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Hypertonicity of the muscular layer of the uterus (myometrium): what is it and why is it dangerous? Myometrial norms during pregnancy. Myometrial hypertonicity during pregnancy

Are you experiencing attacks of nausea in the morning, you want to sleep all the time, and your mood changes every minute? It's unlikely to be food poisoning or emotional distress. Apparently, you are pregnant, so congratulations! Like a bolt from the blue, the news of pregnancy can take even the most prepared woman by surprise, because from that moment on, responsibility falls on her shoulders not only for herself, but also for the unborn baby.

One of the insidious enemies of pregnancy is myometrial hypertonicity. Every second pregnant woman has more than once experienced fear and anxiety about increased uterine tone. Let's try to figure out why myometrial hypertonicity occurs and how to get rid of it.

The uterus is hypertonic. How, why and why?

Sometimes it happens that at the end of the day a pregnant woman experiences a feeling of heaviness in the lower abdomen. The soft and rounded tummy suddenly becomes “stone-like,” which undoubtedly makes the woman worry about the baby’s health. Why is this happening?

The uterus is a hollow muscular organ designed for gestation. After the meeting of the sperm and the egg, the fertilized egg is sent to the uterine cavity to attach to its wall and receive all the nutrition necessary for development. This is a physiologically determined process, therefore, during pregnancy, special hormones are produced that improve blood circulation in the uterus and make its inner layer (endometrium) looser in order to facilitate implantation of the fertilized egg.

The uterus has high contractile activity, due to which the fetus is expelled from its cavity during childbirth. Having been a refuge for the baby for 9 months, the uterus will “push” it out when the most awaited moment of pregnancy comes - its birth. Contractions of the uterus during childbirth are called contractions.

Braxton-Hicks contractions are training contractions of the uterus that appear after the 20th week of pregnancy, are irregular and are not accompanied by pain.

What if the uterus begins to show its ability to contract ahead of time? In this case, we are talking about hypertonicity of the myometrium, that is, lightning-fast excitability of the muscle cells (myocytes) of the uterus.

The causes of myometrial hypertonicity may be:

Low levels of pregnancy hormones (progesterone)

Progesterone is produced in order to maintain the current pregnancy and prevent the onset of a new one. With a lack of progesterone, the uterus comes into “combat readiness” and begins to contract. In addition, hypertonicity of the myometrium may appear due to an increase in androgens - male sex hormones.

Uterine malformations

During the period of bearing a child, deviations from the norm and complications often occur. One of them may be the main organ of the woman’s reproductive system - the uterus. This phenomenon is not always dangerous for the fetus. However, this condition cannot be neglected either. Therefore, it is worth learning in detail about the causes, signs, and treatment of uterine hypertonicity.

Causes of pathology

This phenomenon can be general, that is, widespread throughout the entire inner surface of the uterus, and local. Local, in turn, is divided into hypertonicity along the posterior and anterior walls.

The problem can be accurately diagnosed only with the help of ultrasound. After all, hypertonicity along the posterior wall may not be manifested by any sensations. If pain is a sign of the condition, then doctors talk about a complication of pregnancy.

The causes of pathological tension in the muscular layer of the uterus may be as follows:

Progesterone deficiency. It occurs when there is a lack of development of the genital organs, an excess of androgens (male sex hormones) and the female hormone prolactin in the body.
Pathological changes in the uterus. This is endometriosis.
Flu and other viral diseases. They lead to weakened immunity, which, in turn, negatively affects the uterus.
Polyhydramnios and. Both conditions lead to tension in the posterior wall of the organ.
Inflammatory processes in the ovaries and uterus. Any inflammation is accompanied by periodic tension and relaxation of the diseased organ.
Stress. This is a universal negative factor influencing childbearing.
Overstretching of the uterine muscles. It can occur with a large fetal weight or multiple pregnancies.
Heavy or prolonged physical work. Excessive physical activity always strains the muscles of internal organs, including the uterus.

It is worth knowing that expectant mothers after 30 years and under 18 are more susceptible to this pathological phenomenon.

Signs of hypertonicity of the posterior wall of the uterus

Pathology is not always accompanied by pronounced symptoms. Sometimes trouble can only be detected with the help of ultrasound.

Hypertonicity can be suspected based on the following signs:

Pain in the lower abdomen.
Discomfort and pain in the lumbar spine.
A feeling of tension in the uterus, similar to petrification, which is felt more often in the third trimester of pregnancy.

Diagnosis and elimination of the pathological condition

The most common method for diagnosing hypertension is ultrasound. The doctor can thus accurately assess the condition of the walls of the uterus and find out their thickness.

During the diagnostic procedure, the specialist also determines the condition of the cervix. This is necessary in order to detect signs of its shortening or opening of the pharynx.

After an ultrasound examination and diagnosis of pathology, the expectant mother may be recommended to undergo additional examinations. These include a blood test to determine progesterone and other hormones.

If symptoms of hypertonicity along the posterior wall of the uterus appear, then measures must be taken to prevent complications from occurring. This is the refusal of any physical activity, the adoption of a horizontal pose. The woman should lie down and relax as much as possible, give her body a position in which the uterus will be as comfortable as possible. By the way, this can even be a pose on all fours.

As for the treatment of hypertension with medications, the gynecologist may recommend taking hormonal drugs if a hormone deficiency is detected; prescribe sedatives (calming) drugs, medications containing magnesium. In combination with vitamin B6, it normalizes metabolism and eliminates excess muscle tension. With this pathology, bed rest is mandatory.

A woman should know that failure to comply with such medical recommendations is fraught with a decrease in blood flow and the occurrence of fetal hypoxia, miscarriage, dysfunction of the placenta, etc.

The likelihood of pathology is significantly reduced when the expectant mother gets enough sleep, avoids stressful conditions, and does not overexert herself physically.

The uterus is hypertonic. How, why and why?

Braxton-Hicks contractions are training contractions of the uterus that appear after the 20th week of pregnancy, are irregular and are not accompanied by pain.

The causes of myometrial hypertonicity may be:

Low levels of pregnancy hormones (progesterone)

Uterine malformations

With an infantile (underdeveloped) uterus, a bent uterus, or a bicornuate uterus, hypertonicity of the myometrium very often occurs due to changes in the normal shape and size of the uterine cavity.

Fetal malformations

In this case, natural selection kicks in and myometrial hypertonicity develops. In the presence of chromosomal mutations, which result in fetal malformations, the likelihood of spontaneous abortion is extremely high.

Tumors of the uterus (fibroids)
Inflammatory diseases in the uterine cavity
Previous surgical interventions on the uterus, including abortions
Exposure to harmful factors

Alcohol, tobacco, and harmful working conditions negatively affect the course of pregnancy and can provoke the occurrence of myometrial hypertonicity.

Stressful situations

It is extremely undesirable for pregnant women to be in a state of stress, as this can lead to increased uterine tone and the threat of abortion. Failures at work, lack of support and mutual understanding in the family, hard mental work - all this can cause uterine hypertonicity.

Great physical activity

The uterus is essentially a large muscle that can contract and relax depending on the factors affecting it. For example, during heavy exhausting training, the uterine myometrium, like other muscles of the body, can become toned and contract, despite the developing pregnancy.

Polyhydramnios
Multiple pregnancy
Sexual arousal
Ultrasound examination

IMPORTANT! When the fetus moves or the doctor tries to listen to its heartbeat, the uterus may also become toned. This phenomenon is usually not accompanied by pain and is completely normal.

How does myometrial hypertonicity manifest?

An increase in uterine tone can cause severe nagging pain in the lower abdomen, in particular when hypertonicity of the myometrium occurs along the anterior wall of the uterus. However, in some cases, myometrial hypertonicity remains unnoticeable to a woman, as it is not accompanied by unpleasant sensations. This asymptomatic course is typical for increased tone of the uterus along the posterior wall.

Alarming symptoms of myometrial hypertonicity:

severe cramping pain in the lower abdomen;
nagging pain in the lower back;
bloody discharge from the genital tract;
rapid fetal movement (after 20 weeks of gestation);
weak or absent fetal activity (after 20 weeks of gestation).

IMPORTANT! A sign of myometrial hypertonicity is nagging pain in the lower abdomen, which is a good reason for urgent medical attention.

First aid for myometrial hypertonicity.

1. If possible, eliminate the factor that contributes to myometrial hypertonicity (physical activity, stressful situation, etc.). It is best to sit or lie down if pain occurs in the lower abdomen to reduce the strain on the muscles.

2. Take an antispasmodic. Antispasmodics are a group of drugs that help relax smooth muscles. Tablets will help normalize the tone of the uterus and relieve pain. “No-shpa”, rectal suppositories “Papaverine” and “Viburkol”.

IMPORTANT! Uncontrolled use of medications is permissible only in extreme cases, when it is not possible to see a doctor, and the tone of the uterus increases. Taking antispasmodics without a doctor’s prescription can only be taken once, but not systematically!

3. Seek medical help. Some women believe that uterine hypertonicity is not a reason to see a doctor, because “you can take a pill at home and everything will go away.” It doesn’t happen once at a time, so some people forget about a single episode of increased uterine tone, while others are forced to remain under the close supervision of doctors for the entire nine months who are trying to maintain this pregnancy. In any case, only a doctor can find out why myometrial hypertonicity appeared and how to cure it.

Complications of myometrial hypertonicity.

