Local hypertonicity of the myometrium along the posterior wall. Local hypertonicity of the uterus 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 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 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 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 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

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 it works natural selection 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 an increase in the tone of the uterus 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
• Ultrasonography

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?

Increased 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 characteristic of increased uterine tone by back 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 - nagging pain in the lower abdomen, is a good reason for urgent medical care.

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 with hypertonicity “turns to stone.” Actually, a hard, “stone” belly during pregnancy is the main symptom 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 sign is considered serious enough to require 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 the gestation process 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 in the myometrium, the production of a protein, actyosin, increases (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 - 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 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, excitability, as spinal cord, and uterine receptors are 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 pathology thyroid gland(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 inflammatory reaction in the endometrium, which leads to the formation intrauterine adhesions, and the uterine walls are made incapable of stretching.

Chronic diseases

Often, an increase in uterine tone while expecting a baby is due to chronic diseases mothers ( arterial hypertension, diabetes, overweight 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(caesarean 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 work, constant stress, occupational hazards, marital status (divorced or unmarried), good 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.”

• At gynecological examination In the first trimester, a doctor can easily diagnose uterine hypertonicity, as he can determine 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: abdominal and/or lower back pain, 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). Purpose sedatives necessarily, since 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 arterial 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 in a failed miscarriage. early stages, or 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, and taking antiemetic and antihistamine drugs.
• 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 areas of the cerebral cortex responsible for uterine contractions is minimal. With emotional stress, significant physical activity, acute infections with hyperthermia (flu, ARVI, sore throat), an area of ​​excitation 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 forms 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, experts 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. For elimination 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 the diagnostic search for increased uterine tone is to establish the causes of the disorder and assess its effect on the course of gestation. In some cases, the condition does not manifest itself clinically and becomes an incidental finding during pregnancy ultrasound screening. 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, which allows detecting shortening of the cervix, CTG, fetometry and fetal phonocardiography, aimed at timely identifying a threat to the child, are recommended as additional examination methods. 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, normalization of sleep and rest patterns, avoidance of 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. Traditionally used to relax the myometrium magnesium sulfate(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 smooth fiber muscle. 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. Start birth process characterized by intense contractions of the uterine muscles. In this way, the fetus is pushed out and ensures its smooth passage through 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. Symptoms this state similar to signs of local hypertonicity. Additional feature is a pathologically hard spherical abdomen.

Main reasons for the phenomenon

Very often, myometrial hypertonicity 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 inspection expectant mother, 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. It can be:

• infectious infection;
• structural neoplasms - adenomyotic nodes, polyps, fibroids, etc.;
• congenital malformations of the uterus;
• venereal diseases;
• lack of sleep and rest;
• nervous overload, stressful situations;
• metabolic disease;
• 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. Mostly 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 proper development 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 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.

Pledge successful treatment in this case - 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:

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

All medications are prescribed by a doctor. Take them without consulting a specialist or stop them spontaneously healing process is strictly prohibited.

Possible complications for the fetus

Myometrial hypertonicity in early pregnancy often leads to spontaneous fetal rejection or 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 the future baby, the correct formation of individual systems and organs small organism. 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 actions

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 special attention treat your 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, dosing of 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, a specialist makes a decision to place a pregnant woman in medical institution to undergo appropriate treatment, or strict adherence to bed rest at home is prescribed.

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 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, 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:

1. 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

1. 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 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 fetal size;
• 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 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 has heterogeneous myometrium is a painful sensation in the lower abdomen, bleeding. This condition appears due to the influence of the following factors:

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

Preventive actions

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 blood vessels, which connect mother and child, because of this the child lacks 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::

1. Pain in the lower abdomen, as during menstruation, or radiating to the lumbar region.
2. In the second trimester, there is a feeling of tension, constant excitement of the uterus.
3. 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 choose in advance good clinic and an obstetrician. 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:

1. Medicines that relieve muscle spasms.
2. Sedative medications, since stress or a nervous state can provoke hypertension.
3. Medicines with Mg, since 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:

1. You need to take a comfortable position, bend your head slightly down, and completely relax.
2. 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.
3. It's important to remember that this pathology during pregnancy, it 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:

1. 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 insufficiency corpus luteum. 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.
2. Hypertonicity also occurs with uterine fibroids. Uterine fibroids are benign tumor, arising in the muscular layer of the uterus and consisting of rounded 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.
3. Local hypertonicity 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 endometrial growth in uncharacteristic places.
4. 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.
5. 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.
6. 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:

1. 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.
2. 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.

