Myometrial hypertonicity. Local thickening of the myometrium: normal or pathological? Is it necessary to treat uterine hypertonicity?

Increased uterine tone is observed in 60% of pregnant women, but in only 5% this phenomenon requires special treatment. In other cases, uterine hypertonicity is not considered a dangerous condition during pregnancy. The only thing that is required of the expectant mother is to observe bed rest, sexual rest and adhere to a daily routine.

Pulling painful sensations lower abdomen with uterine hypertonicity

What is uterine hypertonicity during pregnancy?

The female uterus is a muscular, hollow organ that can contract like any other muscle in the human body. The contraction of the muscle fibers of the uterus brings it into the so-called tone. This means that the uterus seemed to “strain” and remained in that state.

Normally, during pregnancy, the uterus is completely relaxed, but sometimes increased tone is observed when muscle layer The uterus contracts, thereby increasing the pressure in the uterine cavity. This condition of the uterus has a bad effect on the course of pregnancy and fetal development, called this state hypertonicity of the uterus.

Symptoms and consequences of increased uterine tone

The main symptom of uterine hypertonicity in the early stages is nagging pain in the lower abdomen (as during menstruation), pain in the lower back and in the sacral area. In the second trimester and later, there are cramping pains and hardening of the abdomen, which is clearly felt when palpating it.

Getting worse increased tone uterus in the early stages with spotting blood from the genital tract. Then there is a risk of spontaneous miscarriage, since it is difficult for the fertilized egg to attach to the wall of the uterus due to the increased tone of the muscular layer of the uterus.

In the second trimester of pregnancy, when the placenta has already fully formed, there is a risk of its detachment due to increased uterine tone.

In the later stages of pregnancy, hypertonicity of the uterus can lead to premature birth, because such contraction of the uterus occurs in the process labor activity to help the baby be born.

Also negative consequence with hypertonicity of the uterus, fetal hypoxia occurs, when the uteroplacental blood flow is disrupted due to the tone of the muscular layer of the uterus. Thus, the fetus receives insufficient oxygen and nutrients necessary for its development. normal development. Typically, such a fetus lags behind in weight and size, its development is also slowed down, and if treatment is not timely, malformations of the fetal organs may develop, or even this may lead to a missed abortion, i.e. to the death of the fetus.

Causes and methods of diagnosing uterine hypertonicity

There are many reasons for the appearance of increased uterine tone during pregnancy:

• hormonal deficiency;
• diseases of the uterus (inflammatory processes of the appendages and the uterus itself, endometriosis, uterine fibroids, etc.) and disruption of the central nervous system;
• exacerbation chronic diseases and the occurrence of colds (acute respiratory infections, acute respiratory viral infections and other ailments characterized by an increase in body temperature);
• constant stress and increased physical activity are not enough long sleep and/or rest, as well as the presence of a pregnant woman bad habits;
• polyhydramnios, multiple births or large fetus.

Local hypertonicity of the uterus can be determined by the posterior or anterior wall using ultrasound examination. At the same time, an ultrasound shows a change in the wall of the uterus at the site of its tone; it bends inward.

There is also a special sensor for determining the tone of the uterus. But, unfortunately, tonuometry is not carried out in all antenatal clinics.

Treatment of uterine hypertonicity

At any stage of pregnancy, No-shpa or Papaverine suppositories will help relieve pain due to uterine tone. These drugs can be taken at home at the first symptoms of tone.

In the first trimester of pregnancy, when the tone of the uterus is caused by a deficiency of the hormone progesterone, Utrozhestan or Duphaston are prescribed to maintain the pregnancy. The main rule of taking hormonal medications is that they cannot be abruptly stopped. If the tone no longer bothers the pregnant woman, then we reduce the dosage of hormonal medications and only then stop taking them altogether.

With placental abruption, uterine tone and aching are observed. Blunt pain, radiating to the thigh or perineum. Then the pregnant woman is hospitalized and prescribed inpatient treatment. Typically, such treatment includes an antispasmodic “plus” a drug containing magnesium (for example, Magne-B6 or magnesium sulfate), which can reduce the activity of the uterus “plus” vitamins and sedatives herbal composition (for example, valerian or motherwort).