Termination of pregnancy (spontaneous abortion)
Placental abruption (development of bleeding, fetal death)
Fetal malnutrition (utero-fetal-placental insufficiency)

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Treatment for hypertension. How to treat increased uterine tone during pregnancy?

Regardless of the causes, uterine hypertonicity must be treated, trying with all our might to maintain the pregnancy. Otherwise, contractions may begin, which may result in miscarriage or premature birth. Fortunately, increased uterine tone during pregnancy can be successfully treated in most cases; the main thing is to consult a doctor or seek medical help in time. What should a pregnant woman do with uterine hypertonicity, how should she behave? What treatment is carried out for hypertonicity, how and how to treat uterine hypertonicity during pregnancy? Let's figure it out. Content:

What to do with uterine hypertonicity, actions of a pregnant woman

Ideally, diagnosis for hypertension begins with a planned consultation of the pregnant woman with the doctor managing the pregnancy. When interviewing a woman, the obstetrician-gynecologist always finds out whether pain is bothering her in the lower abdomen, lower back or in the sacral area. To identify the symptoms of hypertension at an early stage and provide appropriate treatment, a woman should visit a doctor regularly.

But hypertonicity of the uterus during pregnancy can be determined by the woman herself. Increased tone often has vivid manifestations - this is nagging pain in the lower abdomen (in 60% of cases), lower back, and in the sacral area. In later stages, symptoms may manifest as cramping pain; women complain of a hard belly during pregnancy. Often the stomach becomes “stony” with hypertonicity. Actually, a hard, “stone” belly during pregnancy is the main symptom of increased tone.

A characteristic sign is that pain caused by increased myometrial tone goes away when taken orally or injected with antispasmodics (NO-SPA reduces or relieves pain).

What to do with uterine hypertonicity? Actually, the first and most important thing a woman should do if she suspects uterine hypertonicity during pregnancy is to go to an antenatal clinic or call an ambulance. In itself, uterine hypertonicity is a symptom of the threat of spontaneous miscarriage or the onset of premature birth. Therefore, it is urgent to begin treating uterine hypertonicity in order to maintain pregnancy and avoid complications during its course.

How to treat uterine hypertonicity?

If increased tone during pregnancy or Bragston-Higgs contractions occur unaccompanied by dilatation of the uterine cervix (cervical insufficiency), bleeding, pain in the lower abdomen, then treatment for hypertonicity can be limited to bed rest and the exclusion of stress factors of the pregnant woman.

Regardless of the causes of hypertension, taking sedatives, antispasmodics and bed rest are recommended for all pregnant women. If treatment is carried out in a hospital setting, medications are also used that reduce the activity of the uterus. However, after taking emergency medical measures, it is necessary to treat the cause of hypertension in a pregnant woman.

A pregnant woman is hospitalized whenever hypertonicity is accompanied by nagging or cramping pain in the lower abdomen of the pregnant woman or in the lower back. In rare cases, bed rest is provided at home; it is more advisable to carry out treatment and monitoring of pregnancy in an inpatient setting.

Increased uterine tone: drug treatment for hypertonicity

Treatment for hypertension sedatives It is necessary to carry out this procedure, since the fear of losing a child only aggravates the existing hypertension. Valerian tincture and motherwort tincture are often used. If motherwort and valerian turn out to be ineffective, prescribe NOZEPAM, SIBAZOL, TRIOXAZINE etc.

Treatment of increased tone in the first trimester of pregnancy, against the background of a deficiency of the hormone progesterone, is carried out with hormonal drugs - DUPHASTON, TROJESTAN.

It is justified to treat hypertension antispasmodics, to eliminate muscle contractions and pain: NO-SHPA orally or intramuscularly, PAPAVERINE candles etc. These medications can be used independently if symptoms of increased tone appear. It is recommended to drink 2 tablets of NO-SHPA or use a suppository with PAPAVERINE. But after the spasmodic attack is relieved, you should definitely consult a doctor.

Treatment of uterine hypertonicity is also carried out with drugs that reduce uterine activity:

1. 25% solution of magnesium sulfate, which is administered intravenously or intramuscularly;

2. drugs PARTUSISTEN, BRIKANIL, GINIPRAL. They are used until 16 weeks of pregnancy. When they are administered, side effects may occur: drop in blood pressure, palpitations, tremor, agitation, headache, nausea, vomiting, etc. Treatment with drugs that reduce the activity of the uterus is carried out under mandatory monitoring of blood pressure, heart rate and blood glucose.

Is it necessary to treat uterine hypertonicity?

Hypertonicity of the uterus during pregnancy is often accompanied by hypoxia of the developing fetus - the child does not receive enough oxygen, this occurs due to disruption of the uterine and placental blood flow, since the increased tone of the uterus narrows the lumens of the uterine vessels. Hypoxia can cause deviations in the development of the child, malnutrition - fetal growth retardation due to oxygen starvation, as well as a lack of nutrients that reach the fetus with the blood through the placenta. In addition, if uterine hypertonicity is not treated, contractions may begin, resulting in miscarriage or premature birth. Therefore, increased tone must be treated!

When is special monitoring and treatment necessary for hypertension?

If you are worried about pain in the lower abdomen, in the sacral area, or in the lower back, do not ignore them - contact a specialist in a timely manner. Only a doctor, after a conversation with you, examination, palpation of the abdomen, and other necessary examinations, will be able to determine the true cause of the pain and, if necessary, prescribe treatment that will help avoid the threat of miscarriage or premature birth.

If you conceived a baby after infertility treatment, if you had hormonal disorders, endometriosis, fibroids, abortions, inflammatory diseases of the reproductive organs, spontaneous miscarriages or premature birth before pregnancy, then the likelihood of increased uterine tone and the threat of termination of pregnancy, accordingly, is quite high. Therefore, in order to prevent possible complications, from the earliest stages you need to register, be observed and follow all the obstetrician’s instructions.

The lifestyle of a pregnant woman also plays an important role: take care of yourself, go to bed on time, avoid stress, business trips, transfer to light work on time. And be healthy – you and your baby!

Causes of uterine hypertonicity during pregnancy, symptoms, how to relieve hypertonicity

Almost every woman who is about to become a mother, at least once, has encountered such a condition as increased uterine tone. Hypertonicity of the uterus during pregnancy is not a diagnosis, it is only a symptom that indicates a threat of miscarriage. But this symptom is considered quite serious and requires urgent action.

What does the uterus consist of?

The uterus is a muscular organ and therefore is capable of contracting, which is necessary for labor to occur. The outside of the uterus is covered with a serous membrane called perimetry. The middle layer is the most pronounced and consists of smooth muscle tissue.

During gestation, the muscle layer (myometrium) thickens and grows due to an increase in the number and volume of muscle fibers. By the end of pregnancy, the uterus “occupies” almost the entire abdominal cavity. Preparing the fetal sac for contractions during childbirth involves the accumulation of calcium, glycogen and enzymes in the myometrium, which stimulate the contraction of muscle fibers.

In addition, by the end of pregnancy, the production of a protein, actyosin, increases in the myometrium (activates contractions). The inner layer of the fetal sac is the mucous membrane or endometrium, in which the fertilized egg is implanted.

Types of uterine tone

The tone of the uterus characterizes the state of the myometrium, its tension:

hypotonicity of the uterus - is a pathology and indicates excessive relaxation of the muscles, occurs in the first 2 hours after birth and is manifested by hypotonic uterine bleeding (the uterine vessels have not contracted due to a relaxed muscle layer);
normotonus of the uterus - the physiological state of the uterus, regardless of whether there is pregnancy or not, the myometrium is at rest;
hypertonicity or increased tone of the uterus - indicates tension/contraction of the uterine muscles, can be constant (which indicates a threat of interruption) or periodic (contractions during childbirth).

In addition, a distinction is made between local hypertonicity (tension of the myometrium in a certain place) and total hypertonicity - the entire uterus “turns to stone.”

Supports normal uterine tone

Signals from nerve receptors located in the uterus enter the woman’s central and autonomic nervous system, as a result of which a pregnancy dominant is formed in the cerebral cortex. The function of this dominant is to suppress nervous processes not related to the maintenance and development of pregnancy.

But in case of nervous overstrain, other foci of excitation are formed in the brain, which weaken the effect of the dominant pregnancy, which causes increased tone of the uterus. During the entire period of gestation, the excitability of both the spinal cord and uterine receptors is minimal, which ensures the normal course of pregnancy. In turn, by the time of birth, a generic dominant is formed, which is responsible for the contractile activity of the uterus - contractions.

In addition, progesterone is responsible for maintaining normal uterine tone, which is first (up to 10 weeks) produced by the corpus luteum, and later by the placenta. Estriol, necessary for the regulation of uteroplacental blood flow, is also produced in the placenta from a hormone produced by the adrenal glands of the fetus and woman. In addition to relaxing the smooth muscles of the uterus, intestines and ureters, progesterone inhibits the excitability of the central nervous system, as if protecting the dominant of pregnancy.

Calcium ions are necessary for the contractile activity of the uterus. Progesterone and estriol maintain proper permeability of myometrial cells and prevent excess calcium from penetrating into the intracellular space.

What causes uterine hypertonicity?

The reasons that can lead to an increase in uterine tone are numerous and varied. As a rule, not one, but several factors are involved in the development of uterine hypertonicity. The main culprits of uterine hypertonicity include:

Infections

First of all, we mean sexually transmitted infections (ureaplasmosis, chlamydia, genital herpes, cytomegalovirus infection and others). They cause inflammation of the genital organs, in particular endometritis, as a result of which biologically active substances or cytokines begin to be synthesized, which increase the contractile activity of the myometrium. Intrauterine infection of the fetus is also possible.

