Why is there tone in pregnant women? Our uterus is a muscular organ with three layers

Symptoms of uterine tone during pregnancy frighten women in anticipation of a “miracle”. However, such manifestations are not always a pathological condition that threatens the normal course of pregnancy. After all, the uterus and the fetus developing in it are sensitive not only to physical influences, but also to changes in the psycho-emotional status of the expectant mother. Therefore, temporary tone can occur even normally, reflecting the woman’s well-being. What does uterine tone mean during pregnancy and how to find the line between normal and pathological?

The uterus is a “ball” of smooth muscle fibers within which the fetus develops. The walls of the uterus and the body of the fetus do not directly touch each other; they are separated by a thin membrane - the fetal sac, as well as the placenta. The condition in which most of the muscle fibers of the uterus are in the contraction phase is called tone. It is observed during childbirth, which ensures the “pushing out” of the baby from the mother’s womb and is an absolutely normal phenomenon. But tone during premature pregnancy can lead to disastrous consequences.

How to identify it yourself

Signs of uterine tone during pregnancy are not always noticeable to a woman. It all depends on the duration of pregnancy, as well as on the severity of tone. How can you independently determine whether there is uterine tone during the current pregnancy or not? You can do this by listening to your body and studying your own sensations.

In the first half of the term

Immediately after conception and throughout the entire 1st trimester, the expectant mother can judge that the uterus is in good shape only by subjective sensations. At this time, the body of the uterus is deep in the pelvic cavity, and it is not possible to independently palpate it through the abdomen. Therefore, for diagnosis it is important to know the main signs of hypertension.

Painful sensations. Most often, pain above the womb is similar to menstrual pain. Women describe them as nagging, constant or intermittent. After all, during menstruation, the uterus also contracts to evacuate its contents. Therefore, the symptoms are very similar.
Frequent urge to go to the toilet. The body of the uterus lies in close proximity to the bladder. When its muscle fibers contract, it literally puts pressure on the bladder, causing a false urge to urinate.
Pressure on the rectum. If the body of the uterus is tilted back, the impact is not on the bladder, but on the rectum. In this case, there is a feeling of pressure and a feeling of incomplete emptying of the rectum, pain in the perineum when sitting.
Special sensations. Many women find it easier to describe what they feel during pregnancy in figurative terms. They often note that in the lower abdomen there is “something dense, like a stone” or “the uterus is clenched like a fist,” others describe the tone of the uterus as “coldness in the stomach.”

For the doctor, these complaints become a reason for an extraordinary examination. A two-handed examination (through the vagina and abdomen) allows you to accurately determine whether there is hypertonicity of the uterus, or whether the sensations during pregnancy are caused by something else.

Symptoms of uterine tone may appear for no apparent reason. But more often, hypertonicity occurs after physical fatigue, psycho-emotional experiences, during an exacerbation of chronic diseases, or during a cold.

In the second half of the term

In the 2nd trimester (closer to 18-20 weeks), the enlarged uterus can already be clearly felt above the womb. From this moment on, a woman can not only subjectively, but also objectively judge the tone. An increased need to go to the toilet, a feeling of pressure on the rectum, pain in the lower abdomen - all this is just as disturbing as during a short period of time. In addition to this, you can simply try to feel the uterus through the abdomen. Normally, it should be soft and practically no different from the surrounding tissues. If a woman identifies a “hard ball,” this may indicate hypertonicity.

In the 3rd trimester, especially on the eve of childbirth, women clearly determine when the uterus contracts. At the same time, the stomach becomes more formed, and not “blurry”. When stroking, the uterus is dense, but there should be no pain or discomfort. If they occur, acute conditions (for example, placental abruption) should be excluded.

How can you confirm the tone of the uterus during pregnancy?

Every expectant mother can exaggerate her feelings, worrying about the condition of the child. Therefore, additional diagnostic methods are used to confirm the tone of the uterus and the presence of threatening conditions.

Examination by a specialist. Already at the beginning of pregnancy, a gynecologist can detect the tone of the uterus. Normally, when palpated, the pregnant uterus is soft and pliable. But with increased tone, it thickens, and a woman may feel discomfort and pain during examination.
Ultrasonography. Using ultrasound, local tone can be detected. This definition is especially reliable at the beginning of pregnancy. Local tone can be associated with areas of detachment or be caused simply by the study itself. In the latter case, it goes away after 10-15 minutes of rest.
Cardiotocography (CTG). Using this study, it is possible to determine not only the fetal heartbeat, but also the presence of contractions of the uterine muscles. For this, a separate sensor is used, which is most often installed in the area of the fundus of the uterus on the right or left. Rhythmic muscle contractions will be visible on the graph as waves of different amplitudes, and constant tone will be visible in the form of a horizontal line of a certain height. This method is informative to use only from the third trimester. This way you can confirm the onset of labor in normal and premature births.

Pathological tension

The reasons for uterine tone during pregnancy are varied. Periodic tone, which is clearly associated with stress or overwork, is experienced by many expectant mothers. However, causes that increase uterine contractions until full-term pregnancy should be avoided as much as possible.

Pathological tone is characteristic of the following conditions.