More about women's diseases explained 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. Anyone unnoticed alarm signal may 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 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 accept everything possible measures for its prevention and prevention.

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.

Every third pregnant woman different dates is faced with the phenomenon of increased uterine tone. Like any other muscle, the uterus becomes tense and relaxes again. The tone of the uterine myometrium is not always a disease. But when it increases pathologically, the threat of miscarriage increases. Using ultrasound, its exact location is determined. This condition is often accompanied by abdominal pain. There are drugs that help return the uterus to normal tone. In certain cases, hospital treatment is required.

Uterine tone

The uterus is a muscular organ. Like any other muscle, it becomes toned - excessive muscle tension. It is considered a pathology if it does not return to the normal state of wall tone. This problem occurs at all stages of pregnancy. What a woman experiencing hypertension may feel:

• Feeling of a “stony” stomach. The stomach will feel firm to the touch.
• Pain in the uterine area. They may be cutting in nature or simply feel like heaviness.
• After 30 weeks, a pregnant woman may experience a cramp-like tone. The so-called Braxton-Hicks contractions.
• Local tone of the posterior wall of the uterus is often not felt at all and is diagnosed only with the help of ultrasound.

During the normal course of pregnancy, the uterus is in a relaxed state for most of the period, so as not to interfere with the vital activity of the fetus. As tone increases, blood flow deteriorates at the site of its localization. What harm does hypertension cause to mother and child:

• Blood flow to the uterus deteriorates, which leads to fetal hypoxia. It can cause developmental delays, premature birth, or even lead to antenatal death.
• Localization of tone in the area of ​​the placental site can lead to placental abruption. This will lead to bleeding and a threat to the life of the fetus and the woman herself.
• For periods up to 16 weeks, it can lead to detachment of the ovum, cause a miscarriage or provoke a frozen pregnancy.

Diagnostic methods

Based on the patient’s complaints, the doctor will assume that there is excessive tension in the uterus. The tone, if located along the anterior wall, is felt when touching the abdomen. Using an ultrasound, you can accurately determine which wall of the uterus it is located on.

The tone of the posterior wall of the uterus is not diagnosed by palpation and does not always cause complaints. What is dangerous for a woman? Sometimes its symptoms are confused with pain in the back or intestines. In the first and early second trimester of pregnancy, the patient, lying on her back, can observe her uterus sticking out, which has become toned. Often women confuse this condition with “baby bulging.”

What are the reasons

In most cases, the causes of myometrial hypertonicity are stressful situations and constant experiences of the expectant mother. In more emotional women, such conditions occur more often.

Overstretching of muscles also leads to tone. This is possible with multiple pregnancies, with polyhydramnios, with frequent births, due to a large fetus. With oligohydramnios, hypertonicity also occurs due to the stronger effect of the fetus on the myometrium. Ultrasound examination due to oscillatory movements can tone the uterus, especially in the early stages of pregnancy. Excessive physical activity does not occur without consequences for the body.

During pregnancy, you should avoid excessive physical activity, as well as bad habits. Often, transmitted diseases during pregnancy worsen the excitability of muscle fibers, so you should refrain from active and aggressive sex life.

Prevention and treatment

Already at the planning stage, you can start taking Magnesium B6. This promotes muscle relaxation and helps the fertilized egg to gain a foothold in the uterine cavity without any problems. For each specific case, its own therapy is selected. Uterine tone responds well to treatment and does not always require hospitalization. First you need to understand your psycho-emotional state. A woman is recommended to rest more often and receive more positive emotions.

If you are toned, you should observe bed rest and completely exclude sexual activity. For sedatives, tincture of motherwort or valerian is prescribed. If the reason is low level progesterone, then maintenance drugs are prescribed - Duphaston or Utrozhestan. Antispasmodics (No-spa and Papaverine) are actively used. They are used at all stages of pregnancy. From the second trimester, the prescription of adrenergic agonists (Ginipral) is indicated. This drug is used up to 36 weeks; it relieves hypertension well and will help carry the baby to term. If bloody discharge appears against the background of increased tone, drugs are used to stop it (Dicinone, Sodium Etamsylate). If necessary, physiotherapy is prescribed.

