Hypertonicity of the muscular layer of the uterus (myometrium): what is it and why is it dangerous? Manifestations and treatment of hypertonicity of the myometrium of the posterior and anterior wall of the uterus and internal pharynx during pregnancy Hypertonicity of the myometrium along the anterior wall

Myometrium - muscle layer uterus, located between the outer serous and inner mucosa. It is responsible for the ability of the uterus to contract, so its normal functioning is important for successful pregnancy and successful delivery.

Increased contractility or hypertonicity of the myometrium is diagnosed in almost every pregnant woman.

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Let's figure out why this condition is dangerous, why it occurs and how to deal with it.

What is this state?

In itself, an increase in the tone of the uterine muscles is not a pathology. Throughout life, women reproductive age constantly encounter contractions of the myometrium that accompany each menstrual cycle.

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But during the bearing of a child, this process stops under the influence of a changing hormonal background. In the normal course of pregnancy, resumption contractile activity occurs only after the maturation of the fetus, helping him to be born.

Increased tension of the uterus up to this point - alarm symptom posing a threat to the life and health of the unborn child.

Provoking factors

Various factors can provoke uterine hypertonicity in a pregnant woman. The most common ones are:

Note! An ultrasound procedure and a medical examination sometimes provoke a short-term increase in myometrial tone.

This condition usually does not cause discomfort and does not pose a threat.

Symptoms of hypertension

Manifestations of increased contractility of the uterine muscles differ depending on the localization of the tone. On this basis, there are three main forms of pathology:

In the second half of pregnancy, the tone, localized both along the posterior and anterior walls of the uterus, may be accompanied by changes in fetal movements. Therefore, if the child began to move much more often or, conversely, is practically not active, this is a reason to consult a doctor.

Important! The symptoms of uterine hypertonicity are similar to the so-called training contractions.

But, unlike pathological increased tone, such contractions do not last long and do not cause severe pain.

Possible consequences

Hypertonicity of the uterine muscles that occurs early in the gestation of the fetus increases the risk of spontaneous abortion. The situation is aggravated by the fact that in the first trimester of pregnancy, a woman cannot always feel uterine contractions in time and seek treatment.

If the tone of the myometrium increases in the second trimester, this threatens to malnutrition of the fetus due to spasm of the blood vessels of the placenta. This condition is called uteroplacental insufficiency. It affects the unborn child, slowing down its development and causing failures in the maturation of various body systems.

Increased tone along the anterior and posterior wall of the uterus in the third trimester is dangerous because of the possibility of premature birth. This is facilitated by the opening of the cervix, which occurs during hypertonicity, as a result of which the organ cannot hold the growing fetus.

Another danger of contraction of the uterine muscles in pregnant women is placental abruption. This can happen at any gestational age.

A small detachment, if the woman follows the recommendations of the doctor, leaves a chance for the preservation and normal development of the child, but more severe forms can lead to his death, and the bleeding that opens with this poses a serious threat to the life and health of the mother.

Treatment and first aid

Treatment for uterine hypertonicity is necessary if there are alarming symptoms - pain and spotting, as well as in cases where ultrasound reveals a threat of abortion, signs of placental insufficiency or cervical dilatation.

To eliminate the pathological condition, pregnant women are recommended to go to the hospital. With a moderately increased tone, it can be carried out ambulatory treatment prescribed depending on the clinical picture. In this case, the following drugs are used:

If there is a feeling of uterine tension in a pregnant woman in the second and third trimester, the condition can be alleviated at home. To do this, you should get on all fours and perform this exercise several times - bend your lower back while raising your head (keep the pose for 5 seconds). This will relax the muscles of the uterus. Then you need to lie down to rest, taking a comfortable position (preferably on your side).

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Prevention in pregnant women

To prevent an increase in uterine tone, pregnant women are advised to minimize stress, avoid physical activity and weight lifting. It is also important to adhere to proper nutrition:

In the last months of pregnancy, it is advisable to wear a bandage. Being sized, it supports the stomach and does not allow the uterus to overstrain.

Pregnancy is a special period in a woman's life, in which she is responsible not only for herself, but also for her unborn child.

Therefore, in order to prevent the development of complications and give birth healthy baby, you should be doubly attentive to your well-being and consult a doctor at the first suspicion of myometrial hypertonicity or other disturbing symptoms.