Placental abruption. This is one of the most dangerous complications of pregnancy. Abruption is the pathological separation of the placenta from the uterine wall with the formation of a hematoma and subsequent uterine bleeding. In addition to constant tone, the woman will notice pain throughout the entire surface of the uterus and changes in fetal movements. Later, bloody discharge from the genital tract may occur. The condition requires immediate medical attention.
Abortion. Most often, tone is associated with this condition. In this case, bleeding may occur in the short term. When labor begins ahead of schedule, the tone of the uterus becomes cramp-like.
Anomalies of the structure of the uterus. Periodic tone is observed in women with congenital anomalies of the uterus: bicornuate, septate, saddle-shaped. Such developmental features increase the risk of miscarriage, which is associated with an increase in tone.
Neoplasms and other diseases. Myoma often causes tone due to abnormal tissue extensibility in the area of the nodes. When fibroids are located on the anterior wall of the organ, they are palpated as round, focal, dense formations. Severe uterine endometriosis (adenomyosis) is also the cause of similar changes in the myometrium.
Pathology of pregnancy. If the uterus is overstretched, for example, with polyhydramnios, a large fetus or multiple pregnancy, the feeling that it is constantly in good shape can be artificially created. At the same time, only a doctor can distinguish normality from pathology.
Diseases of nearby organs. With pathology of organs that are located close to the uterus, the latter may become toned. For example, with renal colic, appendicitis. Normal constipation or bloating can also provoke tone.

Standard options

In some situations, normal tone occurs, which goes away on its own without consequences.

Physical labor. Any physical work, even if a woman feels good while doing it, can lead to hypertonicity. This is a kind of evidence of overwork.
Touching. As soon as the uterus is well defined above the womb, a woman may notice that when touched, she quickly comes to tone. This is especially clearly seen when examined by a doctor and is a normal reaction to touch.
Intimate relationships. During sex and for some time after it, the muscles of the uterus continue to contract due to the release of the hormone oxytocin, which causes an increase in tone.
Fetal movements. Starting from 26-28 weeks, the baby reaches a fairly large size. Each time his movements bring the myomeria into a state of some contraction, which is more frequent and intense the closer to childbirth.
Mom is stressed. Psycho-emotional stress leads to the release of hormones into the blood, which leads to contraction of the myometrium and the appearance of tone.
Training contractions. From the 37th week of pregnancy, periodic tone appears, especially often occurring at night. This activity of the myometrium is necessary to prepare the cervix.

Although increased uterine tone during pregnancy is not always accompanied by pathological conditions, you should definitely see a doctor if the hypertonicity lasts for a day or two, is cramping in nature, or in addition to the tone, there are abdominal pains, changes in fetal movements (very violent or absent) or discharge with an admixture blood from the vagina.

What is the danger

Normal contractions, for example, before childbirth and after stroking the abdomen, do not provoke any pathological changes. But constant uterine tone, especially during late pregnancy, can be dangerous, so if it is present, it is better to consult a specialist rather than waste precious time.

The fact is that when the baby's place is located on the back wall of the uterus, tone is the only symptom of abruption. Other conditions that a specialist should rule out in this case are:

threat of miscarriage;
uterine bleeding.

But only a doctor can distinguish physiological tone from pathological tone after examination and minimal examination (ultrasound, CTG).

How to cope on your own

The gynecologist who is observing her should tell the woman how to relieve uterine tone during pregnancy and prevent its occurrence. Typically, to prevent hypertension, the following is recommended.

Relaxing gymnastics. Special sets of exercises have been developed for pregnant women to relax and strengthen the pelvic floor muscles. There is also a whole branch of yoga that pursues the same goals. But it is better to do such exercises after consultation with a gynecologist.
Swimming in the pool. Swimming is good for muscular and psychological relaxation. But the pool should only be visited with the permission of a doctor.
Calming herbs. Pregnant women are more susceptible to mood swings, they are more sensitive and vulnerable. And psychosomatics can not only provoke the threat of interruption, but also contribute to the development of toxicosis and gestosis. Therefore, with increased anxiety, irritability and emotional stress, it is useful to take valerian or motherwort.
Fight constipation. Coordinated bowel function is important for maintaining normal uterine tone. Constipation and the constant straining that follows can increase tone. It is especially important to avoid constipation if there is a threat of miscarriage. To improve intestinal motility, you should increase the amount of fiber-rich foods (fruits and vegetables) in your diet. If necessary, you can use safe medications for constipation, for example those containing lactulose (Duphalac).
Rest properly. It is important for pregnant women to know how to lie down, especially during longer periods, so as not to provoke hypertension. In a horizontal position, you should spend more time on your left side. This will prevent the inferior vena cava from being compressed.

By following these simple recommendations, you can relieve uterine tone, which is caused by overwork or minor functional disorders. If discomfort persists or if other complaints are added (for example, questionable discharge), it is necessary to obtain specialist advice as soon as possible.

Therapy

Treatment of uterine tone during pregnancy can be done at home as prescribed by a doctor or in the hospital, and therapy in the early and late stages is different. Medicines are prescribed in the form of vaginal and rectal suppositories, tablets, droppers or intramuscular injections - it all depends on the severity of the tone.

Medicines at the beginning of pregnancy

It is important to observe the medical-protective regime and rest. In case of psycho-emotional instability of a pregnant woman, sedative herbs are prescribed in the form of decoctions or tablets. The following groups of drugs are used for basic treatment.

Antispasmodics. Help relieve tension in the smooth muscle fibers of the uterus. Pills or injections of medications also help dilate blood vessels and increase blood flow in the placenta. Examples of products: “No-shpa”, “Papaverine”, “Drotaverine”.
Hormonal drugs. Progesterone-based products are used (Duphaston, Utrozhestan, Susten). Their administration is effective when the level of progesterone in blood tests is really low. With increased tone, natural progesterone is more often used (in Utrozhestan), which can be used up to 32-34 weeks. Doses and dosage regimens are set individually depending on the clinical picture.
Vitamins and microelements. Magne B6 or other magnesium preparations are used (for example, Magvit, Magnefar). This microelement affects muscle contractions, including relaxing the myometrium. It can be prescribed both in prophylactic doses (one tablet once or twice a day) and in therapeutic doses (two tablets two to three times a day).