Hormonal disorders

A lack of progesterone will certainly negatively affect the tone of the uterus and cause its increase, especially in the first 14 weeks of gestation, when the fertilized egg is fixed and the placenta is formed.
Deficiency of the main pregnancy hormone leads to spontaneous miscarriage or detachment of the chorion (future placenta) and non-developing pregnancy.
Progesterone deficiency is also observed with hyperandrogenism (excess of male sex hormones), with hyperprolactinemia, as well as with sexual infantilism. Genital infantilism is characterized by underdevelopment of the genital organs, in particular the uterus, which, in response to stretching, begins to shrink as the gestation period increases, which ends in miscarriage.
In addition, increased uterine tone can be caused by thyroid pathology (hyperthyroidism and hypothyroidism).

Structural changes in the uterine walls

As a rule, an increase in uterine tone is caused by tumors and tumor-like diseases of the uterus (polyps, fibroids, adenomyotic nodes), which not only interfere with normal implantation and growth of the embryo, but also prevent the stretching of the fetal sac as the gestational age increases, which causes hypertonicity.

In addition, these diseases are caused by hormonal imbalances, which cannot but affect progesterone levels. Various uterine curettages and abortions cause an inflammatory reaction in the endometrium, which leads to the formation of intrauterine adhesions, and makes the uterine walls unable to stretch.

Chronic diseases

Often, an increase in the tone of the uterus while expecting a child is caused by chronic diseases of the mother (arterial hypertension, diabetes, excess weight, and others).

Uterine malformations

Various anomalies in the structure of the uterus cause inferiority of the uterine walls, which leads to an increase in uterine tone. This pathology includes a double uterus or a uterus with an additional horn, an intrauterine septum, as well as an existing scar on the uterus after surgery (cesarean section, myomectomy).

Socio-economic factors

This group of factors is the largest and most numerous. These include: the woman’s age (less than 18 and more than 35 years), low income, heavy physical labor, constant stress, occupational hazards, marital status (divorced or unmarried), poor nutrition, neglect of the regime, chronic lack of sleep, bad habits, etc.

Complications of real pregnancy

Incorrect position and presentation of the fetus often causes hypertonicity of the uterus due to its overstretching (for example, transverse position). Polyhydramnios and multiple pregnancies also contribute to overstretching of the uterus. Violation of fetoplacental blood flow during gestosis or placenta previa also causes uterine hypertonicity.

How to identify uterine hypertonicity

Increased uterine tone, as already mentioned, is not an independent disease, but just one of the signs of miscarriage. Symptoms that accompany uterine hypertonicity can appear at any stage of gestation:

As the tone of the uterus increases in the first 14 weeks, a woman notices the appearance of pain in the lower abdomen, or in the lumbar and sacral areas, especially after some physical exertion.
Pain may radiate to the perineum. The nature of pain varies. This may be a tugging or aching pain, similar to discomfort during menstruation.
A woman should be alerted to the appearance of bloody, brownish, pinkish or blood-streaked discharge, which indicates an incipient miscarriage.

In subsequent trimesters, the pregnant woman independently determines the tension of the uterus, which can occur locally or affect the entire uterus. In such a case, a woman compares uterine hypertonicity to “stoniness.”

During a gynecological examination, a doctor in the first trimester can easily diagnose uterine hypertonicity, as he determines its contraction and tension during palpation. At a later date, increased tone is determined by palpation of parts of the fetus.
Ultrasound – Ultrasound is also of no small importance in diagnosing hypertonicity. In this case, the ultrasound specialist sees local or total thickening of the myometrium.

It should be noted that local hypertonicity of the uterus may appear in response to any actions being performed at the moment. For example, fetal movement, a full bladder, etc. That is, each case of recorded increased tone is individual, and the decision on the need for treatment is made after taking into account all causative factors, assessing the degree of risk of miscarriage, existing pregnancy complications and extragenital diseases.

Uterine hypertonicity: what to do?

Treatment of uterine hypertonicity is prescribed only when, in addition to uterine tension during palpation or ultrasound, there are additional signs indicating a threatening miscarriage (pain syndrome: pain in the abdomen and/or lower back, discharge mixed with blood, the formation of isthmic-cervical insufficiency). If the specified symptoms are present, the pregnant woman should consult a doctor as soon as possible, who will decide on hospitalization. It is possible to prescribe outpatient treatment for moderate hypertonicity, when tension or “petrification” of the uterus is felt only in some situations, periodically.

To successfully reduce hypertension during pregnancy, the cause that caused the increase in uterine tone is determined, if possible. Therapy for increased uterine tone is aimed at providing psycho-emotional and physical peace, relaxing the uterus and normalizing fetoplacental blood circulation:

Sedatives - in a hospital, a pregnant woman is prescribed psycho-emotional rest, usually bed rest and sedatives (motherwort, valerian, peony in tablets or tinctures). Prescribing sedatives is mandatory, as worries about the child aggravate the situation.
Tranquilizers - in case of ineffectiveness of herbal sedatives, tranquilizers (diazepam, phenazepam, chalcionine) are prescribed.
Progesterone - in case of progesterone deficiency, drugs with synthetic progesterone (duphaston or utrozhestan rectally or orally) are prescribed until the 14th - 16th stage of pregnancy.
Antispasmodics - antispasmodics are mandatory, they stop contractions and improve blood supply in the utero-placental-fetal system (no-spa, papaverine, droverine). They are prescribed either intramuscularly or in tablets or rectal suppositories.
Tocolytics - after 16 weeks, it is possible to prescribe tocolytics - special drugs that relieve uterine spasms (ginipral, partusisten) intravenously by drip, and then in tablet form.
Calcium channel inhibitors, they prevent calcium from entering muscle cells: Nifedipine, Corinfar.
Magne B6 or magnesia - also used intravenous infusions or intramuscular injections of magnesium sulfate - relieves uterine tone, causes a sedative effect, lowers blood pressure. An alternative to magnesium sulfate solution are Magne-B6 tablets, which can also be taken in the first trimester (vitamin B6 serves as a conductor for magnesium into the cell).
Improving uteroplacental blood flow - therapy is carried out in parallel, the task of which is to improve blood flow (chimes, aminophylline, trental).
Drugs that regulate metabolism (Actovegin, Riboxin)
Hepatoprotectors (chofitol, Essentiale), see list of hepatoprotectors.

Simple physical exercises will help relieve uterine hypertonicity at home.

First, you should relax the facial and cervical muscles as much as possible, which leads to a decrease in the tension of the uterus.
Secondly, the “cat” exercise is effective. You need to get on all fours, carefully raise your head, arching your lower back. You should breathe deeply and calmly. Maintain this position for 5 seconds.

Why is hypertension dangerous?

The consequences of uterine hypertonicity can be very disastrous. If you ignore the “first bell” - periodic tension of the uterus, then the pregnancy will end either in spontaneous abortion or miscarriage in the early stages, or in premature birth in the second or third trimester.

In addition, a permanent increase in uterine tone leads to the development of fetoplacental insufficiency, which impairs the nutrition of the fetus and its provision of oxygen. This provokes the development of intrauterine hypoxia, and subsequently delayed fetal development.

The prognosis for uterine hypertonicity depends on existing complications of pregnancy and extragenital diseases, the condition of the cervix, gestational age and condition of the child, and, of course, on timely medical care. An equally important role is played by the woman’s attitude towards a favorable outcome.

Obstetrician-gynecologist Anna Sozinova

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Causes of increased uterine tone during pregnancy

The contractile activity of the myometrium increases as a result of neurohumoral effects and pathomorphological changes in the muscular layer of the uterus. Sometimes the increase in tone is physiological in nature (contractions of the uterine muscles during sexual intercourse, training contractions in the second half of the gestational age). However, in most cases, increased tonic activity indicates the development of pathological processes that pose a threat to the normal course of gestation. The tone of the uterus increases under the influence of such reasons as:

Hormonal imbalance. Tonic contractions of myometrial smooth muscle cells are enhanced under conditions of progesterone deficiency. Hypopprogesteronemia occurs with increased androgen levels in pregnant women with ovarian or adrenal disorders of steroidogenesis, increased prolactin levels with hypothyroidism, polycystic ovary syndrome, liver cirrhosis, pituitary tumors, taking antiemetic and antihistamines.
Overstretching of the uterine wall. Muscle fibers reflexively contract when the walls are significantly stretched by the growing child and its membranes. An increase in uterine tone is more often observed in patients suffering from polyhydramnios, carrying multiple pregnancies, or large fetuses. With the normal size of a single fetus, the myometrium is overstretched in women with genital infantilism, developmental anomalies (saddle uterus, etc.).
Pathological changes in the uterine wall. Inflammatory and neoplastic processes in the mucous, muscular, and serous membranes of the uterus reduce its ability to stretch and create foci of pathological impulses that cause local or generalized muscle contractions. The causes of increased tone can be interstitial and submucosal fibroids, endometriosis, cervicitis, endometritis, and adhesions in the pelvis.
Nervous regulation disorders. Normally, until the 38-39th week of pregnancy, the excitability of intrauterine receptors, the spinal cord and the areas of the cerebral cortex responsible for uterine contractions is minimal. During emotional stress, significant physical exertion, acute infections with hyperthermia (flu, ARVI, sore throat), an excitation area can form in the central nervous system, the activity of which negatively affects the tone of the uterus.