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Expecting a child is the most magical period in the life of every woman, which, however, is overshadowed by various complications and threats. Uterine hypertonicity during pregnancy is a frightening term familiar to all planning and bearing women. The body of the uterus consists of three layers: endometrium, myometrium and perimetrium. The endometrium is a mucous lining the organ from the inside, while the perimetry is a serous film covering it from the outside. But the most powerful and strongest layer is the middle layer - the myometrium. It consists of a connective tissue system, smooth muscles and fascia. The muscles of the myometrium are traditionally prone to contraction, which is necessary in the process of natural delivery. If during pregnancy muscle tension occurs earlier than the expected date of birth, this pathology is called "hypertonia". The syndrome is accompanied by a significant increase in pressure in the body of the organ, and can lead to premature birth or abortion.

Normotonus is the normal state of the pregnant uterus, the muscles of which increase 10-12 times and thicken 4-5 times. At the same time, the muscles can be reduced up to 10-15 times a day, but this does not entail any risks and uncomfortable sensations. The causes of uterine hypertonicity are diverse, and the syndrome itself requires immediate medical intervention.

The mechanism of development of hypertonicity during gestation

The causes of uterine hypertonicity are often hormone-dependent, but can also be caused by external factors. Uterine hypertonicity is very common among women who are not ready for pregnancy, who experience depressive and anxiety state. The same factor applies to patients who have previously had a spontaneous abortion, and who are acutely worried about maintaining the pregnancy. The consequences of this condition are reflected in the process of gestation, depending on the period. Hypertonicity on early dates almost always leads to miscarriage.

Among the provoking factors of hypertonicity should be distinguished:

Hormonal dysfunctions. Insufficiency of the ovaries and fetoplacental complex, adrenal dysfunction (adrenogenital syndrome), consequences of improperly selected hormone therapy in the past (OK and COC), any other factors leading to the suppression of the synthesis of estradiol and progesterone (increased androgen production);
Malformations of the body of the uterus (bicornuity, bend);
Violation of puberty in history (underdevelopment of the organs of the reproductive system);
Benign neoplasms in the uterus;
Isthmic-cervical insufficiency (the cervix opens prematurely, unable to withstand the load);
Infections and inflammation of the internal genital organs;
Pathology of the fetal egg;
Transferred surgical, vacuum and medical abortions;
Related somatic diseases - cardiac, renal, hepatic, pulmonary;
ARVI, colds and influenza diseases in the early stages;
Endocrine pathologies;
decline protective functions body during pregnancy
Stress and psycho-emotional upheavals during the gestation period associated with the atmosphere in the family;
Smoking, alcohol abuse;
Chronic insomnia;
genetic factor.

Hypertonicity in the first trimester develops mainly due to a deficiency of the "maternity hormone" - progesterone. The fertilized egg cannot properly attach to the endometrium, and if the introduction occurs, the muscles of the uterus literally "push" it out. Other common causes of hypertonicity in the early stages are hyperandrogenism, hyperprolactinemia, and genital infantilism.

It is hypertonicity in the early stages that is extremely dangerous for the further development and course of pregnancy. The late development of pathology in women is often confused with "training" contractions. In the third trimester, hypertonicity is not so dangerous, but it can lead to fatal consequences. That is why, having discovered specific signs do not hesitate to contact a specialist. With this syndrome, every minute counts, and the timely detection of pathology plays a fundamental role in further development fetus. Regardless of the cause of the disorder, you must take measures to treat, or better yet, take preventive measures at the planning stage.

The insidiousness of local hypertonicity

Hypertonicity of the uterus during pregnancy has its own varieties. AT medical practice often there is a local syndrome that partially spreads through the body of the organ. We are talking about the process when the muscles of the anterior or rear wall uterus. Hypertonicity of the posterior wall of the uterus is insidious in that a woman often confuses it with constipation, indigestion, pain in the intestines, and even osteochondrosis. As a result, the visit to the doctor is postponed until the last moment, when the salvation of the fetus is already called into question. Signs of tension of the anterior wall can be mistaken for symptoms of cystitis. Local hypertonicity manifested by frequent urge to urinate and empty the intestines, aching pain in the sacrum, abdominal discomfort. Hypertonicity of the anterior or posterior wall often develops into a total type of disorder, when the entire organ is involved, and therapy may be ineffective. The reasons for the deviation are the same as for total hypertonicity, but excessive physical activity, irregular daily routine, sedentary lifestyle (office work) are added to them.