If during the treatment the cause of hypertonicity is determined (detachment, inflammation in the vagina), additional groups of drugs (hemostatic, anti-inflammatory suppositories, antibiotics) are prescribed.

Drugs after 20-22 weeks

After 20-22 weeks, the range of drugs expands. The following medications are used.

"Ginipral". The drug acts on certain receptors, which are concentrated in large quantities in the muscle fibers of the uterus. Medicine in the form of intravenous infusion is effective for relieving an acute condition (even contractions), and tablets are used as maintenance therapy. But Ginipral has a side effect in the form of increased heart rate of the woman and fetus. Prescribing drugs that slow down the heart rate (for example, this can be either Nifedipine or Verapamil) helps to avoid such unwanted reactions.
Magnesia. This remedy is universal during pregnancy. It has a complex effect and has almost no contraindications. Most often it is administered intravenously, less often intramuscular injections are prescribed (they are very painful, according to reviews, and can also be complicated by the formation of compactions). Typically, infusions of the solution are carried out in the first half of the day - in the morning.
Physiotherapy. Electrophoresis with magnesium, a Shcherbak collar, and therapeutic sleep are prescribed.

If studies reveal changes in the condition of the fetus, for example, blood flow between the child and the woman is disrupted, vasodilators and agents that improve metabolic processes (Pentoxifylline, Actovegin) are added to the treatment.

Regulation of labor

Pathological tone can occur even during childbirth. This leads to disruption of uterine contractions, prolongation of labor, and sometimes it is necessary to resort to a cesarean section. To quickly reduce the local tone of the cervix that occurs during active labor, both antispasmodics and painkillers are used. In order to ensure adequate pain relief:

spinal anesthesia is administered;
narcotic analgesics (Promedol) are administered.

If they are ineffective, in most cases delivery ends with surgery.

It is important for women to understand what uterine tone is during pregnancy, when it can be normal and when it is pathological. Detection of abnormalities in time can save not only the baby, but also the life of the woman herself. Therefore, if you have disturbing symptoms, it is better to consult your doctor again.

From the very beginning of expecting a child, the expectant mother is worried about all sorts of changes occurring in her body. Uterine tone during pregnancy (1st trimester), symptoms of its occurrence sometimes manifest in the form of pain in the lower back, a fairly common pathology of fruiting. Its timely treatment helps prevent negative developments in the future. Allows you to maintain pregnancy and give birth to a smart, healthy baby.

Increased uterine tone during pregnancy in the first trimester: what is it?

The uterus is an organ that consists of muscles. Its outer serous layer is called the perimeter, the middle layer is the myometrium, and the inner layer is the endometrium. Throughout pregnancy, the uterus experiences enormous stress. It increases and stretches several times, as it has the ability to contract. And in the natural state of the expectant mother, the muscle tone of the uterus is relaxed. If the organ contracts during pregnancy, the tone of the uterus increases. This condition can be short-term or long-term. The first option does not cause much discomfort and goes away quickly. It is enough for a woman to rest and relax. May appear during a gynecological examination. The second one is longer. Accompanied by unpleasant sensations. In this case, you need to urgently consult a doctor and start treating the disease, otherwise the consequences can be very sad.

If the muscles of the uterus are tense for a certain time, then the intrauterine pressure increases and there is a threat of miscarriage in the first trimester and the danger of termination of pregnancy in the remaining stages. This is why uterine tone is dangerous during pregnancy. The 1st trimester (the symptoms of the disease need to be known and cannot be ignored) is considered the most vulnerable. During this period, the fetus has not yet developed properly and there is a high probability of miscarriage. Sometimes a woman does not immediately detect pregnancy and, accordingly, does not take care of herself. Continues to work and lead an active lifestyle. May drink alcohol or smoke. A long working day does not improve health and often provokes uterine tone.

Symptoms of uterine tone in the first trimester

For many women, the tone of the uterus during pregnancy (1st trimester) is of great concern. Symptoms during this period of the life of the expectant mother are as follows:

Severe or mild pain in the lower abdomen. They can be either aching or pulling. Reminds me of menstrual discomfort.
The stomach becomes stone and elastic.
Unpleasant discomfort appears in the lumbar region.
Bloody spotting occurs.
There are cramping urges that occur after a certain period.

If any of the above symptoms occur, you should urgently call an ambulance. Any delay during pregnancy, regardless of the term, can cause miscarriage or premature birth. A toned uterus in some cases causes a frozen pregnancy, oxygen starvation. This leads to retardation and defective development of the embryo.

Pain or heaviness in the lower abdomen in the early stages of fruiting may not indicate the tone of the uterus, but a global restructuring of the body, because inside the body there is an embryo that grows and develops every day. The female body tries to accept it and adapts to the parameters of the unborn child. Trying to coexist comfortably with him.

Even if symptoms of hypertonicity do not appear, a pregnant woman should not miss scheduled consultations with a gynecologist. After all, the uterine tone is often determined by the doctor during a routine examination of the patient. Therefore, feeling well is not a reason to refuse a visit to the doctor.