From the second trimester you can use more effective drug for the treatment of uterine hypertonicity - Ginipral, but in the presence of placental abruption it cannot be used.

In the third trimester, if the baby is mature enough and there is a risk of losing the baby due to excessive placental abruption or dilatation of the cervix, doctors may decide to induce labor or perform C-section, in order to save the life of both the child and the expectant mother.

But usually modern pregnant women suffer from hypertonicity due to psycho-emotional stress: pressure at work, the need to run a household, active pastime with children, etc. All this causes stress and increased fatigue, which is the central concern nervous system the pregnant woman reacts with the manifestation of uterine hypertonicity.

Myometrial hypertonicity caused by an active lifestyle usually doctors do not treat as such, but simply prescribe vitamins and recommend avoiding stressful situations, maintain rest (including sexual rest) and daily routine (sleep at least 8 hours). During an exacerbation, take at least a couple of days off and try not to get out of bed for a day (you should lie on your left side).

If it is not possible to take a day off, then you can do relaxing gymnastics directly at your workplace (if you have your own office or you are surrounded by good female employees).

Kneel down on a chair in a “all fours” position and slowly arch your back while raising your head up. Stay in this position for a few seconds. So the tummy will be in a “suspended” comfortable state. Then slowly arch your back (like a cat), tucking your chin toward your chest, and hold again. Do this exercise several times and try to sit quietly for the next hour, leaning on the back of a chair and stretching your legs slightly forward.

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 food poisoning or emotional shock. Apparently, you are pregnant, so congratulations! Like thunder among clear skies, 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 treacherous enemies pregnancy is hypertonicity of the myometrium. 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 by 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 it inner layer(endometrium) more loose 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” him out when the longest period comes. this moment pregnancy - his 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 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

The time when a woman is pregnant is a wonderful and exciting period. But besides positive emotions, pregnancy can bring expectant mother there is a lot of anxiety, because various deviations and complications are not uncommon in this condition. Most alarming symptom pregnancy, the tone of the uterus is considered to be back wall.

Collapse

Causes of tone

Since the uterus is a muscular organ, it cannot remain in a state of constant relaxation. Tension, even slight, is always present in the uterus. Moreover, if the tone is slightly increased in the area of ​​contact between the wall and the embryo, this indicates that the latter is taking root well.

Minor inflammation may be caused by increased blood flow to that particular area. In this way, the mother’s body supplies the embryo with the substances necessary for its life and development. An ultrasound will characterize this area as edematous, which is understandable and is also considered tone during pregnancy.

Tone can be general, that is, it extends to the entire organ, or local. The latter is divided into hypertonicity along the posterior wall of the uterus and the same condition along the anterior wall.

The muscles of the reproductive organ can be tense for the following reasons:

• Uterine pathologies. These include endometriosis and fibroids. Hypertonicity of the posterior wall of the uterus and problems with bearing a child are closely related to anatomical features uterus. It can be saddle-shaped, bicornuate, or have other structural features. Such anomalies can create difficulties in the process of bearing a child;
• Lack of progesterone. Usually caused by underdevelopment of the genital organs or an abundance of male hormones(androgens);
• Viral infections. They significantly weaken the immune system, which does not have the best effect on the uterus. Infections are accompanied by symptoms such as itching and burning of the external genitalia, qualitative changes in discharge.
• Oligohydramnios or polyhydramnios. The abundance or lack of amniotic fluid equally negatively affects the muscle layer specifically of the posterior uterine wall;
• Stress. They have a detrimental effect on the body as a whole. They weaken the reserves of a pregnant woman’s body, causing the maca to strain unnecessarily;
• Stretching of the uterine muscles. Often occurs in the presence of multiple pregnancies or carrying a large fetus;
• Inflammation in the ovaries or uterus. Such processes can cause alternating tension and relaxation of the reproductive organ;
• Excessive physical exercise. Makes you tense internal organs, the uterus is no exception. Lifting weights or overindulgence physical exercise does not have the best effect on the condition of the uterus.
• Different Rh factors in the blood of mother and fetus. In case of Rh conflict, the process of rejection of the fetus by the mother's body may begin. At this time, the tone of the reproductive organ increases significantly.
• Abortions performed by a woman before her current pregnancy can also cause hypertension. This also includes miscarriages and premature delivery.
• Changes in intestinal motility. The latter changes in size due to the accumulation of gases and puts pressure on the body of the uterus, causing tension in its muscles.