Clinical manifestations of a dangerous disorder

Regardless of localization, uterine hypertonicity manifests itself in almost the same way. It is important to understand that a local syndrome in the first trimester threatens with spontaneous abortion, and a total syndrome reduces the blood supply to the fetus and provokes a complete or partial detachment of the fetal egg. In this case, a woman can suffer a miscarriage without suspecting that she is pregnant.

General symptoms of uterine hypertonicity (total, or anterior, bladder wall):

drawing pain in inguinal region resembling "menstrual";
bloody and brownish discharge from the genital tract;
discomfort in the perineum;
tension, heaviness, "petrification" of the lower abdomen;
feeling of fullness in the groin.

Unlike symptoms in the first trimester, later dates hypertonicity can be identified even visually. Appear characteristics in a modification of the shape and volume of the abdomen: it seems to retract, hardens strongly, acquires abnormal outlines.

The clinic of hypertonicity of the posterior wall of the uterus is expressed somewhat more specifically:

slightly pronounced pain syndrome in the lower abdomen;
severity and It's a dull pain in the sacrum and lower back;
feeling of heaviness in the rectum;
stool disorders;
constant urge to empty the bowels.

Symptoms can be ignored, considering them a banal bowel disorder. Back discomfort is relatively normal, especially during the third trimester. But we advise you to consult a doctor at least for your own peace of mind. All of the above symptoms are often accompanied by spotting from the vagina. It is important to remember that in any trimester this indicates a miscarriage that has begun, so you must be urgently hospitalized for medical preservation of pregnancy.

Medical diagnostic measures

Having found symptoms of uterine tone in yourself, you should immediately consult a doctor to confirm or exclude the diagnosis. Professional diagnostic studies include:

assessment of the condition (current symptoms and history);
gynecological examination with bimanual (in the first trimester) or abdominal palpation;
Ultrasound of the pelvic organs;
tonusometry;
blood test for infections;
study of the reproductive hormonal panel.

Assessing the symptoms of uterine tone, the gynecologist immediately begins diagnostic measures and directs the patient for emergency hospitalization, if necessary. Treatment of uterine hypertonicity during pregnancy "in preservation" is to relax current state organ, stabilization of normotonus and preventive actions to protect against relapses.

Therapeutic measures to eliminate the pathology of pregnancy

Drug treatment of hypertonicity of the body of the uterus includes taking soft sedatives(often phytotherapeutic infusions and decoctions), antispasmodics and agents to reduce uterine activity. In case of pathology in the first trimester, you will be prescribed bed rest and complete rest provided in a hospital setting. Additionally, you will be recommended poly vitamin complexes and supporting drugs. If the reason lies in hormonal failure the doctor will prescribe you hormonal agents to adjust the balance of andro- and estrogen.

The most terrible signs of hypertonicity at 23-25 weeks of pregnancy. This can provoke premature birth, in which the chances of the baby to survive are negligible. After 28 weeks, the risk of stillbirth is significantly minimized, but premature tribal activity try to suppress with tocolytics up to 34 weeks. At this time, it is important to activate pulmonary maturation in the fetus. This is done with hormone therapy. As a rule, artificial preservation for at least 2-3 days gives such an opportunity.

What doctors use to treat pathology:

Utrozhestan, Dufaston - for early preservation;
No-shpa (orally or intramuscularly) + Papaverine (suppositories) - antispasmodics to relax smooth muscles;
Motherwort, Valerian, Trioxazin, Nozepam, Sibazol - mild sedatives for a general calming effect;
Magnesium sulfate (intravenous drip), Brikanil, Partusisten - to reduce the muscular activity of the uterus.

Hormonal drugs and immunomodulators are prescribed strictly on an individual basis. In no case do not choose the treatment yourself, without confirming the diagnosis! You must understand: from now on you are responsible not only for your health, but also for the life of your baby!

You can try to relax the uterus at home with the help of exercises:

Get on all fours and bend your back, eyes look at the ceiling. Stay like this for no more than 3 minutes, return to the starting position. Repeat 5-7 times and then take horizontal position and rest for an hour;
Sit on a comfortable surface and lower your head down. Relax all the muscles of the face and neck, breathe deeply through the mouth. Stay in this state for several minutes, repeat if necessary;
Stand at the table and lean on it with your elbows. Make sure that the uterus is in limbo. Wait 5 minutes and lie down in bed. If symptoms continue, repeat.