Causes of the disease

Uterine tone during pregnancy (1st trimester), the symptoms of this disease were described above, can be caused by the following factors:

negative neuropsychological state of the patient caused by stress and problems of various types;
excessive physical activity: heavy lifting, long walking or, conversely, staying in one position for a long time;
constipation, gas formation and other disorders of the gastrointestinal tract. Here the intestines or other organ puts pressure on the uterus;
active sexual intercourse;
hormonal imbalance in the body associated with an excess of male hormones or a lack of progesterone, which reduces smooth muscle tension;
severe toxicosis;
various uterine anomalies that complicate the course of pregnancy;
Rhesus conflict;
infectious and inflammatory diseases of the female genitalia, accompanied by itching, discharge, pain;

In addition to the listed reasons, uterine hypertonicity occurs: from severe stretching, when the fetus is large or the woman is expecting more than one child; from various tumors and neoplasms; from early abortions and miscarriages; injuries of various types.

If desired, the tone of the uterus can be determined at home. To do this, the woman should lie on her back and relax. Carefully and gently feel the entire abdomen. If his condition is mild, then there is no reason for alarm, and the uterus has normal tone. A hard or overly elastic abdomen indicates increased tone. In this condition, you need to see a doctor as soon as possible.

How is tone treated?

It is imperative to follow all the instructions of the attending physician if uterine tone occurs during pregnancy in the first trimester. Treatment largely depends on the danger of the current situation. If there is no serious threat to pregnancy, the gynecologist can conduct outpatient treatment.

In this case, the woman is advised to worry less and sleep more. Antispasmodics are prescribed, the most popular of which are “No-shpa” and “Papaverine”. A course of magnesium B6 is prescribed. Sedatives are recommended: motherwort, valerian. All these remedies are designed not only to eliminate the diagnosis, but also to remove the root cause of this disease.

If a pregnant woman lacks the hormone progesterone, the patient is prescribed drugs that eliminate its deficiency. Most often it is Duphaston. The cause of tone may be hyperandrogenism or excess levels of male hormones in the body. In this case, medications are prescribed that normalize the levels of hormones in the body. With severe toxicosis, doctors try to alleviate the patient’s condition. If the tone is caused by a malfunction of the gastrointestinal tract, then it is necessary to get rid of gas formation, constipation, flatulence and other intestinal disorders. Certain therapy is also prescribed for Rhesus conflict.

If the tone of the uterus cannot be brought back to normal through outpatient therapy and the situation is critical, doctors hospitalize the patient. A pregnant woman is admitted to the hospital. Here the expectant mother will be in a calm state, will not be able to break bed rest or do household chores. All negative emotions are minimized. In addition, doctors can examine the patient more thoroughly and monitor her condition. They will be able to stop the increase in tone in time. Will prevent miscarriage and premature birth.

By refusing hospitalization, a woman takes a certain risk, which is not always justified.

Preventive measures

Increased uterine tone during pregnancy in the first trimester can be prevented if you remember about prevention in time. First of all, it is necessary to ensure the coordinated functioning of the entire body, including the gastrointestinal tract. Remove, if any, constipation, bloating and flatulence. Physical exercises for pregnant women will strengthen the body. Daily long walks in the fresh air will saturate the body with oxygen. The absence of negative emotions, a positive attitude and humor will help you cope with any everyday situation.

Also, a pregnant woman should get enough sleep. Sleep should last at least eight hours. Eat properly and balanced. Enrich your diet with fruits and vegetables with the maximum content of nutrients. Take a vitamin-mineral complex for pregnant women. This is the period where there is no place for bad habits; if they are present, then you urgently need to part with them. Although they should be abandoned even before the moment of conception.

You should visit your doctor regularly. Take tests and undergo ultrasound examinations on time. Do not lift heavy objects under any circumstances. Transfer some of your responsibilities to your household. Rest more and just enjoy life.

If symptoms indicate uterine tone during pregnancy (the 1st trimester is especially vulnerable to external factors), then you should abstain from sexual intercourse for a while. Pregnant women need to be able to relax. It is also necessary to charge yourself with positive emotions throughout the entire period of pregnancy.

About the appointment of a gynecologist

A competent doctor, when diagnosing increased uterine tone during pregnancy in the first trimester, should study the symptoms thoroughly. Conduct an examination and prescribe an ultrasound. Such a diagnosis will not only help prescribe precise treatment for the patient, but will also provide a complete picture of the disease. As a rule, women in the first trimester, at the first suspicion of hypertonicity, are advised to lie down to ensure maximum rest. There will be no need to regularly visit the clinic to examine the body, because in the hospital all the necessary manipulations will be carried out on the spot.

The gynecologist treating the woman must be aware of all the problems troubling the patient and take into account all pathologies of the uterus at the beginning of pregnancy. Prescribe the necessary medications, ultrasound examinations and tests in a timely manner. Assess the situation from all points of view.

Uterine tone during pregnancy, 1st trimester: what to do first?

When detecting uterine tone, a woman should not panic. She needs to pull herself together and fully assess the situation. You can take “Papaverine” or “No-shpu” yourself. If there are obvious signs of anxiety or agitation, you can drink sedatives such as motherwort or valerian. In this case, you need to visit a doctor immediately, without waiting for a scheduled examination. Self-medication is extremely undesirable here.

At the first signs of uterine tension, you should close your eyes and take several deep breaths. Remember something pleasant. Turn on the beautiful Relax. In this case, the tone of the uterus during pregnancy in the first trimester (the symptoms of which may seem scary at first) will decrease or return to normal, but this is provided that the pathology has not become serious. That is, there is no bleeding and strong cramping calls. In the latter case, you should immediately call an ambulance. If the tone is associated with severe toxicosis, then you should reconsider your diet. You need to eat as many fruits and vegetables as possible. You can consult your doctor about nutrition.