If complaints do not stop and the uterus does not return to normal tone, the pregnant woman is hospitalized or sent to a day hospital. With intravenous or intramuscular magnesium and/or tocolytic therapy, the condition normalizes within a few days. In the first trimester, if there is a threat of miscarriage, injections of progesterone and antispasmodics are indicated. Typically, such hospitalization does not exceed 10 days and the woman is discharged.

Anything can happen to a woman during pregnancy. Any illness is a direct threat to the life of the mother and her unborn child. Among the most critical conditions Women during the period of bearing a child suffer from hypertonicity of the myometrium, and every second expectant mother faces it. In this article we will figure out why the uterus becomes toned, what to do about it and how to prevent it. dangerous consequences this condition.

The myometrium is the muscular lining of the uterus, which is located between the serosa and the endometrium. Normally, the myometrium should be relaxed; it becomes toned only under the influence of factors influencing it. Normal contractions occur during menstruation and during childbirth, when the hormone oxytocin is actively produced. All other factors that provoke myometrial contractions, especially during pregnancy, should alert the woman. Due to contractions of the myometrium during pregnancy, a miscarriage may occur and premature labor may begin.

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

1. Subserosal fibers are strong longitudinal fibers that connect the myometrium to the perimeter.
2. Circular - vascular fibers that reach maximum density in the uterine cervix.
3. Submucosal – internal fragile fibers.

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

• the woman has previously had many abortions;
• she had given birth several times before;
• a hormonal imbalance has occurred in the woman’s body;
• was surgical intervention on the uterus;
• previous births ended in 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 prevent all these negative consequences, a woman must:

• timely take a blood test to detect the level of certain hormones responsible for the safety of pregnancy;
• be constantly monitored by your doctor so as not to miss the beginning inflammatory process in organs genitourinary system;
• You need to lead an absolutely healthy lifestyle and avoid stressful situations whenever possible.

Myometrium during pregnancy: normal

Occurs during pregnancy diffuse changes myometrium, because the uterus increases in size due to the growing fetus. The myometrial 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, taking on the shape of a pear;
• at week 8, the uterus, due to the enlargement of the myometrium and the growth of the fetus, reaches the size of a goose egg, taking on the shape of a ball;
• at week 10, the uterus increases 3 times compared to the indicators at week 8;
• at 12 weeks, the myometrium develops, and the uterus becomes 4 times larger compared to its original size (its size can be compared with the size of the head of a newborn baby);
• at week 20, the myometrial fibers no longer normally thicken or lengthen, they simply stretch.

Normally by the end of pregnancy:

• the thickness of the uterine walls 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 at the end of pregnancy normally corresponds to 25 cm (initial value 6 cm);
• the volume of the uterus before childbirth becomes 500 times greater than the volume of the uterus in the normal state;
• the weight of the uterus before birth is approximately 1.2 kg (not taking into account the weight of the fetus and membranes), and before pregnancy it is 50 g.

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

Myometrial hypertonicity during pregnancy

If an expectant mother is diagnosed with hypertension, there is no need to take it as terrible disease, because it isn't. Myometrial hypertonicity is main symptom the fact that the muscular layer of the uterus is very tense, which should not normally happen during pregnancy, because contractions of the uterus may occur, which will provoke premature birth or miscarriage.

That is why, during ultrasound examinations, diagnosticians must determine the thickness of the myometrium in order to know whether there is a threat of miscarriage.

Causes of myometrial hypertonicity during pregnancy

Due to what factors can the myometrium become hypertonic during pregnancy:

1. Women produce insufficient progesterone.
2. An inflammatory process occurs in the organs of the genitourinary system (most often the cause is endometriosis).
3. Surgical interventions in the uterus that took place before pregnancy.
4. There are neoplasms (tumors, cysts) in the uterus or appendages.
5. The walls of the uterus are overstretched due to the fact that the woman has multiple pregnancies.
6. The expectant mother is constantly exposed to severe physical stress and injury.
7. The woman is in a state of severe emotional shock.
8. A pregnant woman has diseases of internal organs and systems affecting the uterus.
9. Problems with the myometrium occur in older women.
10. Problems with intestinal motility can cause myometrial hypertonicity during pregnancy.