To ensure the normal condition of the muscles of the uterus and protect yourself from relapses of hypertonicity will help you:

compression hosiery (special bandage for pregnant women) - wearing is relevant from the second trimester;
taking warm baths with soothing herbs (only if there is a threat of tone!);
self-massage - circular stroking of relaxed abdominal muscles;
correction of the daily routine and rationalization of nutrition ( more sleep and recreation, emphasis on cereals and nuts in the menu, an absolute rejection of bad habits);
preventive gymnastics.

What causes neglect of medical measures

Hypertonicity of the uterus during pregnancy can lead to tragic consequences:

spontaneous abortion;
death of the fetal egg;
fading pregnancy;
stillbirth;
development of isthmic-cervical insufficiency.

We urge you to take a responsible approach to pregnancy and consult a doctor in a timely manner at the first "alarm bells". If you already have a history of miscarriage due to hypertonicity, be sure to take care of its prevention at the planning stage. After conception, provide yourself with peace and good rest, do not be nervous over trifles, do yoga or simple relaxing exercises, rationalize your diet and enrich the menu with vitamins. And most importantly, remember: hypertonicity is not a sentence! Timely actions taken will help you maintain pregnancy and give birth to a healthy baby.

Anything can happen to a woman during pregnancy. Any ailment is a direct threat to the life of the mother and her unborn child. Among the most critical conditions of a woman during the period of bearing a child is myometrial hypertonicity, and every second expectant mother faces it. In this article we will figure out why the uterus comes into tone, what to do about it and how to prevent it. dangerous consequences this state.

Myometrium is the muscular layer of the uterus, which is located between the serosa and the endometrium. Normally, the myometrium should be relaxed, it comes into tone only under the influence of factors that influence it. Normal contractions occur during menstruation and during childbirth, when the hormone oxytocin is actively produced. All other factors that provoked contractions of the myometrium, especially during pregnancy, should alert the woman. Due to contractions of the myometrium during pregnancy, a miscarriage can occur, premature birth can begin.

The fact that everything is in order with the health of a woman can be evidenced by the homogeneous structure of the myometrium. This muscular layer of the uterus should consist of 3 fibers:

Subserous are strong longitudinal fibers that connect the myometrium to the perimetrium.
Circular - vascular fibers that reach their maximum density in the uterine cervix.
Submucosal - internal fragile fibers.

Heterogeneous myometrium during pregnancy is a reason to start a thorough examination and appropriate treatment. Why it can be diagnosed:

the woman has had many abortions before;
before that, she had repeatedly given birth;
in the body of a woman there was a hormonal failure;
It was surgical intervention on the uterus;
previous births ended with a caesarean section;
constant exposure to stressful situations.

If the myometrium is heterogeneous during pregnancy, then uterine hypertonicity may occur, due to which spontaneous abortion may occur or labor will begin earlier than necessary. To all these Negative consequences prevent, a woman should:

timely take a blood test to detect the level of certain hormones responsible for the safety of pregnancy;
be constantly observed by your doctor so as not to miss the onset of the inflammatory process in the organs genitourinary system;
must be absolutely healthy lifestyle life and avoid stressful situations whenever possible.

Myometrium during pregnancy: normal

occur during pregnancy diffuse changes myometrium, because the uterus increases in size due to the growing fetus. Myometrium fibers gradually lengthen and thicken. This is already noticeable in the very first weeks of pregnancy:

at 4 weeks, the uterus acquires size due to changes in the myometrium chicken egg, acquiring the shape of a pear;
at week 8, the uterus, due to an increase in the myometrium and the growth of the fetus, reaches the size of a goose egg, acquiring the shape of a ball;
at week 10, the uterus is 3 times larger than at week 8;
at 12 weeks, the myometrium develops, and the uterus becomes 4 times larger than its original size (its dimensions can be compared with the size of the head of a newborn baby);
at week 20, the myometrial fibers no longer thicken normally and do not lengthen, they just stretch.

Normal by the end of pregnancy:

the thickness of the walls of the uterus is 1.5-0.5 cm;
the length of the uterus reaches 38 cm, although its original size is 7 cm;
the width of the uterus by the end of pregnancy normally corresponds to 25 cm (initial value 6 cm);
the volume of the uterus before childbirth becomes 500 times the volume of the uterus in the normal state;
pre-delivery uterine weight is approximately 1.2 kg (excluding fetal weight and membranes), and before pregnancy 50 g.