Diagnosis of the disease

The tone of the uterus during pregnancy in the first trimester is determined through a diagnostic examination, which is carried out only by the treating gynecologist. He does palpation. Checks the belly of a pregnant woman by touch; if the uterus is in good shape, then it will be hard. At this time, the pregnant woman lies on her back. After these manipulations, the doctor, if necessary, prescribes an ultrasound, which determines the size of the local or total muscular layer of the uterus. In some cases, tone is determined with a special device - a tonometer, which has a special sensor and accurately determines the diagnosis. Only after a thorough examination does the doctor prescribe full therapeutic treatment to the patient.

How dangerous is uterine tone?

Throughout pregnancy, short-term and long-term tension in the uterine muscles may occur. The first is considered the norm. This uterine tone can be removed without leaving home. It does not pose a serious danger to the life of mother and child.

Prolonged uterine tone during pregnancy (1st trimester) can have the most tragic consequences and end in spontaneous miscarriage. Particularly dangerous are nagging pains in the lower abdomen and spotting. This health indicator also affects the child, since adequate blood supply to the pelvic organs is disrupted, which leads to fetal hypoxia and affects its physical and mental development. A frozen pregnancy may occur. Only timely qualified assistance can help avoid all this.

Timely help without drugs

Uterine tone during pregnancy (first trimester) can be removed without resorting to medicine. For example, a yoga exercise called “Cat”. Standing on all fours, you need to raise your head up and arch your back. You should remain in this position for at least five seconds. Then smoothly return to your previous position. It must be done at least three times. Next you should lie down for about an hour. After the body has rested and recovered, you should leave the bed smoothly, without making sudden movements.

Muscle relaxation of the face and neck, even and calm breathing will help remove or weaken the tone of the uterus during pregnancy (1st trimester). Treatment is continued with soothing herbal tea, which may include plants such as lemon balm, mint, valerian and motherwort.

A pose in which the pregnant woman kneels and rests her elbows on the floor will relax the uterus. In this case, the uterus is in a suspended position. You should stand like this for 10-15 minutes. After this you need to lie down for a while.

A pregnant woman should not only refrain from carrying heavy objects, but also adhere to a certain daily routine, follow a diet and get enough sleep. Carrying a baby is a serious matter and must be approached with all responsibility. Complete all assignments on time. Take care of yourself and your unborn baby. Have only positive emotions.

Uterine tone is a characteristic of the state of the uterine muscles, which describes the degree of its tension and is measured in millimeters of mercury.

The following variants of the state of the uterine muscles are distinguished:

- The uterus is hypotonic- this is a pathological condition of the uterus, in which its muscles are excessively relaxed, it is a complication of the early postpartum period, the cause of hypotonic uterine bleeding.
- The uterus is in normal tone- this is a physiological state of both the pregnant and non-pregnant uterus, in which the muscles are at rest.
- The uterus is in increased tone- a state of tension in the uterine muscles, which can be either permanent or temporary (contractions during childbirth). An increase in uterine tone can be either in one specific place (local) or involve all parts of the uterus (total).
- Hypertonicity of the uterus– an anomaly of labor, in which the number of contractions in 10 minutes is more than four, i.e. this pathology occurs only during childbirth.

It should be noted that the expression “hypertonicity of the uterus,” which is mistakenly used by some specialists and their patients, implying an increase in uterine tone during pregnancy, is incorrect, because this term describes one of the types of labor anomalies.

Uterine tone in normal and pathological conditions

Normally, the tone of the uterus during pregnancy ranges from 8 to 12 mm Hg. Exceeding these values during pregnancy can be both physiological in nature, for example, when it occurs in response to fetal movement, and pathological, when such uterine activity is constant and/or accompanied by painful sensations, and in this case is a symptom of impending premature labor or threatened spontaneous abortion. If such uterine activity becomes periodic and contractions are repeated after a certain time interval, leading to the opening of the cervix, then we speak of labor activity, i.e. the onset of premature labor (if the period is 22-37 weeks) or the onset of spontaneous abortion (up to 22 weeks).

Causes of increased uterine tone

There are many reasons for increased uterine tone. Among them, the main role is played by infections that exist in the mother’s body, such as: infections of the oral cavity, genitourinary system, gastrointestinal tract, and skin infections. In second place in importance are socio-economic factors: age (less than 18 and more than 35 years), the presence of serious underlying diseases (diabetes mellitus, arterial hypertension, obesity), the presence of bad habits (alcohol abuse, smoking, drug use), low level of education, poor living conditions, the presence of psycho-emotional overload, poor working conditions, non-compliance with work and rest schedules - all these factors, both individually and taken together, have a very strong influence on the course of pregnancy.

In addition, the reasons for the increased tone of the uterus can be complications of this pregnancy: incorrect position of the fetus (breech presentation, transverse position of the fetus), pathologies of the placenta (placental insufficiency, placenta previa), developmental anomalies and diseases of the uterus (bicornuate uterus, doubling of the uterus, the presence of septum in the uterus, uterine fibroids, uterine scar after a previous cesarean section or removal of a myomatous node), complications of this pregnancy (moderate and severe nephropathy), a history of premature birth, abortion (both spontaneous and artificial), the presence of miscarriage in blood relatives in the family, the presence of congenital malformations of the fetus (especially those incompatible with life).