Strengthening and increased frequency of myometrial contractions, which can provoke termination of pregnancy, is also observed in cases of immunity disorders (Rh-conflict, isoimmune incompatibility), when the uterus tries to get rid of the child, perceived as a foreign organism. A similar situation arises in case of fetal developmental anomalies incompatible with life or its antenatal death.

Pathogenesis

The key link that leads to increased uterine tone during pregnancy is increased contractility of muscle fibers under the influence of external or internal stimuli. The physiological tone of the myometrium is provided by the autonomic nervous system. An increase in contractility is prevented by progesterone, which relaxes smooth muscle fibers, and the gestational dominant - a focus of excitation that is formed in the cerebral cortex under the influence of afferent impulses from the intrareceptors of the uterus and inhibits nervous processes that can disrupt gestation. Taking this into account, specialists in the field of obstetrics and gynecology identify two mechanisms for increasing uterine tone - humoral and neurogenic.

In the first case, increased tonic contraction develops in response to a decrease in the level of progesterone, in the second - due to the emergence of a pathological focus of excitation in the central nervous system or a weakening of the gestational dominant due to changes in the flow of nerve impulses from the pregnant uterus in the event of its overextension, the presence of inflammatory processes, and neoplasia. Sometimes humoral and neurogenic components of pathogenesis are combined. Increased physiological contraction of the myometrium is accompanied by an increased release of catecholamines and other bioactive compounds into the blood during physical stress, emotional experiences, intimacy, vaginal examination, and fetal movements.

Classification

The main criteria for systematizing increased uterine tone during pregnancy are the nature, intensity and duration of pathological sensations, and the frequency of their occurrence. This approach allows us to develop optimal tactics for accompanying a pregnant woman and prevent gestation interruption in time. There are 3 degrees of severity of high myometrial tone:

Idegree. A pregnant woman is worried about slight or moderate short-term pain in the lower abdomen. Discomfort and hardening of the uterus disappear with rest without medication.
IIdegree. More pronounced pain is noted not only in the lower abdomen, but also in the lumbosacral spine. The uterus becomes significantly denser. To eliminate pathological symptoms, antispasmodics are required.
IIIdegree. Intense painful sensations in the abdomen, sacrum and lower back are observed even with minor physical exertion and emotional experiences. Palpation of the uterus is very hard. The pregnant woman must be hospitalized.

Symptoms of increased uterine tone during pregnancy

A sign of increased contraction of the myometrium is the appearance of discomfort in the pelvic area. A woman complains of nagging or bursting pain of varying intensity - from mild to severe, localized above the pubis, lower abdomen, sacrum, lower back, and sometimes in the perineum. At the same time, there is a feeling of tension and “hardening” of the abdomen, during which in the 2nd-3rd trimesters of pregnancy a compacted uterus is palpated through the abdominal wall. In some patients, urination becomes more frequent, the urge to defecate occurs, and fetal movements become more intense. In mild cases, signs of increased tone disappear with deep, calm breathing in a lying position. As the condition progresses, tonic contraction of the uterine muscles may develop into contractions.

Complications

An increasing increase in the tone of the smooth muscle fibers of the uterus can provoke early or late miscarriage in the first half of pregnancy and premature birth in the second. Contraction of the uterine wall is often accompanied by impaired blood flow in the vessels of the uterus and placenta, and a deterioration in the blood supply to the child. With frequent increases in grade II-III tone, fetoplacental insufficiency, intrauterine fetal hypoxia, and delayed fetal development may occur. The disorder increases the risk of premature rupture of amniotic fluid, isthmic-cervical insufficiency, and abruption of a normally located placenta. During childbirth, patients who noted increased uterine tone more often experience violent labor and discoordinated contractions of the myometrium.

Diagnostics

The main task of a diagnostic search for increased uterine tone is to establish the causes of the disorder and assess its impact on the course of gestation. In some cases, the condition does not manifest clinically and becomes an incidental finding during ultrasound screening of pregnancy. Recommended examination methods for suspected increased tone of the uterine muscles are:

Palpation of the abdomen. With normal tone during the 2-3 trimesters of pregnancy, the abdomen is soft; at longer gestation periods, the position and presentation of the baby can be easily determined through the wall of the uterus. Increased tone is indicated by compaction and tension of the uterine wall, sometimes reaching the level of stony hardness. The fetus cannot be palpated.
Ultrasound of the uterus. The wall of the uterus is locally or completely thickened due to contraction of muscle fibers. With a small area of compaction, clinical symptoms may be absent. The method allows timely identification of signs of placental abruption. In case of possible fetoplacental insufficiency, ultrasound is supplemented with Dopplerography of the uteroplacental blood flow.
Tonuometry. The degree of myometrial contraction is assessed in conventional units, measured by special tonometers. The sensor of the device is installed above the projection of the uterus, after which the depth of immersion of its pin into the uterine wall is recorded on the scale of the device. Spring and electric tonometers are used for research.
Analysis of sex hormone levels. Since increased uterine contractility is often associated with dishormonal conditions, the causes of the pathology can be identified using laboratory diagnostic methods. In pregnant women with high uterine tone, a decreased level of progesterone and an increased concentration of testosterone and prolactin may be detected.

Cervicometry is recommended as additional examination methods, which makes it possible to detect shortening of the cervix, CTG, fetometry and phonocardiography of the fetus, aimed at timely identifying a threat to the child. Differential diagnosis is carried out between various diseases accompanied by increased myometrial tone, as well as natural local thickening of the uterine wall at the site of fetal implantation. According to indications, the pregnant woman is consulted by an endocrinologist, an infectious disease specialist, a neurologist, and a psychotherapist.

Treatment of increased uterine tone during pregnancy

The patient's management tactics are determined by the severity of the pathology. With a slight increase in tone, it is recommended to reduce physical and psychological stress, normalize sleep and rest patterns, and avoid spicy foods and spices. For pregnant women with moderate or severe tonic contraction of the myometrium, in addition to limiting activity, tocolytic therapy aimed at relaxing the uterus is indicated. In case of degree II disorder, conservative treatment is carried out on an outpatient basis using tablet forms of antispasmodics, in case of degree III - inpatient treatment with strict adherence to bed rest and predominantly parenteral administration of drugs. To reduce the tone of the uterus, the following is prescribed:

Sedatives. Sedatives help reduce anxiety, emotional tension, fear of losing a child, weaken alternative sources of excitation, and increase the dominance of pregnancy in the central nervous system. With moderately increased tone, sedative herbal remedies are used; in severe conditions, tranquilizers and even antipsychotics can be prescribed.
Antispasmodics. Relaxation of smooth muscles is achieved through selective inhibition of type IV phosphodiesterase activity and a decrease in intracellular calcium levels. Antispasmodics effectively eliminate spasms of smooth muscle fibers of both nerve and muscle origin and increase blood flow in tissues.
Tocolytics. For tocolytic purposes, β-2-sympathomimetics are used that activate adenylate cyclase. As a result of increased synthesis of cAMP and stimulation of the calcium pump, the calcium concentration in the myofibrils decreases, and the contractile activity of the uterus is inhibited. To relax the myometrium, magnesium sulfate is traditionally used (magnesium ions are competitors of calcium).

If a change in uterine tone is caused by progesterone deficiency, the patient is shown drugs with a selective progestogenic effect. Pregnancy in patients with increased contractile activity of the myometrium is recommended to be completed with natural childbirth at a physiological time. Caesarean section is performed only if there are obstetric indications (placental abruption, anatomically or clinically narrow pelvis, oblique or transverse position of the fetus, threat of uterine rupture, umbilical cord entanglement, etc.).

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General information

The uterus is a muscular organ. Therefore, it has the ability to contract and stretch as the fetus grows. The multilayer walls of the uterus give this organ strength and protect the fetus during intrauterine development.

Myometrium is the middle thickened muscular layer of the uterine wall, which has a complex structure. The main composition of the myometrium is formed by smooth fiber muscle tissue. It is supplemented by elastic fibers and connective tissue fibers.

Myometrial hypertonicity is not a disease. A woman's uterus periodically tenses and contracts throughout the menstrual cycle. In the normal state, such changes in tone in most cases occur unnoticed. After all, this is a natural process. However, during pregnancy, many ordinary processes are perceived by the female body as pathologies.

Myometrial tone is the degree of its tension. Based on this, they differ:

weakened, or hypotonic;
normal, or normotonus;
increased, or hypertonicity.

During pregnancy, the uterus is in a relaxed state under the influence of hormones. This is necessary for the normal development of the fetus and providing it with the necessary space. Therefore, excessive tension in the muscular layer of the uterus, the myometrium, is unacceptable during the period of intrauterine maturation of the fetus.

During the prenatal period, the uterus gradually tightens. The onset of labor is characterized by intense contractions of the uterine muscles. In this way, the fetus is pushed out and ensures its smooth passage through the birth canal.

Localization of pathology

Hypertonicity also varies in prevalence. Both local and widespread (total) hypertonicity of the myometrium is observed. In any case, increased tone is dangerous and requires specialist supervision and special treatment.

Total hypertonicity spreads throughout the uterus. The symptoms of this condition are similar to those of local hypertonicity. An additional sign is a pathologically hard, spherical abdomen.