The remaining indicators, which are significantly lower or higher than normal during pregnancy, are a direct indication for the hospitalization of the future mother.

Myometrial hypertonicity during pregnancy

If a future mother is diagnosed with hypertension, it should not be taken as a terrible disease, because it is not. Myometrial hypertonicity is main symptom the fact that the muscular layer of the uterus is very tense, which should not normally occur during pregnancy, because uterine contractions may occur, which will provoke premature birth or miscarriage.

That is why during ultrasound examinations, diagnosticians necessarily determine the thickness of the myometrium in order to know if there is a threat of abortion.

Causes of myometrial hypertonicity during pregnancy

Due to what factors the myometrium in the process of carrying a child can come into hypertonicity:

A woman does not produce enough progesterone.
An inflammatory process occurs in the organs of the genitourinary system (most often the cause is endometriosis).
Surgical interventions in the uterus that took place before pregnancy.
There are neoplasms in the uterus or on the appendages (tumors, cysts).
The walls of the uterus are overstretched due to the fact that a woman has a multiple pregnancy.
The expectant mother is constantly exposed to severe physical stress and injury.
The woman is in a state of strong emotional shock.
The pregnant woman has diseases internal organs and systems affecting the uterus.
Problems with myometrium occur in older women.
Problems with intestinal motility can provoke hypertonicity of the myometrium during pregnancy.

Myometrial hypertonicity: localization and symptoms during pregnancy

Hypertonicity is localized in different areas myometrium:

Hypertonicity of the myometrium along the anterior wall during pregnancy is a sign that the process of bearing a child proceeds with complications. Often future mom at the same time, she feels pain in the lower abdomen, in the perineum, she has frequent urges for bowel movements and Bladder. With hypertonicity of the myometrium along the anterior wall during pregnancy, uterine bleeding is often observed.
Myometrial hypertonicity along the posterior wall during pregnancy can long time be asymptomatic. In the later stages, he can only feel fullness in the perineum and pain in the lower back.
A pregnant woman will feel 100% hypertonicity of the entire uterus, because with such a pathology, the uterus seems to turn to stone, resembling a large ball outwardly. This is very dangerous symptom which should be reported to the doctor immediately.

What is dangerous thickening of the myometrium during pregnancy?

Thickening of the myometrium different terms Pregnancy, as we have mentioned before, can be very life threatening for mother and baby:

The worst thing that can happen in the early stages is a miscarriage. Uterine hypertonicity is one of the most common causes of spontaneous abortion.
Starting from the 2nd trimester, uterine hypertonicity can cause oxygen starvation fetus, and it, in turn, will lead to malformations of the internal organs and systems of the child.
In the 3rd trimester, due to hypertonicity of the myometrium, premature birth occurs. The baby may be born prematurely, and the mother will develop isthmic-cervical insufficiency, and placental abruption will occur, which can ruin the life of the child inside the womb.
Hypertonicity of the myometrium before childbirth is not crowned with anything bad either for the mother or for the child. On the contrary, contractions of the uterus will prepare it for labor.

What to do with myometrial hypertonicity during pregnancy?

If the thickness of the myometrium exceeds the norm during pregnancy and periodically makes itself felt, then you can do some exercises to alleviate your condition:

Get on all fours with your back arched and your head up. Hold in this state for 1 minute, and then arch your back and lower your head. By doing this exercise, your uterus will be in a state of weightlessness, which will help it relax. After you have done 2-3 sets, sit in a chair and try to relax completely. Drink tea with lemon balm and honey, turn on pleasant music.
Wear a bandage and eat as many foods as possible that contain magnesium and vitamin B.
Stroke your tummy every morning and evening, lying in bed, completely relaxed.
If the doctor prescribes antispasmodic drugs and the hormone progesterone, then you will need to take them according to the schedule and observe strict bed rest so that the contractile activity of the uterus is minimal.

Important! All of the above can be done at home outpatient settings. If there are bleeding, strong drawing pains then call an ambulance to take you to the hospital for hospitalization.

Listen to your body every minute, because by some of the symptoms you will be able to determine for yourself whether everything is fine with you and your baby. At the slightest suspicion of pregnancy complications, immediately go to the doctor to avoid fatal consequences.