Symptoms of increased uterine tone during pregnancy

An increase in the tone of the uterus is manifested by pain in the abdomen, especially in the lower parts, of a pulling nature, periodic “hardening of the abdomen,” a feeling of tension in the abdomen, sometimes increased urination and sometimes increased motor activity of the fetus.

Diagnostics

Increased uterine tone in itself is not a diagnosis; it is the main symptom of threatened miscarriage. In order to diagnose increased uterine tone, sometimes simple palpation is sufficient, but it should be remembered that it is not always objective, unlike cardiotocography (simultaneous recording of uterine contractions and fetal heartbeat), which objectively assesses the situation and allows for comparison between earlier indicators and later ones, i.e. evaluate the effectiveness of the treatment and the dynamics of uterine activity.

Treatment of increased uterine tone during pregnancy

To avoid spontaneous abortion in the early stages and premature birth in the later stages, the increased tone of the uterus must be reduced. Most often, if there is a threat of miscarriage, the pregnant woman is recommended to go to the hospital and undergo treatment. With increased uterine tone, the supply of oxygen and nutrition to the fetus deteriorates, so treatment is necessary. To reduce uterine activity, special drugs called tocolytics are used.
These are drugs belonging to different pharmacological groups, having different mechanisms of action, but one effect: they reduce increased uterine activity. Help relieve increased uterine tone:

Ginipral, partusisten, salbutamol, terbutaline. Currently, the most effective safe drug from this group is ginipral. In emergency cases, it is prescribed in the form of droppers, after which it is switched to tablet form.

Nifedipine, this drug exists only in tablet form.

Magnesium sulfate/magnesium sulfate, only in the form of a solution for intravenous administration, to reduce increased uterine tone, it is currently used only when other drugs are contraindicated for one reason or another

Indomethacin is prescribed as a rectal suppository.

Forecast

A favorable outcome depends on many factors: the condition of the birth canal, the duration of pregnancy, the condition of the fetus, including its position in the uterus, the integrity of the membranes (rupture of amniotic fluid), the presence of pregnancy complications, the presence of concomitant diseases, and also on the timeliness of contacting a doctor . Of course, the patient’s positive attitude is very important.

Prevention of increased uterine tone

First of all, it should be noted the importance of preparing for pregnancy, timely treatment of infections of the genitourinary system, sanitation (improvement) of the oral cavity, then you should pay attention to the work and rest schedule, and then take into account the need to strictly follow all the recommendations of the attending physician.

Obstetrician-gynecologist Kondrashova D.V.

From the very beginning of pregnancy, the concentration of progesterone in a woman’s blood increases. This hormone acts in the interests of the fetus: it relieves the tone of the uterus and prevents its contractions, which is necessary to preserve the child. If symptoms of uterine tone appear during pregnancy, the likelihood of having a baby prematurely increases. But there are treatments for this condition.

The tone of the uterus enters the category of safe states when the moment of birth approaches. The uterus begins to increasingly come into a state of tension, sometimes reminiscent of contractions. This is a workout that starts against the background of a gradual decrease in progesterone.

Symptoms of uterine tone during pregnancy

The basis of the uterus is made up of muscles. Before pregnancy, its size is small: it is no larger than a chicken egg and does not even protrude from the symphysis pubis. As the baby develops, the uterus stretches many times. The muscles are located in three layers in three mutually perpendicular directions. This is necessary so that during labor the baby is pushed out during labor. Each muscle fiber thickens four to five times and lengthens 10-12 times.

Under the influence of progesterone, the uterus is in a relaxed state. But sometimes local or general tension arises. That is, uterine tone during pregnancy is a temporary or permanent state of myometrial tension.

During pregnancy, subjective signs of uterine tone may differ, therefore, to determine medical tactics, several degrees of tone are distinguished.

First degree. The pain in the lower abdomen is short-lived and does not cause significant discomfort or anxiety. Goes away on its own at rest.
Second degree. Severe pain in the abdomen, pain can radiate to the lower back, sacrum. The uterus enters a state of high density.
Third degree. Small physical or mental stress leads to the appearance of tone. The uterus becomes “stony” and does not relax well. This condition requires medical attention.

Hypertonicity of the uterus during pregnancy can occur at any stage and appear periodically until the time of birth.

How it manifests itself

Increased tone can be a dangerous symptom of the onset of premature labor, so you need to listen to your body. You should consult a doctor if the following symptoms appear, regardless of gestational age:

lower abdominal pain;
cramping pain in the uterine area;
rocky uterine density;
bloody discharge from the genital tract.

When can it develop

You can independently determine the tone during a normal pregnancy when the uterus is clearly visible. Sometimes she “turns to stone” even when touching her stomach.

1st trimester

In the 1st trimester, uterine tension becomes a sign of a possible miscarriage. It has been noticed that on ultrasound, tone along the anterior wall of the uterus appears when the child has chromosomal abnormalities. But many other reasons can affect the condition of the uterus:

sex;
physical exercise;
stress;
constipation;
severe toxicosis.

2nd trimester

In the 2nd trimester, uterine tension may be more pronounced. The main reasons are the same conditions as at the beginning of gestation, but rapid fetal growth is added to them. Other possible causes of uterine tone during pregnancy at this stage:

polyhydramnios;
pregnancy with twins;
myoma;
endometriosis;
Rhesus conflict;
placenta previa;
premature placental abruption;
pathologies of uterine development;
inflammatory processes in the genital organs.

