Hypertonicity along the anterior wall of the uterus. Uterine hypertonicity: “commercial diagnosis” or a real threat to the fetus

Probably every pregnant woman has heard this phrase, and most have encountered this diagnosis personally. Hypertonicity is said to occur when there is tension in the uterine muscles before the onset of labor.

Why is uterine hypertonicity dangerous?

There are several development options depending on the duration of pregnancy. But in any case there is risk of spontaneous interruption I'm pregnant. So on early stages The tone of the uterus prevents the embryo from properly fixing itself in the endometrium; later, when the placenta has already formed, there is a risk of its detachment. In addition, hypertonicity of the uterus during pregnancy compresses blood vessels, connecting the organisms of mother and child, and therefore the fetus does not receive sufficient quantity oxygen and nutrients.

Hypertonicity occurs especially often in the early stages of pregnancy, when it most seriously threatens the continuation of pregnancy. In addition, it is often similar condition occurs in women later. Then it can be confused with training contractions.

How to determine uterine hypertonicity

Symptoms Hypertonicity of the uterus during pregnancy is simple - nagging pain in the lower abdomen, as during menstruation, or pain in the lower back. In the later stages, the tension of the uterus can not only be felt physically, but also seen: the uterus tenses, hardens, the woman’s entire belly shrinks and changes shape.

However, a woman may not feel anything like this. In some cases, uterine hypertonicity during pregnancy is determined only by examination by a gynecologist or by ultrasound. It is worth noting that in both cases, tone can be a direct consequence nervous tension women before examination and examination. Considering the danger to the fetus, in any case, additional research in order to accurately determine the presence of a problem and find out its cause.

Separately, mention can be made of local hypertonicity uterus on the back or front wall. By the way, it is the localization that may be the reason that pain due to hypertonicity is felt by a woman only in one place: the stomach or lower back.

On ultrasound, hypertonicity of one of the walls is noticeable obvious change shape of the uterus: one of its walls bends inward.

Causes of uterine hypertonicity

It is very important to determine the causes of uterine hypertonicity during pregnancy, since treatment will directly depend on this. This condition may occur against the background hormonal imbalances women, for example, if there is an excess male hormones or lack of female ones. Sometimes it happens that the mother’s body perceives the fetus as foreign body and he himself seeks to reject it, for example, if some genes of the husband and wife coincide.

The cause of tone may be pathologies of uterine development, infectious diseases , as well as some somatic diseases , not related in any way to reproductive system. We should not forget that the condition of the uterus is directly affected by psychological condition women.

Doctors noticed that women who have had several abortions have a higher chance of encountering this problem, although the reasons for this have not been studied. In addition, if a woman has already lost a child in the past due to increased uterine tone, most likely next pregnancy she will face the same problem.

It is very important to set yourself up for a positive outcome, and also to choose a really good and attentive doctor in advance. And to make it easier to bear a child in the future, in the event of a miscarriage, it is necessary to undergo examinations and establish exact reason what happened.

What to do with uterine hypertonicity?

Naturally, the question arises - what to do with uterine hypertonicity? If you feel the symptoms described above, especially if spotting occurs bloody issues, you need to urgently consult a doctor.

He will conduct an examination, order an ultrasound and several other tests that will help determine the cause of the problem and decide how to relieve uterine hypertonicity.

While you are waiting for test results, you will be prescribed medications that will relieve tension in the uterus, namely:

antispasmodics - drugs that relieve muscle spasms;
sedatives, because emotional stress can also cause hypertension;
preparations containing magnesium, as it prevents the penetration of calcium into muscle tissue, and calcium also contributes to the occurrence of cramps.

Further treatment of uterine hypertonicity during pregnancy depends entirely on the cause of uterine hypertonicity. So, if failures are detected in hormonal background, then the woman will be prescribed medications to normalize it. However, many women are afraid to take hormonal drugs during pregnancy.

However, today the hormone content in drugs is minimal and strictly verified, and cannot harm the child. In addition, if the cause is not eliminated, the uterus may become toned again, and as a result, the woman may lose her pregnancy.

If the causes of hypertension lie in the field of immunology, then one of the treatment options may be the introduction of the husband’s leukocytes into the wife’s blood. If the causes of the problem are purely psychological, it makes sense to consult a psychiatrist.

To get relief, you can try relax the uterus on your own. First, you need to sit in a comfortable position, tilt your head down slightly, relaxing the muscles of your face and neck.