Video: "Why is there uterine hypertonicity during pregnancy?"

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

General information

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

Causes of uterine hypertonicity

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

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

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

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

Symptoms of uterine hypertonicity

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

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

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

Diagnosis of uterine hypertonicity

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

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

Treatment of uterine hypertonicity

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

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

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

Prediction and prevention of uterine hypertonicity

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

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

The tone of the uterus during pregnancy occurs often. Pathology is accompanied by certain symptoms. Subsequent treatment is carried out using medications and other methods.

Every pregnant woman has experienced an increased tone of the uterus. Regardless of the cause of this condition, it should be treated to keep the pregnancy going. Exist effective methods, which allow you to get rid of the pathology.

What it is?

The uterus is a hollow muscular organ that can contract, and its basis is the myometrium. During pregnancy, the uterus tends to increase. Nature is arranged in such a way that throughout pregnancy, the muscle tissue of the uterus is in a relatively calm state. Thanks to this, it is possible to bear the fruit.

Also, the uterus can sometimes shrink, this phenomenon occurs closer to childbirth. These abbreviations are called "training". It often happens that during pregnancy, the muscle tissue of the uterus is in a tense state (uterine tone).

The danger of uterine tone for a child

First of all, the condition is dangerous with an increasing risk of miscarriage. In the early stages of gestation, the increased tone of the uterus does not allow the fetus to gain a good foothold in the endometrium. Also, this condition often leads to exfoliation of the placenta.

Moreover, uterine hypertonicity is able to pinch blood vessels connecting the body of the baby and the mother. Because of this, the child loses most of nutrients and oxygen.

The most common manifestation of hypertension is early stages pregnancy. It is during this period that he seriously threatens the health of the baby.

The reasons

The tone of the uterus is rather not a disease, but a consequence of negative effects on healthy body pregnant. There are certain causes and circumstances leading to uterine tone.

At the beginning of pregnancy

An increase in tone occurs in the early and late stages bearing a fetus. But often this happens at the beginning of pregnancy. This is due to contractions of the uterus, but at this stage it is not ready for childbirth. Most often, these changes are accompanied dull pain lower abdomen.

The reasons for the tone in the first trimester are as follows:

hormonal disruptions that occur in the body of a pregnant woman;
lack of progesterone production;
nervous experiences;
pathological processes occurring in the body of a pregnant woman.

At the end of pregnancy

Curiously, in the 2nd trimester, increased tone can also be characterized by the above conditions. However, most often main reason It's a load and a wrong way of life.

An increase in tone also occurs due to stretching of the muscles of the uterus. As a rule, this occurs due to multiple pregnancy, polyhydramnios or a large fetus. If inflammatory processes occur in the body of a pregnant woman, this phenomenon also contributes to an increase in the tone of the uterus. Also, a pathological condition can develop as a result of a respiratory viral infection.

Known types of uterine tone

During the period of bearing a baby, deviations from generally accepted norms often occur, one of which is the hypertonicity of the reproductive organ. Exist different kinds this pathology, characterized by unpleasant sensations and symptoms.

Hypertonicity of the posterior wall

The whole danger of this condition lies in the fact that hypertonicity of the posterior wall of the uterus may not cause discomfort and inconvenience. If there is some soreness, this may indicate complications of pregnancy.

However, in most cases, the symptoms are not pronounced. You can suspect hypertonicity of the posterior wall by the following signs:

discomfort in the lower abdomen;
pain in the lumbar region;
discomfort during physical activity;
voltage in reproductive organ, feeling of heaviness.

Hypertonicity of the myometrium along the anterior wall

Normal contractions and tensions of the uterus are 15 times a day. If this phenomenon occurs more often, it can be defined as hypertonicity of the anterior wall. This condition causes some inconvenience:

pulling painful sensation lower abdomen (below the umbilical region);
feeling of heaviness or tension in the perineum;
frequent urination and urge to urinate.

Local tone

Pregnant women often confuse local muscle tension with cystitis, osteochondrosis, or intestinal upset. Often disturbed by pain in the sacrum, lower back or abdomen. However, most often discomfort occurs in the lower abdomen and in the perineum.

Short-term tone

Such pathological changes felt as short-term contractions of the muscles of the reproductive organ. It is at week 20 that short-term tone often occurs for the first time. This is due to the intensive growth of the fetus and the increase in the size of the uterus.