High parity of births (frequent pregnancies with a short break between them) can also lead to increased tone.

For a pregnant woman, an additional increase in intra-abdominal pressure that occurs due to vomiting due to poisoning, severe diarrhea, and flatulence is dangerous. This may cause uterine contractions.

3rd trimester

In the 3rd trimester the baby is already quite big. But before the 35th week, the appearance of increased uterine tone is undesirable. There may be the following additional causes for this condition:

malposition;
gestosis;
placental insufficiency;
history of caesarean section;
miscarriage in the past.

The female body is subject to the influence of external factors. Stress affects not only mood, but also sexual function, the ability to conceive and bear a child, and lactation. Constant emotional stress and lack of sleep also provoke the appearance of uterine tone. Some doctors attribute this condition to psychosomatics.

Risks

A toned uterus does not always go away without a trace. In the early stages, this condition can result in termination of pregnancy. An additional symptom is bloody discharge from the genital tract.

In later stages, uterine tone is dangerous due to impaired blood flow in the placenta. In this case, a spasm of blood vessels appears, and then their relaxation. These processes can lead to abruption of a normally located placenta and fetal death.

If tone occurs periodically, the consequences are malnutrition of the fetus and intrauterine growth retardation.

Ways to influence the condition

Diagnosing uterine tone is not difficult. Upon examination, the doctor can determine a change in the shape of the abdomen, a hard uterus, which hurts even more when touched. In the short term, tone is diagnosed during ultrasound. Most often this is a local process along the front or back wall.

For periods after 27 weeks, the use of a CTG machine is informative. It has two sensors. One reflects the fetal heartbeat, and the second reflects uterine contractions. This allows you to evaluate not only the strength and duration of uterine contractions, but also the child’s reaction to them. A pronounced decrease in heartbeat, which takes a long time to return to normal, indicates the suffering of the fetus.

Early dates

The cause of the pathological condition is often a lack of progesterone, and the consequence is the threat of interruption. Therefore, hormonal drugs that can compensate for hormone deficiency are used for treatment. The most commonly prescribed drug is Duphaston. But some women are more suitable for Utrozhestan, which can be taken orally or vaginally. The vaginal form is indispensable for signs of toxicosis - severe vomiting in the morning.

Treatment is supplemented with antispasmodics. You can use No-Shpa tablets (analogous to Drotaverine). For frequent vomiting, Papaverine suppositories are prescribed, which are best taken at night.

In a hospital setting, Vikasol and Dicinon may be prescribed to stop bleeding. You can calm your nerves with motherwort tincture. But you shouldn’t get carried away: it contains ethyl alcohol.

Treatment of uterine tone in early pregnancy involves changing the patient’s lifestyle. The woman is prescribed sexual rest. In some cases - hospitalization. It is recommended to normalize the work and rest schedule, sleep at night, but also go to bed to rest for an hour during the day. Foods that promote gas formation, as well as coffee and strong tea, are removed from the diet. If you suffer from constipation, then you need a laxative diet.

Mid-gestation

Approaches to eliminating tone in this period are different. Some women with progesterone deficiency continue to take Duphaston until week 20 (followed by a gradual reduction in dose). Antispasmodics help in treatment. If necessary, they are used in the form of injections.

But the main drug for quickly reducing local cervical tone and generalized spasm is a magnesium solution. It is used in the form of droppers. Magnesium sulfate helps relax muscles and also calm the nervous system. The solution lowers blood pressure and improves diuresis, which is used for gestosis. Prescription is contraindicated for bradycardia, low baseline blood pressure and severe kidney disease.

The choice of other drugs depends on concomitant pathologies that could cause the deterioration of the condition.

After discharge from the hospital, women are prescribed Magnesium B6 in courses in the form of tablets. This is necessary to improve the condition of the fetoplacental complex. At home, a pregnant woman can perform breathing exercises that help calm her down in stressful situations. Some people do yoga for pregnant women, but these should be light asanas that exclude raising your arms and straining your stomach. Dietary recommendations remain the same as in the previous trimester.

From 7 months

During this period, the uterus also responds to the administration of magnesium. But the number of receptors in it increases, which can be influenced with the help of the drug "Ginipral". It belongs to the group of sympathomimetics and is able to reduce the tone and contractility of the myometrium. Available in the form of tablets and solution. But most often the drug is used in hospitals for tocolysis - relieving contractions during premature birth or during complicated labor.

Collapse

Uterine tone is the tension of this organ during pregnancy, which is very important for bearing a baby. The uterus is a muscle that contracts and tenses. However, tone can also be dangerous. For example, hypertonicity is a phenomenon in which the uterus is overly tense, which poses a danger to pregnancy. With this phenomenon, a woman reduces the tone of the myometrium with the help of exercises and special medications. However, there are cases in which the tone of the uterus needs to be increased. For example, after an abortion, childbirth, if it is impossible to get pregnant. How to increase the tone of the uterus? This will be discussed in this article.

Drugs to increase tone

In obstetrics, drugs that affect the contractile activity of the uterus are often used. In what cases are medications prescribed to improve tone?

with weakness of labor;
with decreased tone after childbirth;
early post-abortion period;
in case of late pregnancy termination for medical reasons.

Let's look at some groups of drugs.

Oxytocin. A drug that causes contraction of the myometrium, characteristic of labor. Especially if it was administered in large doses. A pregnant uterus is much more sensitive to oxytocin than a non-pregnant uterus. As pregnancy progresses, so does susceptibility to oxytocin. How to use? The woman is given intravenously. The effect of the drug is about 3 minutes. In what cases will the patient be injected with oxytocin:

to stimulate labor;
to stop bleeding after childbirth.

