(especially the location of the tumor, when it protrudes into the uterine cavity, deforming it) - all these are circumstances accompanying the increase in myometrial tone during pregnancy.
In women with disturbances in the hemostatic system (a complex of body reactions aimed at preventing and stopping bleeding), with changes in the parameters of the blood coagulation or anticoagulation systems, and the presence of antibodies to cell phospholipids, pregnancy proceeds with increased uterine tone, starting from the earliest stages.

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

In patients with chronic diseases, with heavy somatic pathology(For example, bronchial asthma, diabetes), who have had colds, viral diseases During the current pregnancy, uterine tone is very common.

How to treat uterine hypertonicity

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

If the expectant mother is not included in any of the risk groups, everything is fine with her health, this is the first pregnancy that occurred without any problems and has been proceeding well until now, there was no bleeding from the genital tract during the entire period of gestation, but with In this case, the woman is bothered by minor nagging pain in the lower abdomen and, according to the doctor, the tone of the uterus is increased or the uterus is excitable upon palpation - this can be done ambulatory treatment, but subject to mandatory bed rest. Therefore, it is important to remember that there is no question of any work, even routine work, around the house!

In this case, antispasmodics are prescribed (NO-SPA in tablets, CANDLES WITH PAPAVERINE), vitamins, MAGNE B6, sedatives(VALERIAN, MOOMORN), it is possible to prescribe gestagenic drugs - DUFASTON, MOTROZHESTAN. Dosages and treatment regimens are prescribed individually for each patient by a doctor.

If the expectant mother at home or at work feels characteristic nagging pain in the lower abdomen, and there is no way to contact the attending doctor, you need to drink NO-SHPU in a dosage of 0.04–0.08 g, you can administer a SUPPORT WITH PAPAVERINE rectally and take 2 tablets of VALERIAN .

If the expectant mother is at risk, there is bleeding, cramping,
different pains in the lower abdomen - immediate hospitalization is required. Treatment provided in the hospital will depend on the duration of pregnancy and the clinical picture.

In the 1st trimester, intramuscular injections of PAPAVERINE, NO-SHPA, PROGESTERONE, vitamins, sedatives (sedatives), UTROZHESTAN or DUFASTON are usually prescribed. These medicines have by various mechanisms actions, but the result of taking them is the same - relaxation of the uterine muscles. When bleeding It is mandatory to prescribe hemostatic (hemostatic) drugs - SODIUM ETHAMSYLATE, DICYNONE, TRANEXAM.

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

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

Endonasal galvanization – application with therapeutic purpose continuous direct current of low strength and low voltage, supplied to the body contactally, through electrodes.

Electrophoresis with magnesium - effects on the body DC and particles introduced with its help through the skin or mucous membranes medicinal substance– magnesium sulfate.

Electroanalgesia is pain relief using weak electrical discharges delivered through the skin, which block the transmission of pain impulses to the brain.

Electrorelaxation of the uterus is the effect on the neuromuscular apparatus of the uterus with an alternating sinusoidal current to suppress the contractile activity of this organ. If there is a threat of miscarriage from 15–16 weeks, electrorelaxation is more effective preferred method before other methods of therapy there is a threat of interruption, since there is no side effect medications, and the effect occurs already during the procedure.

Electrical relaxation of the uterus can be used to help emergency assistance in case of threat of miscarriage.

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

Injections of antispasmodics - PAPAVERINE, NO-SPA - are also indicated. Recommended drugs are calcium channel blockers (NIFEDIPINE, KORINFAR). These drugs block calcium channels in the myometrium, calcium is not transported, and the muscle cannot contract and relaxes.
To enhance the antispasmodic effect, add tablet forms of drugs that reduce the tone of the uterus - GINIPRAL, NO-SHPU in tablets, as well as CANDLES WITH PAPAVERINE.

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

Sedatives are also prescribed in tablet form or in the form of tinctures. It is necessary to use drugs that improve uteroplacental blood circulation (CURANTIL, PENTOXYFILLINE, EUFYLLINE, TRENTAL), drugs that improve metabolic processes(ACTOVEGIN, COCARBOXYLASE, RIBOXIN, POTASSIUM OROTATE, CALCIUM PANTOTHENATE, LIPOIC ACID), antihypoxants (drugs that increase resistance nerve cells fetus to lack of oxygen - INSTENON, PIRACETAM), hepatoprotectors (substances that improve liver function - CHOFITOL, ESSENTIALE).

Increased muscle tone of the uterus is not a reason for emotions, but for a more attentive attitude towards yourself. Therefore, if the doctor has diagnosed the expectant mother with uterine hypertonicity, she should not be upset, but just pay a little more attention to herself and her condition and listen to the advice of the attending physician.