Main reasons for the phenomenon

Very often, hypertonicity of the myometrium is observed during pregnancy. In late pregnancy, moderate hypertonicity occurs under the influence of fetal movements. Usually this process is localized on the back wall of the uterus.

In this case, this condition is a normal reaction of the uterus to changes associated with fetal development. The need for medical procedures in such cases is determined by the doctor. This is done after a general examination of the expectant mother, an anamnestic conversation with her, as well as studying the condition of the uterus using ultrasound.

Various neoplasms on the surface of the uterine tissue often cause overstrain of the myometrial layer. After all, the presence of fibroids or polyps does not allow the embryo to develop normally. The uterine walls lose their elasticity due to these neoplasms. The consequence of the situation is hypertension.

In addition to pregnancy, there are other reasons that cause an increase in the tone of the myometrial layer. These could be:

infectious infection;
structural neoplasms - adenomyotic nodes, polyps, fibroids, etc.;
congenital malformations of the uterus;
sexually transmitted diseases;
lack of sleep and rest;
nervous overload, stressful situations;
metabolic disorders;
poor nutrition;
excessive physical activity;
constantly wearing uncomfortable shoes with very high heels;
bad habits;
dysfunction of the body's physiological defenses;
deterioration of health.

Therefore, only periodic visits to the gynecologist and careful attention to your health, especially in the early stages of pregnancy, when the risk of miscarriage is very high, will help you track the moderate or increased tone of the myometrial layer of the uterus in time.

Characteristic symptoms

The main symptoms of a pathological increase in myometrial tone are vaginal discharge mixed with blood and a dull aching pain in the pelvic area. Blood is usually released in small quantities. Mainly in the form of veins or small drops.

Hypertonicity of the anterior wall of the uterus is manifested by symptoms such as:

aching pain in the lower abdomen;
pain in the perineal area;
frequent discharge of natural needs.

Hypertonicity of the myometrium of the posterior wall of the uterus is most often asymptomatic. A similar condition is determined during an examination in a gynecological chair and through ultrasound.

In this case, a woman may feel:

pain in the pelvic area;
distension in the lower abdomen;
lumbar pain.

Pain in the pelvic area can be permanent or temporary. In general, pain can be eliminated with the help of medications. Taking them without a doctor's permission during pregnancy is strictly prohibited.

In the early stages of pregnancy, pain caused by increased tension in the muscle tissue of the uterus is localized in the area of the anterior wall. As the fetus grows and the uterus enlarges, the intensity of the pain gradually decreases until it disappears completely.

During the prenatal period, pain caused by hypertonicity can be felt in the fundus of the uterus. The most dangerous signal at this stage is vaginal discharge mixed with blood. They usually range from pale pink to light brown. This situation can cause fetal loss.

With an increase in myometrial tone during this period, the expectant mother's abdomen becomes pathologically hard. There is a feeling of hardening of the uterus. This causes discomfort or pain of varying intensity during normal movements.

Changes in tone under the influence of hormones

During the period of gestation, the hormonal background of the female body changes. Normal hormone balance involves increased levels of progesterone and decreased levels of estrogen. This creates the necessary conditions for the proper development of the fetus. Even a slight imbalance of these hormones can provoke uterine bleeding and spontaneous abortion.

Estrogen is required to ensure the elasticity of the uterine walls. It regulates the tone of this organ and is responsible for the activity of her uterine muscles. The hormone is a normalizer of intrauterine development and the reproductive process.

Treatment used

During the period of gestation, treatment of myometrial hypertonicity is undertaken only in particularly difficult cases. Basically, if there is a risk of pathological termination of pregnancy or a sharp deterioration in the general condition of the expectant mother and her baby.

The main signs that require immediate contact with a specialist are vaginal discharge of an unusual color, possibly bloody, or severe pain in the abdomen, lower back and other parts of the body. In such a situation, treatment is carried out only in a hospital setting.

Outpatient treatment is undertaken if the hypertonicity is moderate, with periodic myometrial tension.

The key to successful treatment in this case is the correct identification of the reasons causing the increase in tone, and the precise determination of the localization of tension - on the cervix, wall, fundus of the uterus, or everywhere.

The main means used to restore normal myometrial tone:

Antispasmodics - Papaverine, Droverine, No-shpa.
Sedatives - tincture of valerian or motherwort, Trioxazin, Sibazol, Nozepam.
Tranquilizers - Halcyonine, Diazepam.
Magnesium Sulfate - 25% solution for intravenous or intramuscular injection.
Tocolytics: Ipradol, Ginipral.
Means that improve blood supply to the uterus: Curantil, Trental.
Drugs that reduce the contractile dynamics of the uterus: Bricanil, Patrusisten.
Means for restoring hormonal balance - Utrozhestan, Duphaston.
Painkillers.
Hepatoprotectors - Essentiale, Hofitol.
Drugs to improve metabolism - Riboxin, Actovegin.

All medications are prescribed by a doctor. Taking them without consulting a specialist or spontaneously interrupting the treatment process is strictly prohibited.

Possible complications for the fetus

Hypertonicity of the myometrium in early pregnancy often leads to spontaneous rejection of the fetus or its intrauterine death. In the 2nd trimester of pregnancy, myometrial hypertonicity provokes the development of fetoplacental insufficiency. This, in turn, causes oxygen starvation of the fetus. As a result, the normal intrauterine development of the unborn baby and the correct formation of individual systems and organs of the small organism are disrupted. As a result, the risk of having an unhealthy child with various congenital pathologies and diseases increases.

In late pregnancy, hypertonicity of the myometrium causes premature onset of labor and the birth of a premature baby. This happens because under the influence of tense myometrium, ICI develops, i.e. isthmic-cervical insufficiency.

The cervix and isthmus of the uterus experience significant overload. After all, the child’s weight increases noticeably during this period. Therefore, the uterus can open prematurely, pushing the fetus into the birth canal. Premature labor begins.

Placental abruption is another dangerous consequence of myometrial hypertonicity, especially if the placenta is located too low. As a result, the fetus does not receive vital substances and may ultimately die.

Mode correction

At home, the expectant mother with myometrial hypertonicity should observe bed rest. Physical activity, nervous experiences, and sexual relations should be limited as much as possible.

If you experience tense sensations in the uterine area that occur in late pregnancy, special relaxing exercises are recommended. The doctor who monitors the woman during pregnancy will help you choose specific exercises. Using the recommendations of a specialist, the expectant mother will be able to independently reduce the tension of the uterine muscles, bringing the uterus to a normal state.

Preventive measures

The following measures will help to avoid the appearance of myometrial hypertonicity during pregnancy:

lack of excessive physical activity;
peace of mind;
positive emotions;
special gymnastics for expectant mothers;
use of a bandage in late pregnancy.

The expectant mother should pay special attention to her own health. After all, not only the health, but also the life of the unborn baby directly depends on this. Therefore, adherence to the regime, dosed exercise, restful sleep and walks in the fresh air are a necessary condition for the absence of myometrial hypertonicity, a calm pregnancy and a normal birth process.

A pregnant woman's food should be rich in magnesium, vitamins, and nutrients. Products that cause flatulence should be limited. Drinking enough fluids will help avoid constipation and other gastrointestinal disorders.

The period of gestation and preparation for childbirth is a very important and difficult moment for a woman’s body. Therefore, the expectant mother should be under the constant supervision of a specialist. This will allow timely detection and elimination of many dangerous situations, including increased tone of the main reproductive organ - the uterus.

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Causes of development of myometrial hypertonicity and treatment methods

The causes of hypertension during pregnancy may lie in structural changes in the uterine wall

Pregnancy is the most long-awaited and exciting event for a woman, but its course is often overshadowed by various diseases. Often, when visiting a gynecologist, you can hear such an unpleasant diagnosis as “myometrial hypertonicity,” which causes a lot of worry and anxiety in the expectant mother. Most often, the specialist decides to place the pregnant woman in a medical institution to undergo appropriate treatment or assigns strict adherence to bed rest at home.

What is actually dangerous about myometrial hypertonicity during pregnancy that such drastic measures are required? In fact, increased myometrial tone during pregnancy is considered a dangerous pathological condition that requires increased attention. This is explained by the fact that the supply of sufficient nutrients and oxygen to the developing fetus, as well as the favorable end of pregnancy, subsequently depends on this.

Features of the pathology

From a biology course we know that the uterine cavity is lined with three layers:

endometrium;
myometrium;
parimetry.

The endometrium is the layer that covers the surface of the uterus from the inside, and the parimetry is a serous film lining the outside of the reproductive organ. However, the most important and complex layer is the myometrium, which is characterized by muscle contraction, which plays a huge role in the successful completion of labor. If during pregnancy such increased muscle tension is diagnosed before the due date, then experts talk about a pathology such as hypertonicity. This pathological condition of the female body causes increased pressure in the reproductive organ and the result of this phenomenon can be the premature onset of labor.

However, diagnosing such a pathology does not necessarily lead to the onset of premature labor or miscarriage, since there are cases of favorable pregnancy outcomes. Most often, increased myometrial tone along the anterior or posterior wall ends with a disruption in the supply of oxygen and nutrients to the fetus, which can negatively affect its further development.

Reasons for the development of pathology

Today, increased myometrial tone can develop for various reasons.

Reasons for the increase

Most often, the development of hypertension is observed as a result of changes in a woman’s hormonal levels, that is, a decrease in progesterone levels.