Main features

One of the signs of hypertension is painful sensations in the lumbar region

The phenomenon of uterine tone along the posterior wall can be asymptomatic. This pathology often can only be diagnosed after an ultrasound procedure. But sometimes the tone of the posterior wall of the uterus during pregnancy is accompanied by the following symptoms:

• pain in the lower abdomen (similar to menstrual pain);
• lower back pain;
• increased pain due to fatigue or physical overload;
• the reproductive organ is tense and seems to “turn to stone” (this condition most often accompanies the last trimester of pregnancy).

The presence of one or more specified symptoms may indicate the tone of the uterus along the posterior wall, in which case you should immediately consult a doctor. Especially warning sign- bloody spotting or heavy vaginal bleeding. When they appear, the woman should immediately call an ambulance and try to calm down as much as possible. At this stage of medical development, doctors often manage to save a child in the womb.

How to diagnose hypertension?

It is possible to confirm or refute the presence of hypertonicity along the posterior wall of the uterus by undergoing an ultrasound. This procedure will provide detailed information about the condition of the uterus, the thickness of its walls and the degree of tension of its muscle layer. In this way, you can find out what degree of hypertonicity the patient currently has and along which wall it is visualized. Hypertonicity along one of the walls affects appearance organ, changing its size. The degree of tone depends on which wall of the uterus the fetus was attached to during pregnancy.

In parallel with the examination of the uterus, the specialist pays attention to the cervix of the reproductive organ. This is necessary in order to detect possible shortening of the cervix or opening of the uterine pharynx. Such conditions are fraught with miscarriage or the onset of premature labor.

An experienced specialist can diagnose hypertonicity by palpating the patient’s abdomen.

Together with ultrasound, the doctor can prescribe to the patient additional examinations. These include testing for progesterone or other hormones.

Dangers and possible complications

The consequences of hypertension can be quite sad. In the early stages it can cause miscarriage, in later stages it can cause premature birth.

1. Mostly, uterine tension occurs in the early stages. Often, hypertonicity of the posterior wall of the uterus interferes with the attachment of the fertilized egg or provokes its rejection.
2. Sometimes hypertonicity occurs before childbirth. This type of tension is called training contractions, which are not dangerous to the health of mother and child. In this way, the uterus seems to be preparing for childbirth.
3. In addition, tension in the uterus does not have the best effect on the blood flow of the reproductive organ. Sometimes this causes fetal hypoxia.
4. Hypertonicity of the posterior wall of the uterus can disrupt the functionality of the placenta and lead to its abruption. This is fraught with miscarriage or premature birth.

Women who have a history of miscarriages or inflammatory diseases. The risk of hypertonicity that occurs along the posterior wall of the uterus during pregnancy increases significantly. A pregnant woman needs to visit a doctor regularly to monitor the situation.

Important! It has been clinically proven that pregnant women who get enough sleep, avoid stressful situations and physical strain are much less at risk of developing uterine hypertonicity.

A good sleep schedule is the key to a successful and easy pregnancy.

How to cope?

If a pregnant woman has symptoms of hypertension that worry her, it is necessary to urgently take measures to eliminate it. Such activities can be therapeutic in nature and carried out in medical institution. A woman can also relieve these symptoms on her own.

So, before the ambulance arrives, you can remove or partially reduce the tone of the uterus along the back wall in the following ways:

• limit all physical or emotional stress;
• take a comfortable horizontal position;
• relax your body as much as possible, Special attention paying attention to facial relaxation;
• If the condition allows, you can take a position that provides the freest position for the uterus. For example, standing on all fours. In this position, it is permissible to perform several simple movements - arching your back while lowering your head.

Exercise "Cat" will help cope with tension in the reproductive organ

Attention! Even if the symptoms of hypertension were relieved at home, the expectant mother should immediately visit medical institution. There will be held full examination with further selection of therapeutic methods.