Secondly, take a body position in which the uterus is in a “suspended” state. You need to get on all fours and slowly arch your back while raising your head. Maintain this position for a few seconds, and then do the same movement again. reverse direction. Repeat the exercise several times and lie down for about an hour.

In addition, it is very important to remember that uterine hypertonicity during pregnancy obliges a woman to change the rhythm of life. Any stress, heavy lifting, or sex are contraindicated.

Don't spend too much time on your feet. Very often, women are offered hospitalization precisely because clinical settings They will be able to provide her with peace, while at home, a woman freed from work can begin cleaning and landscaping.

Whether or not to go to the hospital is, of course, up to the woman herself. If you are confident that you will be able to comply with the regime, then, of course, it is better to stay at home, where you will be calmer and more comfortable. However, if, in addition to hypertension, other symptoms of threatened miscarriage are observed, it is still recommended to consent to hospitalization.

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Uterine tone (hypertonicity) is an involuntary contraction of the uterus. The threat of pregnancy caused by uterine tone is one of the most common diagnoses these days. The uterus is an organ consisting of muscle tissue. The walls of the uterus themselves have three layers: The serosa, or “perimetry,” is a thin “film” covering the outside of the uterus; The muscle layer, or “myometrium,” is the middle layer of the uterus, the most powerful, which consists of smooth muscle fibers and connective tissue. Muscle fibers in the myometrium they are not located in one direction: there are vertical (outside), spiral (middle) and circular (inside) fibers; The inner mucous membrane, or “endometrium,” lines the inside of the uterine cavity. The increased tone of the uterus during pregnancy is created precisely by muscle fibers, which tend to contract. At nervous stress or overexertion, the muscle fibers contract, increasing their tone and pressure in the uterus itself. This is called increased tone or uterine tone. Causes of uterine tone: Uterine tone can occur throughout pregnancy. Uterine tone in the second trimester usually appears due to overload at work or wrong image life. In the third trimester, the size of the uterus increases greatly. Uterine tone in the third trimester can lead to premature birth. In this case, the child can already live, but it will take a lot of effort and time to finally leave him. Uterine tone in early pregnancy can occur due to improper hormone production. The main hormone responsible for maintaining normal tone in the uterus, progesterone. Numerous conditions can affect the quality of its production. If there is too little progesterone in the body, a miscarriage may occur. Conditions in which there is a lack of progesterone are: Genital infantilism - incomplete development and growth of the organs of the reproductive system. In such a case, the not fully developed uterus may contract due to too much pressure on it; Hyperandrogenism is an increased amount of male hormones in a woman’s body that can be produced by the adrenal glands. Similar problem manifests itself even before pregnancy. Possible disturbances in the menstrual cycle, excess hair, problematic skin, whose condition worsens before menstruation; Hyperprolactinemia – increased content prolactin in a woman's blood. Prolactin is a hormone produced by the pituitary gland. With this deviation, infertility most often develops. Before pregnancy, hyperprolactinemia manifests itself in the form of milk discharge from the nipples and irregular cycle; Endometriosis is the growth of the lining inside the uterus in uncharacteristic areas; Uterine fibroids are a benign uterine tumor. Diseases of an inflammatory nature, both the uterus itself and the appendages, which could have been suffered long before pregnancy itself. Uterine tone before childbirth can also occur due to polyhydramnios, multiple pregnancies or an overly large fetus. In case of disruption of the central nervous system, the process of regulating muscle contractions in the uterus is disrupted, which also leads to an increase in tone. Such failures can be caused by too heavy physical exertion, constant stress, infectious and inflammatory diseases, for example, acute respiratory infections, influenza, pyelonephritis. Before pregnancy, infertility, endometriosis, and fibroids indicate that the body has problems with the production of hormones. During pregnancy similar anomalies may cause increased uterine tone and miscarriage. In addition to problems with hormones, there are some other prerequisites for the development of uterine tone. The reasons also lie in the tissues of the uterine walls and fibers themselves. If you become pregnant after infertility treatment, you had hormonal disorders, fibroids, endometriosis, inflammatory diseases female genital organs, abortions, spontaneous miscarriages, premature birth, then the likelihood of uterine tone and, accordingly, the threat of miscarriage is high. Therefore, you need to register early and strictly follow all the instructions of your obstetrician in order to prevent complications. Diagnosis of uterine tone: Doctors are able to accurately determine the tone of the uterus. For diagnosis they use: Palpation, i.e. palpating and palpating the abdomen of a pregnant woman: with increased tone, the abdomen and uterus become hard as stone. This is clearly felt when palpating a pregnant woman’s abdomen while she lies on her back. Using ultrasound, you can determine local or total thickening of the muscular layer of the uterus. Tonuometry uses a special device with a built-in sensor to help accurately determine the tone of the uterus. Seek immediate advice if you feel heaviness or pain in the lower abdomen. Although quite often, back pain in the early stages of pregnancy does not indicate an emerging problem, but only that the body is adapting to the fetus growing inside it, trying to accept it and coexist with it as comfortably as possible. But still, if you feel contractions or squeezing and unpleasant pain lower abdomen, then it is better to pay attention to this. Such sensations, which can bring both very noticeable discomfort and practically not be felt, can indicate uterine tone. During pregnancy, the symptoms of this disorder can manifest themselves in completely different ways. Therefore, once again we strongly recommend that you contact qualified specialist. Treatment of uterine tone Regardless of the reasons for uterine tone, bed rest, sedatives, antispasmodics, and drugs that reduce the activity of the uterus are recommended for all pregnant women. Hospitalization is carried out in all cases when an increase in the tone of the uterus is accompanied by nagging or cramping pain in the lower abdomen or lower back. Bed rest is provided either in a hospital setting or (in rare cases) at home. Treatment with sedatives is mandatory, since the fear of losing the child only aggravates the existing tone of the uterus. In cases of increased tone in the first trimester of pregnancy, if the cause of the threat of increased tone is progesterone deficiency, progesterone preparations are prescribed. Treatment is carried out under control blood pressure, heart rate and blood sugar. Prevention of increased uterine tone Undoubtedly, it is best to engage in prevention even before the planned pregnancy: undergo an examination for the presence of infectious diseases of the pelvic organs, consult with a gynecologist-endocrinologist, and, if necessary, a psychotherapist. If pregnancy has occurred, you should provide yourself (and your baby) with a gentle regime, reduce physical and mental stress, master relaxation techniques that are vital for a pregnant woman, and at the slightest sign of increased uterine tone, consult a doctor. The lifestyle of a pregnant woman also plays an important role: take care of yourself, avoid stress, business trips, transfer to a better position in time. light work, go to bed on time.