Myometrial hypertonicity: localization and symptoms during pregnancy

Hypertonicity is localized in different areas of the myometrium:

1. Hypertonicity of the myometrium along the anterior wall during pregnancy is a sign that the process of bearing a child occurs with complications. Very often, the expectant mother feels pain in the lower abdomen, in the perineum, and has a frequent urge to empty her bowels and bladder. With hypertonicity of the myometrium along the anterior wall during pregnancy, uterine bleeding is often observed.
2. Hypertonicity of the myometrium along the posterior wall during pregnancy can be asymptomatic for a long time. In the later stages, he may only feel fullness in the perineum and pain in the lower back.
3. 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 in appearance. This is very dangerous symptom, which should be reported to your doctor immediately.

Why is myometrial thickening dangerous during pregnancy?

Thickening of the myometrium at different stages of pregnancy, as we mentioned earlier, can be very dangerous for the life of mother and child:

1. 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.
2. Starting from the 2nd trimester, uterine hypertonicity can cause oxygen starvation of the fetus, which in turn will lead to malformations of the child’s internal organs and systems.
3. 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.
4. Hypertonicity of the myometrium before childbirth will not result in anything bad for either the mother or 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 perform some exercises to alleviate your condition:

• Get on all fours, arching your back and raising your head. 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 completely relax. 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.
• Rub your belly every morning and evening while lying in bed, completely relaxed.
• If your doctor prescribes antispasmodic drugs and the hormone progesterone, you will need to take them on a schedule and maintain strict bed rest so that contractile activity of the uterus is minimal.

Important! All of the above can be done at home in outpatient setting. If bleeding or severe nagging pain appears, call an ambulance to be taken to the hospital for hospitalization.

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

Video: “Why does uterine hypertonicity occur during pregnancy?”

Myometrial hypertonicity is a pathological condition characterized by increased contractile activity of the muscle fibers of the uterus. The development of such a disorder during pregnancy is fraught with miscarriages, premature birth and other dangerous consequences.

Causes of increased uterine tone in pregnant women

Hypertonicity of the uterus (myometrium) can be general or localized in a specific area.

Treatment of severe myometrial hypertonicity is carried out in a hospital

The main hormone responsible for the normal course of pregnancy is progesterone. It performs the following functions in the body of the expectant mother:

• prepares the uterus for the attachment of a fertilized egg;
• reduces the contractility of the myometrium;
• facilitates labor.

With progesterone deficiency, uterine hypertonicity and other serious complications of pregnancy develop.

The second hormone that affects muscle tone is prolactin, which stimulates the development and growth of the mammary glands, preparing them for lactation. Increased contractile activity of the uterus can be caused by a high level of this substance in the blood. Thyroid hormones have no less impact on reproductive function.

Chronic pathologies of the uterus are another common cause of hypertension. These include:

• endometriosis;
• endometritis;
• benign or malignant neoplasms.

Such diseases often occur in women who have had abortions, experienced early or late miscarriages, have scars on the uterus, etc. Increased contractile activity of the myometrium in this case begins from the first days of delayed menstruation and often ends with rejection of the fertilized egg. In the second trimester, increased tone often develops due to a short interval between births, multiple pregnancies, large fetal size, and underdevelopment of the female genital organs.

Other causes of hypertension include:

• infections – respiratory, intestinal, sexually transmitted;
• bad habits – smoking, alcohol, drugs;
• brain damage of traumatic, infectious or tumor origin;
• physical and psychological stress;
• taking a contrast shower;
• drinking strong black tea or coffee;
• abdominal injuries, falls;
• nutritional deficiencies, especially magnesium;
• constipation;
• strong vibration;
• fright

In some women, hypertonicity develops due to stroking the abdomen, exposure to the nipple area, and intimate intimacy.

Patients with increased level male sex hormones - androgens - also run the risk of increased contractile activity of the myometrium. These disorders can be recognized even before testing. Such women have a lot of body hair and have a tendency to develop acne and stretch marks on the skin.

Hypertonicity of the uterus during pregnancy can cause miscarriage, premature birth and other serious consequences

What threatens myometrial hypertonicity at different stages of pregnancy?

In the first trimester, increased contractile activity of the uterus leads to miscarriages, since at this stage the fertilized egg is weakly attached to the uterus.

In the second trimester, there is a risk of developing fetoplacental insufficiency, characterized by premature aging of the placenta. With this pathology, the fetus does not receive enough oxygen and other nutrients, which negatively affects its development and the functioning of the cardiovascular and other systems. There is a high risk at this stage:

• intrauterine fetal death due to severe hypoxia;
• retardation in physical development;
• premature birth, which often ends in the death of the baby if he was born before 22 weeks.