• therapy hormonal drugs(recommended if there is a deficiency in the pregnant woman’s body necessary for the child substances);
• sedatives (calming) drugs;
• treatment with antispasmodics;
• taking medications that contain magnesium;
• bed rest (strict adherence);

Hypertonicity of the uterus along the posterior wall is not always considered dangerous for the mother and baby in her womb. However, a woman should pay close attention to such a diagnosis. Taking care of your health, correct mode sleep and nutrition, lack of stress and bad habits will help pregnancy proceed easily and calmly. The joy of meeting the baby soon and the unconditional love of a mother for her unborn baby can eliminate all unpleasant symptoms. However, we should also not forget about systematically visiting a doctor to monitor the condition of the expectant mother.

Pregnancy is important event in a woman’s life, however, often during its course a pathology such as increased myometrial tone is diagnosed. It is important to know the symptoms of this pathology and possible reasons its development. Timely consultation with a doctor will help avoid various complications.

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 female body causes high blood pressure in the reproductive organ and the result of this phenomenon may 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 favorable outcome pregnancy. 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, one can highlight following reasons pathologies:

• 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 has a history of various diseases inflammatory nature 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;

Local hypertonicity occurs predominantly in endometriosis, when pathological cells cause structural changes muscle fibers.

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 such a condition develops during labor, problems may arise. various kinds complications.

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 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:

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

• strong nagging pain lower abdomen;
• pain in the lower back;
• bloody vaginal discharge

1. An increase in tone along the anterior wall causes severe pain in the lower abdomen, which are 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 posterior wall is the site of localization of large blood vessels, through which they are supplied nutrients 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 there is an increase in uterine tone physiological nature It can be eliminated by simply relaxing the facial muscles and resting on your 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, the following are most often prescribed: medications antispasmodic action. 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.

Complications of pregnancy

Increased tone during pregnancy leads to the progression of this dangerous condition as fetal hypoxia. With this pathological condition there is a narrowing of the lumens of the uterine vessels and an insufficient amount of oxygen reaches the child, and this ends in a violation of the uteroplacental blood flow.

Hypoxia can cause the development various types abnormalities in the baby and malnutrition.

If no effort is made to eliminate hypertonicity, this may result in premature onset of labor or spontaneous miscarriage. Today, increased uterine tone can be successful treatment and this helps prevent the development of many complications. The most important thing in such a situation is a timely visit to a specialist for medical help.

Very often this phenomenon appears in the very early pregnancy, so maybe.

Uterine hypertonicity can be local (limited) in nature and occur in the anterior or. Localization of muscle tension has great importance, but it is also necessary to take into account, since other negative consequences largely depend on this factor.

Causes

Symptoms of hypertonicity of the anterior wall of the uterus

important The doctor pays special attention to, since either the opening of the throat may be a symptom of approaching or.

Methods for relieving hypertonicity of the anterior wall of the uterus

If signs of increased uterine tone appear along the anterior wall, the woman must take the following measures:

• stop any physical activity and try to take a horizontal position;
• try to relax the facial muscles, the tension of which directly affects the tone;
• take a body position in which the uterus will be in a free position: for example, standing on all fours. In this position, you should carefully arch your back, while slowly raising your head. After a few seconds, you can return to the starting position and repeat the exercise several times;
• if signs of hypertonicity do not disappear, you should urgently contact a medical facility.

After the examination, the doctor may recommend following methods elimination of hypertonicity along the anterior wall of the uterus: excessive tension of the uterine muscles;

– possible in the second half;

the occurrence of disturbances in fetal development, which is associated with possible hormonal imbalance and other violations;

partial ;

disruption of the fetal nutrition process due to compression of the blood vessels through which nutrients enter the baby’s body.

additionally However, not in all cases, increased hypertonicity of the anterior wall of the uterus can lead to such disastrous consequences.

You need to worry when the diagnosis is confirmed by an experienced specialist and the corresponding signs are present: pain, unusual, etc. In such a situation, the life of the unborn baby is at stake, so you should count on the help of specialists.