Most often this phenomenon stops after the pregnant woman takes a horizontal position.

Diagnostic measures

Held diagnostic procedures allow with 100% probability to determine the pathological changes that have occurred in the reproductive organ of the pregnant woman. Such activities are carried out by an experienced specialist doctor, using special tools.

How does it feel?

First of all, the doctor will take an anamnesis. It is important for the patient to talk about unpleasant sensations that he feels. These include:

pain in the lower abdomen, which is aching in nature;
unpleasant compression in the perineum;
sudden tension in the abdomen;
lower back pain;
frequent urge to urinate.

In especially severe cases, pain is accompanied by bloody discharge. In this condition, you should immediately seek help from a doctor, as this is fraught with miscarriage. Also alarm signal cramping pains lasting more than one minute will serve.

What does it look like on an ultrasound?

As the main method for determining hypertonicity, doctors conduct an ultrasound examination. This procedure helps to visually determine the total or local contraction of the muscles of the genital organ.

As a rule, there is a compaction of the surface of the uterus from a certain side. If it is revealed this feature in the area of attachment of the placenta, there is a possibility of its detachment. Thickening of the entire myometrium may also be observed, which is confirmed by the emerging clinical symptoms.

What are the tests?

After the ultrasound the doctor recommends the expectant mother to undergo additional examinations, thanks to which it will be possible to see a wider clinical picture. Among them is a blood test, in which specialists determine the amount of progesterone.

Treatment methods

After diagnostic measures doctor prescribes effective therapy to help keep the pregnancy going.

In no case should you self-medicate, as this can lead to serious consequences.

Who prescribes the treatment?

When unpleasant symptoms and suspicions of the development of pathology, you should contact your obstetrician-gynecologist. Thanks to his recommendations, it will subsequently be possible to prevent the development pathological process in the reproductive organ of a pregnant woman.

What drugs are prescribed?

AT without fail therapy involves the use sedatives. Most often, valerian or motherwort is prescribed. In case of ineffectiveness of these drugs, the specialist prescribes Nozepam.

If progesterone deficiency is responsible for the increased tone of the reproductive organ, the following drugs are prescribed:

Utrozhestan;
Duphaston.

Also, in most cases, patients are prescribed Magne B6, thanks to which it is possible to make up for the lack of vitamin B in the body.

Treatment with candles

Usually doctors prescribe Papaverine in candles. it effective remedy which has a beneficial effect on the body of a pregnant woman. In case of increased tone, it is recommended to use the drug according to the attached instructions.

The duration of the course of treatment

The therapy carried out depends on the nature and severity of the pathology. An experienced doctor determines the period of treatment based on the patient's condition and ongoing diagnostic measures.

Proper nutrition

Thanks to a healthy diet, it will be possible to increase the overall well-being of the pregnant woman and have a positive effect on the tone of the uterus. Some phenomena caused by malnutrition can lead to diarrhea, flatulence and constipation. It is these phenomena that most often provoke the tone of the reproductive organ.

Doctors recommend sticking to healthy eating throughout the entire period of pregnancy. You should also protect yourself from bad habits: drinking alcohol and smoking. This will have a beneficial effect on the condition of the expectant mother and her unborn baby.

Exercises

The doctor can advise how to reduce physical activity, as well as its increase. Regarding uterine hypertonicity, the second option is more often recommended.

An increase in physical activity is primarily recommended for those people who are actively involved in sports and subjected themselves to physical exertion.

spontaneous movements at home to pleasant music;
walking outdoors;
swimming in the pool;
yoga classes;
breathing exercises.

Loads should be enjoyable, in which case they will lead to positive changes in the body of a pregnant woman.

Decreasing tone at home

At home, perform a number of simple tricks that will help eliminate the tone:

Get on all fours, raise your head up and bend your back. Hold this position for no more than 1 minute. The exercise is repeated several times a day.
Many had no idea that by relaxing the muscles of the face, you can reduce tension in the reproductive organ. It is enough to lie down comfortably and relax the muscles of the neck and face.
It is necessary to take a pose in which the uterus is in a free suspended state. Get on all fours, focus on your elbows.

Finally

And yet, one should not give preference only to folk methods and refuse traditional treatment. Thus, the clinical picture can be aggravated. Before treatment, you should consult with your doctor.