In the third trimester, pregnant women face the same dangers as in the second. Prolonged hypoxia can lead to irreversible changes in the brain, cardiovascular and central nervous systems. These children are often diagnosed with:

• retardation in physical and psychological development;
• speech delay;
• epilepsy;
• pathologies associated with the functioning of the immune system.

The severity of complications depends on the duration of the pathological condition, localization, early diagnosis and other factors. Tone can bother a woman throughout pregnancy or occur from time to time under the influence of unfavorable factors. In both cases, the pregnant woman needs an examination to exclude serious pathologies.

Characteristic signs of the pathological condition

Symptoms of increased myometrial tone vary greatly depending on the duration and location of the pathological process. In the early stages, expectant mothers feel aching pain in the lower abdomen, as during menstruation. It can radiate to the lower back or sacrum. Many people at this stage experience spotting vaginal discharge, varying in intensity and color. The doctor will tell you what this or that symptom means, and you should go to see it immediately after it appears. Otherwise, there is a risk of termination of pregnancy.

Hypertonicity of the myometrium along the posterior wall is most often detected on ultrasound

At later stages, the tone is manifested by the fossilization of the uterus. The abdomen becomes hard and painful. Spotting is less common during this period. Their appearance may indicate placental abruption.

Hypertonicity along the anterior wall of the uterus is felt most clearly. If pathological process is localized in another part, then there may be no symptoms. Increased contractile activity of the uterus along the posterior wall is usually detected during a routine examination.

Diagnostic methods

A gynecologist detects pronounced contractile activity of the myometrium. To confirm the diagnosis, an ultrasound examination of the uterus is performed. It allows you to identify general and local hypertonicity.

To detect the cause of the pathology, the following is taken:

• blood for hormones (progesterone, prolactin, TSH);
• tests for sexually transmitted diseases, herpes, Torch infections;
• clinical analysis of blood and urine.

According to indications, ultrasound of the kidneys and adrenal glands and MRI of the brain are performed. X-ray studies Contraindicated for pregnant women.

At later stages, cardiotocography is prescribed.

Outpatient and inpatient treatment

For most pregnant women with this pathology, doctors suggest hospitalization, but the final decision is made by the patient. Severe hypertonicity requires mandatory hospital stay.

The gynecology department does the following:

• treat the underlying pathology;
• drips with magnesium, glucose, drotaverine are placed;
• They give progesterone injections.

Outpatient treatment of hypertension includes taking sedatives, antispasmodics and hormonal drugs. They are usually prescribed in tablets or suppositories. The duration of treatment is determined by the doctor. Hormonal preparations based on progesterone are taken according to an individual regimen, which involves a gradual reduction in dosage. With abrupt cancellation there is a risk of embryo rejection.

For local or general hypertension, which occurs in a mild form, valerian or motherwort helps.

For improvement therapeutic effect a woman needs peace and rest.

Stress, severe psychological or physical stress during this period are unacceptable. Intimacy also prohibited.

If hypertension does not go away for a long time or occurs too often, you need to go to the hospital for treatment.

In most cases, myometrial hypertonicity can be prevented. To do this, married couples are advised to prepare for pregnancy in advance, namely:

• quit smoking, stop drinking alcohol and drugs;
• stop taking medications prohibited during pregnancy;
• take tests for sex hormones and infections;
• do an ultrasound of the pelvic organs;
• take care of proper nutrition so that there is no nutritional deficiency in the body.

In case of unplanned conception, you need to register as quickly as possible and undergo an initial examination.

• get plenty of rest and good sleep;
• spend a lot of time outdoors;
• do light exercises for pregnant women;
• avoid stressful situations;
• visit a gynecologist regularly;
• do not refuse a scheduled examination;
• limit communication with infectious patients;
• If you suspect hypertension, go to the doctor immediately.

At the antenatal clinic, pregnant women with complaints of spotting and pain in the lower abdomen are admitted without waiting in line. If a woman feels unwell and cannot walk on her own, it is better to call an ambulance.

If hypertonicity is detected along the anterior or posterior wall, you need to be examined and find its cause

With timely detection of myometrial hypertonicity, the prognosis is usually favorable. Ignoring the problem and lack of treatment often leads to the death of the fetus or the birth of a child with pathologies.