This disorder is especially dangerous at the very beginning of pregnancy, when the final formation of the placenta has not yet occurred. In addition, the following causes of pathology can be identified:

Myometrial tone can increase when a woman’s production of the male sex hormone, androgen, increases;
often experts diagnose hypertonicity with underdevelopment of the reproductive organ and its small size;
increased uterine tone can be diagnosed when the expectant mother’s history includes various inflammatory diseases of the uterus or malignant neoplasms.
tone can increase under the influence of various stressful situations, constant anxiety, smoking and drinking alcoholic beverages.
uterine fibroids cause hormonal imbalance in the female body and tone is often diagnosed precisely with this pathology;

Often doctors are faced with such a pathological condition of the female body as uterine hypotonicity. During pregnancy, such a pathology does not pose any significant threat to the woman and the baby, however, if this condition develops during labor, various kinds of complications may arise.

Risk factors

In addition to the reasons that lead to increased myometrial tone, risk factors can be identified. Most often, experts diagnose pregnancy failure in the presence of certain medical factors:

identifying various pathologies during pregnancy;
genetic predisposition;
diseases of various types in the genital and internal organs;
progression of inflammatory processes in the reproductive system;
thyroid diseases;
harmful production, that is, an increase in the tone of the uterus can occur with constant interaction of a woman with harmful substances, with heavy physical labor and daily work;
The age of the pregnant woman plays an important role, since doctors note that after 35 years, women become susceptible to uterine hypertonicity;
irrational organization of her daily routine, that is, the woman does not get enough rest.

Symptoms of pathology

In modern medicine, uterine hypertonicity is divided into:

local increase in myometrial tone, that is, muscle tension in a separate area of the myometrium occurs;
a general increase in uterine tone is a tension of the entire myometrium.

The following zones of occurrence of hypertonicity in the cavity of the reproductive organ are distinguished:

An increase in myometrial tone along the posterior wall causes the following symptoms:

severe nagging pain in the lower abdomen;
pain in the lower back;
bloody vaginal discharge

An increase in tone along the anterior wall causes severe pain in the lower abdomen, which is accompanied by severe tension. Increased tone of the uterus along the anterior wall at the end of pregnancy can lead to slower fetal movements. This pathological condition often ends in spontaneous miscarriage.

The back wall is the location of large blood vessels through which nutrients are supplied to the baby. If the myometrium is tense, they are compressed, and the result is fetal hypoxia. Often, increased tone of the uterus along the anterior wall can occur with any external irritation that affects the abdominal cavity.

Features of pathology treatment

Many believe that the spasmodic state of the uterus is the main reason for the development of premature labor and miscarriage, and various abnormalities can be observed during pregnancy.

However, uterine hypertonicity does not always require treatment and is most often resorted to when there are symptoms such as:

shortened neck and a threat to its opening;
the appearance of spotting discharge;
painful sensations in the abdominal area.

If such symptoms are absent, then no special treatment is required. If an increase in the tone of the uterus of a physiological nature occurs, it can be eliminated by simply relaxing the facial muscles and resting on the side. Another relaxing exercise that doctors advise to do if the uterus has high tone is getting on all fours and gently arching your lower back.

When deciding on special treatment for such a pathology, antispasmodic medications are most often prescribed. These remedies do not eliminate the possibility of miscarriage, but they do allow you to get rid of unpleasant symptoms. If there is a history of premature birth, a drug such as Utrozhestan is prescribed.

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Causes

During a routine examination in a gynecologist's office, a diagnosis such as frequent uterine contractions is made very often. The course of this symptom can be harmless or, conversely, dangerous for the health of the expectant mother and child. The reasons for tone can be very different. During pregnancy, the female body is rebuilt and works differently, not as it always has. The behavior of the uterus is influenced by both external and internal factors:

diseases of the uterus;
presence of chronic diseases;
abnormal shape of the uterus;
hormonal deficiency;
repeated abortions or uterine surgeries;
bad habits;
poor sleep, stressful situations;
large fruit;
multiple ovarian cysts;
polyhydramnios.
infantility of the uterus (small size, underdevelopment).

A more precise cause can be determined after an ultrasound examination. The doctor writes a referral for blood tests to determine hormone levels.

In early pregnancy

Myometrial hypertonicity at the beginning of pregnancy indicates that the woman’s body does not produce enough progesterone or there is an excess of male hormones.

The reason for increased uterine tone in the second trimester is:

impaired fat metabolism;
constant stress;
inflammatory diseases of the reproductive system;
magnesium deficiency;
large size of the fetus;
multiple pregnancy.

Severe toxicosis, accompanied by profuse vomiting, leads to frequent contractions of many muscles, including the uterus. The most dangerous phenomenon that can accompany pregnancy is Rh conflict, which causes fetal rejection; a clear symptom of this is the tone of the uterine myometrium.

There are reasons that cause increased tone that are not at all dangerous, for example, severe gas formation in the intestines. Painful sensations are associated with gases that press on the walls of the uterus. In this case, you need to exclude celery, garlic and salty foods from your diet.

Symptoms of increased tone

Any woman can detect uterine hypertonicity, especially in the early stages of pregnancy. You don’t need a paid gynecologist for this:

nagging pains similar to those that occur during menstruation;
heaviness in the very bottom of the abdomen;
pain in the lower back, radiating to the sacrum;
spotting, but not always.

At later stages, in addition to all the listed reasons, abdominal hardness is added.

Treatment of myometrium

If during the examination it turns out that the tone of the uterine myometrium does not pose a direct threat to the life and health of the woman and fetus, treatment is carried out at home. In critical situations, the expectant mother is sent to hospitalization. For outpatient treatment the following are prescribed:

"Papaverine";
"No-Shpa";
"Magne B 6";
sedatives;
products containing magnesium: “Partusisten”, “Bricanil” and “Ginipral”.

All medications are prescribed by a doctor; during their use, the condition is monitored, blood pressure, blood sugar levels and heartbeat are checked. All these drugs are used to eliminate pain symptoms and alleviate the condition of a pregnant woman.

“Magne B 6” take 1-2 tablets daily, during meals, with plenty of water. The drug should be taken under the supervision of a doctor. The medicine reduces the level of iron in the blood, which leads to anemia. Side effects are expressed in the form of nausea, constipation, flatulence, vomiting.

If there is a deficiency of progesterone in the initial stages of pregnancy, hormonal drugs - Dufostan or Utrozhestan - are prescribed to preserve it. It is important to remember that only a doctor can prescribe and cancel treatment, since you need to stop taking hormonal drugs gradually.

Treatment in the second and third semesters

In the second trimester, stronger and more effective drugs are prescribed, for example Ginipral. If there is a risk of placental abruption, the medicine is not used. By the third trimester, the fetus is sufficiently mature, but pregnancy pathologies such as excessive placental abruption occur. Here an emergency decision is made to induce labor or a caesarean section, so as not to lose the child and save the life of the mother.

You can ease the pain by kneeling on a chair and slowly arching your back on all fours. The head is raised up. Next, you need to carefully bend over like a cat, as far as your stomach will allow, with your chin pulled towards your chest. After this exercise, you need to sit down in a comfortable position, stretch your legs and relax.

Hospital treatment and diagnosis

Increased tone of the uterus is easily determined during a routine examination by a gynecologist; the doctor feels the fossilization of the uterus. The woman lies on her back during palpation (examination), bending her legs at the hips and knees to relieve tension in the abdomen.

But the most accurate and widespread method is ultrasound examination (ultrasound). The scan will determine the degree of development of the pathology. There are special drugs, myometers or tonometers. Such equipment is rarely used in more complex cases, because the pathology is easy to detect using other methods.

The decision to hospitalize is made as a last resort, when the pregnancy is initially difficult or all attempts have been made to relax the muscle, but the myometrial hypertonicity does not change. The woman is provided with absolute peace in the hospital, the doctor monitors the condition of the expectant mother and child and takes measures for any changes in the behavior of the uterus.

In the hospital, Magnesia is prescribed for intramuscular administration. Treat orally:

magnesium gluconate;
magnesium citrate;
magnesium orotate;
magnesium lactate;

If there are problems with the kidneys, medications are not prescribed or are used as carefully as possible.

How to help yourself with sudden pain?

Sudden myometrial hypertonicity: what to do? First of all, you need to take the most comfortable position and relax, breathe evenly and calmly. It is recommended to drink a sedative, such as motherwort. Take medications for increased uterine tone, the pain should go away within 15-20 minutes. If this does not happen, you need to call an ambulance.

Consequences of uterine hypertonicity

In some cases, uterine hypertonicity is a real pathology of pregnancy, which can lead to premature birth or miscarriage. Compressed vessels often cause hypoxia (lack of oxygen) or malnutrition (stunted growth) of the fetus.

Myometrial hypertonicity can also lead to the following consequences:

long labor;
indication for caesarean section;
postpartum bleeding.

The uterus cannot contract on its own, so in the maternity hospital the doctor monitors its tone. If a woman is exhausted and cannot give birth on her own, a decision is made to have a caesarean section to save the baby.

If it so happens that the myometrium is heterogeneous, it causes a lot of problems, so it is important to monitor your health and the behavior of the abdomen. If it often becomes hard and pain is felt, you should definitely seek help from a doctor. This will save you from many troubles and allow you to carry a healthy baby.

Complications:

pathology can cause miscarriage;
inhibit fetal development;
premature placental abruption.

