If the uterus is in good shape what to do. Tone of the uterus during early pregnancy. Causes, symptoms, treatment, how to recognize and what to do. Video: How to do the exercise "Cat"

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How to remove the increased tone of the uterus during pregnancy. Causes and symptoms in the 1st, 2nd and 3rd trimester. Sensations of pregnant women with tone. What to do and how to treat at home (mom reviews).

From a medical point of view, the uterus is a hollow internal organ. It consists of two mucous membranes (external and internal) and a muscular "layer". In a normal state, the uterus is relaxed (the so-called normal uterine tone).

During pregnancy, the muscles of the uterus contract, in medicine this phenomenon is called tone. Muscles can contract due to laughter, coughing, sneezing, and the psychological state of a woman can affect them.

A slight tension of the muscles of the uterus is considered normal if it is short-term and does not cause expectant mother inconvenience.

Prolonged and painful contraction of the muscles of the uterus is called hypertonicity. This condition threatens the fetus and pregnancy. In the 1-2 trimester, the tone can cause a miscarriage, at a later date (3 trimester) it can provoke premature birth.

Reasons for the appearance

Prolonged, painful tension in the muscles of the uterus (hypertonicity) occurs from:

• nervous overload, stress;
• unhealthy lifestyle (bad habits);
• muscle strain during significant physical exertion;
• improper production of hormones at the initial stage of pregnancy (the body does not produce enough progesterone, which relaxes the muscles);
• structural and inflammatory changes in the body (myoma, endometriosis);
• significant stretching of the muscles of the uterus (the uterus can stretch from a large fetus, multiple pregnancy, polyhydramnios);
• diseases transferred by the mother (tonsillitis, pyelonephritis, influenza);
• previous abortions;
• severe toxicosis;
• Rh - conflict between mother and child (the body of a Rh - negative mother can reject a Rh - positive child as a foreign body, resulting in an increased tone).

Feelings in the first trimester

The tone of the uterus at the beginning of pregnancy can lead to the death of the embryo and miscarriage. The danger of hypertonicity in a short time is that it is almost impossible to “feel” it on your own (the uterus is still small in size).

Strong and prolonged pain in the lower abdomen should alert (pain is stronger than that which happens during menstruation).

A pregnant woman needs to visit a doctor in order to find out exactly the cause of the pain, since there are often cases when this “manifests itself” ectopic pregnancy. In addition to frequent and prolonged pain in the lower abdomen, you should also consult a doctor if there is bloody discharge from the vagina, the sudden disappearance of signs of pregnancy (the breast has stopped swelling, the basal temperature has decreased).

Tone in the second trimester

In the 2nd trimester, a small tummy appears, but increased uterine tone still poses a danger to pregnancy. The tension of the muscles of the uterus negatively affects the development of the child. The baby does not receive enough nutrients (tense muscles can "block" the blood vessels, provoking the development of hypoxia). In especially severe cases, this leads to a fading pregnancy or miscarriage.

It is rather difficult for most women to determine uterine tone even in the second trimester, since again the main sign of “malfunctions” is the characteristic pain in the lower abdomen, while the uterus “hardens”, shrinks (at the end of the second trimester, the expectant mother can already visually notice signs of tone when the uterus tenses, shrinks).

Tonus in the third trimester symptoms

The tone of the uterus in the third trimester is most often periodic. The uterus may contract and relax after a few seconds. This situation is considered quite normal, since the woman’s body is preparing for childbirth, such “changes” are called training contractions.

However, not all cramping pains of the third trimester should be attributed to training contractions. You can do a simple test. You need to take paper and a stopwatch and detect the frequency of pain. If the stomach tenses up every 5-10 minutes, this is a “training” of the body before childbirth (the test is informative after 30 weeks).

With severe and prolonged pain that does not go away for a long time, you should consult a doctor. Hypertonicity of the uterus in the third trimester is fraught with premature birth. The child may not yet be ready for birth (28-30 weeks), then the baby will need long-term rehabilitation and nursing.

What to do, how to treat

The answer is simple - see a doctor. Moreover, it is best to do this at the first suspicion of increased tone. The specialist will determine the severity of the tone, possible risks.

If there is no threat of termination of pregnancy, treatment is possible at home. A woman is prescribed bed rest, prescribed drugs that relieve spasm (no-shpa, papaverine), drugs containing magnesium and sedatives (sedatives).

AT difficult cases The mother-to-be needs hospitalization. In the hospital, constant monitoring of doctors is provided, there are fewer “temptations” to violate the regime ( complete absence physical activity, whereas at home it can be problematic to provide peace).

Toning exercises

From increased tone you can get rid of the uterus at home, but this does not mean that you need to forget about medications prescribed by the doctor. You can use relaxation exercises.

What is uterine tone?