Myometrial hypertonicity - every pregnant woman knows about this diagnosis. It accompanies every second pregnancy at any stage. This real threat pregnancy and fetal health. What are its symptoms, why does it occur and how to prevent it.

Norm and pathology

In the uterus, hollow muscular organ, three layers of fabrics:

The outer layer, the perimeter, is a membrane of serous tissue.
The mucous membrane that lines inner layer, called the endometrium.
The wall of the middle layer (myometrium) is formed by smooth muscle tissue. It provides the organ with the ability to contract during childbirth and pushes menstrual fluid out of the non-pregnant uterus.

After a fertilized egg has been implanted into the organ cavity, the myometrium begins to “prepare” for gestation and childbirth. It strengthens, becomes more and more thickened, and grows. A sufficient amount of calcium, glycogen and enzymes accumulate inside it, which will stimulate its contraction during labor.

Physiologically, like any other muscular structure of the body, the myometrium must be in good shape.

Pathology is determined by how tense or relaxed the walls of the organ are:

With hypotonicity, the muscles are completely relaxed. This condition is observed in the first hours after birth and may be the cause uterine bleeding.
With hypertonicity of the myometrium, the wall becomes tense above normal.

If myometrial hypertonicity is periodic during contractions, this is also considered normal. But if it is constant and observed during the period of gestation, then this is a pathology. It can cause premature miscarriage.

According to the degree of tension, myometrial hypertonicity can be total (tension over the entire surface), local (tension in a separate area).

How does pathology develop?

There are many factors that provoke uterine hypertonicity during pregnancy. Basically, for this pathology to develop, several factors act.

Causes of uterine hypertonicity during pregnancy:

Chronic urogenital infection (ureaplasma, chlamydia, genital herpes virus, cytomegavirus). On the background inflammatory process synthesized in the organ a large number of biologically active compounds that provoke contractility and hypertonicity of the myometrium.

Hormonal diseases, in which progesterone deficiency is observed: hyperandrogenism, hyperprolactinemia, sexual infantilism. Against this background, local uterine tone is possible in the early stages of pregnancy (the period of the first 14 weeks). Hormonal deficiency is a prerequisite for miscarriage and chorionic detachment. Hypertonicity of the uterus during pregnancy also develops against the background of hyperthyroidism or hypothyroidism.
Diseases in which the structure changes uterine wall(neoplasms in the form of polypous growths, fibroids, adenomyotic nodes), malformations ( double uterus, accessory horn, uterine septum). Such pathologies prevent the egg from being properly implanted and the embryo grows, and with the stretching of the organ, they cause increased local uterine hypertonicity.
Chronic diseases internal organs (hypertonic disease, diabetes, obesity, kidney failure).
Pregnancy with complications such as incorrect position with presentation, polyhydramnios, preeclampsia, Rh conflict, toxicosis.
Increased gas formation with altered intestinal motility.