Heterogeneous myometrium

Clear signs that a woman’s myometrium is heterogeneous are a painful sensation in the lower abdomen, bleeding. This condition appears due to the influence of the following factors:

hormonal imbalance;
abortions and other intrauterine curettages;
having multiple pregnancies;
trauma to the inner lining of the uterus.

Preventive measures

To avoid many problems associated with bearing a child, pregnancy should be planned. It is important to prepare for it in a timely manner, undergo examination, and undergo a course of treatment for chronic diseases.

Every woman must register with an antenatal clinic before 12 weeks of pregnancy and regularly visit an obstetrician-gynecologist; it would be a good idea to visit a private clinic, where the examination will be carried out by a paid gynecologist.

It is important to ensure yourself adequate sleep and quality rest, switch from hard work to easier work, and eliminate emotional stress and physical activity.

The main condition for preventing the appearance of uterine hypertonicity is careful attention to your health and a routine examination by a gynecologist. This condition is regarded as a threat of miscarriage, so it is very important to seek medical help in a timely manner.

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Why is increased uterine tone dangerous during pregnancy?

Options for the development of the situation depend on the gestation period. But in any case, hypertonicity is dangerous at any stage through termination of pregnancy. So in the early stages, uterine tone prevents the fetus from becoming well established in the endometrium, then, when the placenta has formed, there is a risk of its detachment. In addition, the hypertonicity of the uterus during pregnancy puts pressure on the blood vessels that connect mother and child, causing the child to lack oxygen and nutrients for normal development. Especially often, the pathological condition develops precisely in the early stages of pregnancy, and this is a threat to pregnancy. In addition, hypertension is often increased in late pregnant women. Then it may be confused with training contractions.

Symptoms of hypertension in pregnant women are as follows::

Pain in the lower abdomen, as during menstruation, or radiating to the lumbar region.
In the second trimester, there is a feeling of tension, constant excitement of the uterus.
The uterus is hard, the pregnant woman’s belly moves and can change shape.

However, these signs may not appear. Sometimes doctors determine this pathological condition during an ultrasound examination. It must be said that in both cases, the tone can be provoked by the emotional state of the pregnant woman before the ultrasound.

Due to the high risks for the fetus, additional medications are required. research in order to accurately establish the pathology and find out its cause.

Separately, it should be said about local uterine hypertonicity along the posterior or anterior wall. By the way, the development of pain syndrome only in the abdomen or in the lumbar region depends on the location of the pathology. On an ultrasound examination, the pathology video shows an obvious change in the shape of the organ: one of its walls bends into the inner part.

Causes of uterine hypertonicity during pregnancy

Determining the causes of uterine pathology when carrying a baby is not easy, since treatment will depend on this. The causes of the occurrence can develop against the background of hormonal failure, for example, if there are a lot of male hormones or a deficiency of female hormones. It happens that the mother’s body perceives the “new life” as someone else’s body and tries to tear it away, for example, if a number of the partners’ genes are the same.

The cause of the pathological condition may be:

Diseases of the development of the uterus;
Infections;
Somatic pathologies.

We must remember that the condition of the uterus is also influenced by the psychological state of the pregnant woman. Doctors have noticed that women who have had more than one abortion have a higher risk of encountering this problem, although this point has not been fully studied.

In addition, if a woman has already had a miscarriage due to uterine tone, she will most likely be diagnosed with it in a subsequent pregnancy.

It is very important to set yourself up for the positive, and also to choose a good clinic and obstetrician in advance. And in order for a pregnancy in the future, after a miscarriage, to be successful, you need to undergo examinations and establish the cause of the tone of the uterus.

How is uterine hypertonicity treated during early pregnancy?

Naturally, the question arises - what to do when there is hyperactivity of the organ, how to avoid negative consequences? If a woman feels the symptoms described above, in addition, if there is bleeding (spotting), she needs to go to the hospital herself. The doctor will examine the patient, send her for an ultrasound and prescribe other tests that will help identify the cause of hypertension and make it possible to understand how to deal with the pathology.

While a pregnant woman is waiting for test results, the doctor may prescribe medications to relieve uterine hypertension:

Medicines that relieve muscle spasms.
Sedative medications, since stress or a nervous state can provoke hypertension.
Medicines with Mg, as it prevents the penetration of Ca into the muscles, and thereby protects against spasms.

Subsequent therapy for pathology during pregnancy depends entirely on the cause of uterine hypertonicity. You cannot cure high tone on your own; negative consequences may occur. A doctor should treat.

If a hormonal imbalance is diagnosed, the pregnant woman will be prescribed medications that will provoke normal tone of the uterus.

At the same time, many women are afraid to take hormones during pregnancy. But nowadays the hormone content in medications is minimal, so taking medications will not harm the baby. In addition, if the cause is not eliminated, the main female organ may become toned again, and because of this, pregnancy may stop prematurely.

What to do with uterine tone during pregnancy

If the cause of the pathology is hidden in problems with the immune system, then one of the treatment options may be the introduction of leukocytes from the sexual partner into the blood of a pregnant woman. If the reasons are hidden in the field of psychology, you should visit a psychiatrist.

In order to weaken a strong or moderate tone, you can independently:

You need to take a comfortable position, bend your head slightly down, and completely relax.
You should take a body position in which the female reproductive organ is in a “suspended” state. You need to stand on four supports and slowly bend your back, at the same time raising your head. You need to stand like this for 5-6 seconds, and then do everything in the opposite direction. Several repetitions are recommended, after which you need to rest for 30 minutes.
It is important to remember that this pathology during pregnancy obliges the pregnant woman to change the rhythm of life. You should not lift heavy loads or have sex. You shouldn't walk too often.

It is not uncommon for pregnant women to be asked to go to a hospital precisely because at home they cannot create conditions favorable to calming the uterus. Whether or not to go to the clinic is, naturally, up to the pregnant woman to decide. If a woman is confident that she can maintain a gentle regime, then it is right to stay at home, where there is peace and comfort. But, if, in addition to hypertension, other signs of a threatened miscarriage are observed, you should still go to the hospital. Hypertonicity is treated successfully today. Good medications that are harmless to the fetus help to get rid of the manifestations of pathology. For example, the drug Duphaston does not increase, but perfectly reduces the symptoms of uterine tone of varying degrees.

When to see a doctor: myometrial hypertonicity during pregnancy

An increase in uterine tone provokes a severe nagging pain syndrome in the abdomen from below, usually when the myometrium is observed along the anterior wall of the organ. But sometimes a pregnant woman does not notice hypertonicity of the myometrium, since symptoms do not appear. This asymptomatic manifestation is characteristic of pathology of the posterior wall organ.

You should immediately consult a doctor if you experience:

Severe pain similar to contractions in the lower abdomen;
Nagging pain in the lumbar region;
Discharge of blood from the vagina;
Strong movement of the child (after 20 weeks of gestation);
The fetus is not active or does not move at all (after 20 weeks of gestation).

Attention! A nagging pain syndrome in the lower abdomen is the reason to urgently go to the clinic. Only a doctor can diagnose retrochorial or other uterine tone.

Treatment of uterine tone during pregnancy

First aid for myometrial hypertonicity at any week of gestation is as follows. If it is possible to eliminate the factor that provokes the pathological state of the myometrium (overload, stress, etc.). If pain syndrome has developed in the lower peritoneum, you must take a horizontal position. The difference in pain syndrome is the reason for going to the hospital. Take a medication that reduces spasm. No-shpa, Papaverine and Viburkol suppositories will help normalize the tone of the uterus and eliminate pain.

Attention! Medicines must be prescribed by a doctor. Taking medications without a specialist’s prescription can only be taken once!

Seek medical help. Some pregnant women believe that pathology is not a reason to visit the doctor, because “you can take a pill at home and everything will go away.” This is a mistake; if negative symptoms recur, you should definitely consult a doctor.

High myometrial tone is dangerous due to the following complications:

Miscarriage;
Placental abruption (development of bleeding, death of the child in the womb);
Utero-fetal-placental insufficiency.

Prevention of the pathological condition will avoid the development of uterine tone. There is no need to reinvent the wheel and look for some innovative methods of maintaining pregnancy. The main thing is to lead a healthy lifestyle, get enough sleep, have quality rest, eat proven, non-junk food, and avoid stress. All this will help you carry your child to term successfully and give birth to a strong, healthy baby.

A woman’s uterus is a hollow muscular organ that serves as a receptacle for the fetus during gestation. The walls of the uterus consist of several layers, one of which is the myometrium, the function of which is to nourish, protect, and, in the last stages of pregnancy, expel the fetus. For normal pregnancy, the muscular layer of the uterus must be relaxed. Hypertonicity of the myometrium along the posterior wall is a direct sign of a threatened miscarriage.

Why can this pathology develop?