Contraindications:

discrepancy between the size of the baby and the uterus;
incorrect position of the child;
presence of scars on the organ;
danger of rupture.

Desaminooxytocin. The action of the drug is similar to oxytocin, but its effect lasts longer. This drug is prescribed

to enhance existing labor activity;
for contraction of the uterus after childbirth;
to increase lactation.

It is taken as a lozenge under the tongue or behind the cheek. Contraindicated for any abnormal fetal position.

Pituitrin and Hyfotocin. These two similar drugs are obtained from the pituitary gland of cattle. In addition to oxytocin, the drugs contain small amounts of vasopressin. Used intravenously to increase tone under the supervision of a doctor. The following are added to the contraindications:

sepsis;
nephropathy;
hypertension;
thrombophlebitis.

Products that increase uterine tone

If the situation is not critical, then you can increase the tone of the uterus at home with the help of the necessary food products. Below is a list of foods that you should eat if you are hypotonic. If a woman suffers from hypertension, then the following products are contraindications for her.

Bread. There is an opinion that baked goods can increase the tone of the uterus. Especially if they are made from white flour. Therefore, if you have a weak uterine muscle, allow yourself to eat a fragrant bun or a piece of white crispy bread. But the norm is important in everything. Do not overdo it, otherwise problems with your figure and gastrointestinal health cannot be avoided.
Legumes. This type of product causes increased gas formation. There is an opinion that any gas formation in the abdomen can increase the tone of the muscles of the uterus. Eat beans, peas, and asparagus as a separate dish or as an addition to soups and porridges.
Fresh fruits. If you did not eat any fruit before pregnancy, you should not start doing so during pregnancy to avoid allergic reactions. What fruits will help increase myometrial tone? Pineapple, which contains organic acids. Papaya, which increases the contractile function of the uterus. You need to eat all fruits that contain sugar.
Vegetables. All green fresh vegetables in any quantity will do. For example, cucumber, cabbage, broccoli, lettuce, greens.
Dairy products. First of all, it is a source of calcium, which is so necessary for the pregnant body. With decreased tone, “milk” will help strengthen the muscles of the uterus and avoid miscarriage. But you shouldn't eat blue cheese, as it can cause a fungal infection.

Spices

It would seem just a spice, a flavoring. However, even such minor seasonings in dishes can become both enemies and friends for pregnant women. What spices should you take for muscle hypotonicity?

Parsley. This green, aromatic addition to dishes has the property of increasing the tone of the uterus during pregnancy. Of course, a small amount in a soup or salad won't help you. However, if you want, then eat up to 100 g per day. Among other things, it contains a huge amount of vitamin C.
Bay leaves and cumin increase the contractile function of the organ.
Dill. Its infusion increases lactation in pregnant women and increases uterine contractions.
Fennel in large quantities also causes uterine tone.
Black pepper is a great tonic. Among other things, it promotes digestion. Naturally, in moderation.
Cinnamon, namely a teaspoon per day, increases tone, increases appetite and improves mood, which is very important for pregnant women.
Thyme. This spice, although slightly, still increases uterine contraction.

Medicinal plants

You should be careful with herbs, because unknowingly you can cause an abortion. If only the doctor diagnosed you with low tone, and not you yourself, then you can take herbal extracts. To increase tension in the female organ, pay attention to the following herbs.

Calamus is a herb that has a hemostatic effect. It increases peristalsis of the intestines and uterus. High content of female hormones.
Aloe is known for causing a rush of blood to the female organs, improving their functioning.
Arnica – quite significantly increases the tone in the uterus.
In addition to its main function, black elderberry has a laxative effect.
Water pepper is great for strengthening the uterine muscles.
Common oregano. You should be careful with its use, as if the dosage is incorrect, you can cause abortion.
Hyssop, in addition to the function we need, improves intestinal function.
Calendula – leads to uterine contractions.
Nettle is, in addition to its main function, a hemostatic agent.
Lavender perfectly tones the myometrium.
Madder causes hypertension and is a fairly strong laxative.
Tansy leads to uterine contractions.
Mistletoe is poisonous. But knowing the correct dosage, you can successfully solve the problem discussed in this article.
Senna is an excellent laxative that strengthens the muscles of the female organ.
Knotweed will do a great job with weak uterine muscles.

Beverages

What to drink, besides the infusions of medicinal herbs described above, to increase the contractility of the female organ?

Alcohol can cause hypertension. Of course, it is harmful to the fetus. However, if the pregnancy is progressing normally, a woman can afford a glass of red wine for blood formation.
You should not drink black tea in bags. However, leaf tea, which is brewed correctly and in small quantities, can help strengthen the myometrial muscles.
Carbonated drinks. All drinks that increase gas formation in the intestines create pressure on the uterus, thereby increasing its contractions.
Coffee causes muscle tone. Pregnant women should be careful with caffeine to avoid harm.

Product combination

Not only individual foods can strengthen myometrial muscles, but also entire dishes. For example, fish dishes.

Tuna with spices undergoes low heat treatment. In addition, it is combined with those spices that tone. Eating this combination of foods will help solve your problem.

Sushi. This dish combines fish, rice, nori seaweed, and all kinds of “hot spices.” This can strengthen muscles and increase blood circulation in the pelvic organs. Of course, you shouldn’t abuse them. It is very important to find out if the fish in them is raw? It is better to eat sushi in which the fish has been heat-treated.