Socio-economic causes of uterine hypertonicity:

Heavy physical labor, hazardous production, night shift work.
Period of financial difficulties.
The woman's age is under 18 and after 40 years.
Family conflicts, stressful situations.
Adverse habits of a pregnant woman.
Insufficient or unbalanced diet.

With hypertonicity of the myometrium, the blood vessels that connect the maternal body and the fetus spasm. The fruit does not receive enough nutrients with oxygen. Threats in the form of developmental delays and interrupted pregnancy increases several times.

Localization

Increased contractility of the organ can develop in three forms: local, along the posterior and anterior surfaces.

When does hypertension develop? back wall uterus, the process is asymptomatic.

The attending physician establishes pathology only on the basis ultrasound diagnostics. Pathological tone along the posterior wall of the uterus is determined by changes in the uterine muscle fibers.

Pregnant woman shown ambulatory treatment. Sedatives and antispasmodics are prescribed medicines. In case of uterine hypertonicity of the 1st degree, it is recommended to reduce physical exercise, limit your sexual contacts.

The tone of the posterior wall of the uterus during second-degree pregnancy gives a brighter clinical symptoms: aching constant pain in the lower third abdominal cavity, feeling of “fullness” in the vagina, rectum. If the diagnosis is confirmed by ultrasound, the pregnant woman is indicated for hospitalization. Comprehensive treatment is carried out with bed rest and under medical supervision.

The likelihood of posterior wall pathology depends on age. Expectant mothers under 18 and over 35 years of age are at risk.

Hypertonicity of the anterior wall of the uterus during pregnancy causes pain in the lower third of the abdominal cavity with an increased urge to urinate and empty the intestines.

With increased tone along the anterior wall, painful sensations, similar to those experienced by a non-pregnant woman with the onset of menstruation.

With hypertonicity of the anterior wall of the uterus, there is a high probability of uterine bleeding. If a woman’s discharge changes or traces of blood appear, this should be a reason for immediate hospitalization.

Symptoms of total uterine hypertonicity: a woman feels “petrified” abdominal walls, complains of pain with watery, bloody discharge.

It is possible that after the fourth month with this pathology, fetal movements will change. If this happens and the fetus moves more often or less frequently, the pregnant woman should immediately contact a gynecologist.

Diagnostic and therapeutic measures

During an examination, the doctor discovers general symptoms hypertonicity of the uterus during pregnancy: deterioration in general health, nervousness, nagging pain in the lower third of the abdomen, increased pain after minor physical exertion.

To confirm the diagnosis, the doctor conducts gynecological examination, appoints ultrasonography, tonusometry.

So that the treatment of pathology gives positive result, the first stage shows complete psycho-emotional and physical peace. Preparations:

Before treating uterine hypertonicity with strong medicines, prescribe sedatives for plant based: tincture of motherwort, valerian, peony.
If herbal sedatives are ineffective, treatment includes one of the tranquilizers: Diazepam, Phenazepam, Halcyonine.
If it is determined that the cause of the development of pathology is progesterone deficiency, synthetic drugs are prescribed. hormonal agents: Duphaston, Utrozhestan, Metipred.
To relieve spasms and improve blood supply, antispasmodics are prescribed: No-shpu, Papaverine.
To treat pregnancy pathologies after 16 weeks, special tocolytic drugs are prescribed: Ginipral, Partusisten. They reduce contractile function and protect against premature labor.
Complex therapy is supplemented with Magne-B6 preparations, multivitamins, and folic acid.

What should a woman do on her own, and how to cope with the first signs of hypertension at home:

Learn to breathe calmly, be as nervous and worry as little as possible.
For a while, completely eliminate physical activity and any housework.
Breathe fresh air as much as possible.
Avoid public transport.
Limit sex life.
Do not take baths, limit yourself to showers.
If your doctor recommends, purchase a bandage. A properly selected product will be an excellent prevention of hypertension.
Learn and regularly perform relaxation exercises.

In order to prevent myometrial hypertonicity, a woman should adjust her diet: be sure to include dishes made from oatmeal and buckwheat, nuts, and fresh herbs.

And most importantly: do not miss scheduled visits, strictly follow all doctor’s prescriptions.