There are a number of factors that increase the tone of the uterus. With successful determination of the etiological reason for which the myometrial tone is increased, it is possible to develop the most effective technique and strategy for its treatment. The most common reasons include the following factors:

In the first trimester of pregnancy, that is, in the first three months, increased myometrial tone may be due to a decrease in the production of progesterone by the corpus luteum, and then the condition is called corpus luteum insufficiency. Considering the fact that progesterone reduces the contractility of the myometrium and its sensitivity to estrogen, accordingly, when it is sufficiently present in the blood of a pregnant woman, the myometrial fibers remain relaxed. If there is a deficiency of progesterone, then the uterus becomes toned, and in such cases spontaneous miscarriage cannot be ruled out.
Hypertonicity also occurs with uterine fibroids. Uterine fibroids are a benign tumor that arises in the muscular layer of the uterus and consists of round-shaped nodes. Uterine fibroids are still considered a hormone-dependent tumor, and if it is present, an imbalance of estrogen and progesterone with a shift towards increasing estrogen content is necessarily diagnosed in parallel.
Local hypertonicity of the myometrium is often observed in endometriosis, when the growth of endometrial cells in localized areas changes the very structure of the endometrial muscle fibers and leads it to a state of hypertonicity. This occurs against the background of the growth of the endometrium in uncharacteristic places.
In case of any inflammatory processes in the uterus that were experienced before pregnancy and detected during pregnancy, the area of the myometrium with a disturbed structure is rendered incapable of stretching. It is this fact that leads to the fact that the myometrial tone becomes increased.
Another important reason for the occurrence of the pathology under discussion is adnexitis. Inflammation of the ovaries leads to significant hormonal deficiency. This is a trigger for the development of a condition in which myometrial tone is increased.
Neurogenic mechanisms of development of uterine hypertonicity. In addition to the reasons listed above, myometrial tone may be increased due to dysregulation at the level of the central nervous system. Failure of the hypothalamic-pituitary axis, for example, leads to excess production of prostaglandins. And they, in turn, provoke the release of excess estrogen into the woman’s bloodstream. Which ultimately leads to the development of hypertonicity.

Typical conditions and symptoms of increased uterine tone

According to localization, hypertonicity can be in the following areas of the uterus:

Hypertonicity along the posterior wall of the uterus is accompanied, in addition to nagging pain in the lower abdomen, pain in the lower back. With prolonged pain, bleeding may occur. This condition can lead to miscarriage.
Hypertonicity of the myometrium of the anterior wall is also accompanied by pain in the lower abdomen. But in this case there is tension, the stomach becomes like “stone”. If this condition occurs later in pregnancy, fetal movements may slow down. This condition is also threatening for miscarriage.

Large blood vessels also pass along the back wall of the uterus, which nourish the fetus. When the myometrium is tense, they become compressed, and fetal hypoxia begins to develop.

Often, hypertonicity along the anterior wall can occur due to external irritation of the uterus, for example, during ultrasound. Sometimes this occurs with other effects on the anterior abdominal wall.

Additional information about women's diseases is described in the video:

Treatment and prevention of increased uterine tone

It is important to understand that any pain or other manifestations of discomfort during pregnancy cannot be ignored. Any unnoticed alarm signal can cause an irreparable tragedy. The pregnant woman herself and the relatives around her are simply obliged to create a favorable environment for the expectant mother.

Adequate sleep, avoidance of psycho-emotional overload, a ban on heavy lifting, nutritious nutrition rich in vitamins - this is a small list of conditions for the birth of a healthy and full-fledged child. Increased local myometrial tone and its diffuse distribution are always considered emergency conditions requiring medical intervention. To prevent the onset of spontaneous abortion in the early stages or miscarriage in later stages, it is necessary to prevent the onset of conditions that can provoke an increase in uterine tension. It should always be remembered that it is impossible to stop a spontaneous abortion that has begun. You can only take all possible measures to prevent and prevent it.

For emergency relief of this condition at home, you can take the drug No-shpa, which relieves spasms of the smooth muscles of the uterus. It is also recommended that immediately if symptoms of increasing uterine tone are detected, lie down on the bed and do not get up until the doctor arrives or the emergency medical team arrives.

Having understood and realized what hypertonicity is, you can prevent its onset or stop the total spasm of the uterine muscles that has already begun. And, thereby, maintain the pregnancy and give birth to a healthy and strong baby.

Hypertonicity of the uterus can provoke the premature birth of a child. Accordingly, if it appears in the second half of pregnancy, you should contact a doctor immediately.

What is uterine hypertonicity?

Pregnancy is undoubtedly the best time in every woman's life. But it can often be overshadowed by some malfunctions and imbalances in the body. For example, increased uterine tone can be quite dangerous in the second trimester of pregnancy, because the baby may be born prematurely. Of course, medicine does not stand still and children born at the end of the second trimester of pregnancy are nursed thanks to special equipment and the practice of doctors. But this does not mean that it is worth exposing an unborn child to such danger. Therefore, the slightest feeling of discomfort during this period should be accompanied by an examination or consultation with a doctor.

The second trimester of pregnancy is often accompanied by increased uterine tone, which looks like spontaneous contraction. Such a reduction poses a threat to the fetus. The uterus consists of three balls:

outer shell of perimetrium;
muscular part of the myometrium;
endometrial mucosa.

Contraction of the myometrium is dangerous for pregnancy.

Reasons

The second trimester is characterized by an almost doubling of the fetal weight, which puts additional stress on the walls of the uterus. Hypertonicity of the uterus during pregnancy can be of two types:

hypertonicity of the anterior wall;
hypertonicity of the posterior wall.

Increased tone of the myometrium of the anterior wall can occur as a result of:

Hormonal changes in the body of a pregnant woman. As a rule, during this period there is a lack of progesterone.
Fatigue caused by excessive physical activity during pregnancy.
Damage to the body by viruses.
Loads on the walls of the uterus resulting from carrying a fetus that is too large or carrying several fetuses at the same time.
Oligohydramnios, polyhydramnios, or inflammation of the appendages.
An unhealthy lifestyle that harms not only the unborn child, but also his mother.

The tone of the myometrium of the anterior wall can be judged by the unpleasant and painful sensations that arise in the uterus and radiate to the perineum. When moving or exercising, the discomfort may increase and be accompanied by increased urination and bowel movements.

The tone of the myometrium of the posterior wall can be caused by:

insufficient production of progesterone;
formation of fibroids on the wall of the uterus;
polyhydramnios, oligohydramnios;
inflammatory processes in the organs of the uterus and ovaries that are important for bearing a child;
experienced stressful situations;
bearing a large fetus;
hard physical labor and unhealthy lifestyle.

The tone of the myometrium of the posterior wall is characterized by pain arising not only in the uterus, but also in the lower back, and sensations of hardening of the uterus.

If such symptoms appear, it is mandatory to visit a doctor, who, after studying the full picture, will decide to eliminate the cause of hypertonicity.

Prevention

In order to protect yourself in the second trimester of pregnancy from myometrial hypertonicity, it is necessary to exclude all possible causes and factors that can provoke it. It’s not for nothing that during pregnancy women are advised to rest more, spend time in the fresh air and not be nervous.

You can protect yourself from involuntary contractions of the anterior and posterior walls of the uterus by following these recommendations. It is advisable to avoid long trips and active sports. Physical activity may be present in the life of a future mother, but it should be moderate and under the supervision of a specialist. You should avoid those sports where you need to make sudden movements.

Not only external factors can provoke uterine hypertonicity, but also some infections that have entered the body of a pregnant woman. The second trimester of pregnancy may have complications in the form of myometrial tone, the causes of which are torch infections. In this case, complications can be avoided only if you follow the doctor’s orders, undergo all recommended examinations, and take tests in a timely manner.

Hypertonicity can be prevented if during pregnancy the woman does not be in stressful situations, experience negative emotions, or get upset. The moment a woman cries, the uterus begins to contract. By eliminating the causes of uterine hypertonicity, the likelihood that it will appear is significantly reduced.

Solutions

In order to protect the unborn child from negative influences on his body and prevent many diseases, you need to prepare for the upcoming pregnancy. Check the general health of the mother, make sure there are no infections, check hormones.

Most women begin to worry about the health of their unborn baby only when pregnancy has already occurred. In such cases, you may encounter a problem such as uterine tone, and the causes of its appearance must be eliminated as they arise under the strict supervision of a doctor.

The second trimester of pregnancy can have complications in the form of myometrium, so if you experience discomfort in the lower abdomen or lower back, painful spasms similar to contractions and tension, the first thing to do is consult a doctor. Having found out the reasons, the doctor will do everything possible to relieve tension from the uterus. In order to relieve uterine hypertonicity, a pregnant woman needs to calm down and relax. Sometimes, to achieve the desired state, it is enough to rest for some time and do nothing. But it is not always possible to eliminate hypertension with rest. Then sedatives that are approved for use during pregnancy will help alleviate the condition.

In the case when it is not possible to relieve tension from the uterus, and the doctor sees a danger in this, he has every reason to admit the pregnant woman to a hospital, where she will undergo a course of treatment under the supervision of medical staff. In most cases, uterine hypertonicity can be prevented by a timely visit to the antenatal clinic or a private doctor. After all, such regular examinations help not only to assess the health of the mother and her unborn baby, but also to prevent most of the complications that can overshadow the second trimester of pregnancy and jeopardize its further course.

Examinations that should be carried out in the second trimester of pregnancy make it possible to detect hypertension in time and prevent it. To confirm this diagnosis, it is not necessary to do additional examinations, because myometrial hypertonicity can be felt during examination of the pregnant woman’s abdomen and is easily recognized. Uterine hypertonicity is primarily a hardening of the uterus and abdomen. In order to verify the truth of the diagnosis, you can additionally undergo tonuometry using a special device.

The second trimester of pregnancy requires special attention from the expectant mother to her body and health. During this period, it is necessary to listen to the sensations and monitor the changes occurring in the body. After all, some symptoms that are common during pregnancy can cost the health, and often the life of the child.