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

There are the following options for the state of the uterine muscles:

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

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

Causes of increased uterine tone

Increased uterine tone is very often observed in early or late pregnancy. There are many factors that cause tension in the muscles of the uterus during pregnancy. Usually these are various irritations that can cause tension in the muscular organ: sexual arousal, any physical activity, stress, nervous tension etc. This phenomenon cannot be neglected, since the high tone of the uterus can be very dangerous.

When a pregnant woman first has uterine hypertonicity, she just needs to tell the doctor about this so that he sends her for an ultrasound diagnosis. In the absence of any pathologies during the diagnosis, a closed cervix of the uterus, a cervix over 3 cm long and a fetal heartbeat should be visible.

These indicators show that the appearance of increased uterine tone is not dangerous either for the pregnant woman or for the fetus. If during ultrasound diagnostics, the opening of the cervix of the uterus at a distance of more than 5 mm, a small uterus (length from 2.5 to 3 cm), this indicates a serious risk of miscarriage in the first trimester.

How to remove the tone of the uterus at home?

The uterus can contract not only under the influence of the factors described above, but also with contraction Bladder or intestines. The contraction of the bladder occurs as a result of its filling, and the intestines - at the moment food enters it. If a woman has no complications during ultrasound diagnostics, then spasms usually pass quickly and do not cause severe pain.

If uterine spasms cause unpleasant pain and are accompanied by any pathologies, then it may be necessary to relieve the tone of the uterus. health care so you should consult a doctor. If there are cramps in the lower abdomen, you should try to remove them yourself. To do this, you need to relax - sit down or lie down, stroking your stomach and talking to your future baby.

If possible, to relieve the tone of the uterus, you can try to take a relaxing warm bath. When taking a bath, it is not recommended to add various aromatic substances, because they can cause uterine tone or increase it. It is impossible to take a bath to relieve the tone of the uterus for women who do not have any pathologies, namely, discharge from the genital tract.

The main causes of increased uterine tone

The basis of the tone of the muscles of the uterus is the activity of the endocrine system, namely the synthesis of the hormone progesterone. This hormone is synthesized very actively in the first 2.5 months of pregnancy, later its synthesis declines. The hormone progesterone helps to reduce the tone of the uterus, as well as reduce intestinal tone.

This is the reason why women often experience constipation during pregnancy. Lack of progesterone production can lead to increased uterine muscle tone. The lack of progesterone is due to several reasons. First, underdeveloped organs of the reproductive system. An underdeveloped uterus cannot withstand the heavy load that affects it, and, as a result, it shrinks.

Secondly, the increased content of male hormones in the female body. They are produced by the adrenal glands. A woman can find out about this even before pregnancy by the following signs: violations menstrual cycle, increased hairline, deterioration of the skin before menstruation, etc. Thirdly, the increased content of the hormone prolactin in the blood.

It manifests itself in the release of milk from the nipples and menstrual irregularities before pregnancy. Cause the tone of the uterus can not only lack of progesterone, but also various diseases suffered before pregnancy. These include: growth of the inner lining of the uterus, called endometriosis; inflammatory diseases uterus and its appendages.

The tone of the uterus during pregnancy can be identified independently by the following signs: heaviness and discomfort in the lower abdomen. Pain in the lower abdomen with increased tone of the uterine muscles is very similar to pain during menstruation. For diagnosis, in addition to ultrasound diagnostics, palpation can be used.

During probing of the abdomen with an increased tone of the muscles of the uterus, the abdomen will feel the firmness of the abdomen, which should normally be soft. To diagnose the tone of the uterus, you can use one of the most modern methods - tonusometry (measurement of the tone of the uterus using a special device).

Having learned about the tone of the uterus, it is extremely important for a pregnant woman to try to calm down and avoid unnecessary worries. Very often, when detecting the tone of the uterus, a pregnant woman is prescribed sedatives and advised to observe bed rest. Often, the tone of the uterus is treated in the hospital under the strict supervision of specialists, because there may be a risk of miscarriage.

Treatment of increased uterine tone

If the cause of uterine tone is any pathology, then it is necessary to start with its treatment. If the reason is insufficient synthesis of the hormone progesterone, then pregnant women are prescribed drugs Utrozhestan or Dufaston. Often, with uterine muscle tone, antispasmodic drugs are prescribed, such as Papaverine, No-Shpa, bromine infusion, valerian, vitamins E and C. Before you start taking any of these drugs, you should consult a doctor to avoid negative consequences.

Highly a good remedy, which allows you to cope with increased muscle tone, is Magne B6. This drug allows you to restore the lack of vitamin B6 in the body. Magne B6 contains a large amount of magnesium, which reduces muscle tension. Vitamin B6, which is part of this drug, has a calming effect on the nervous system, which is simply necessary for pregnant women suffering from uterine hypertonicity.

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

To remove the increased tone of the uterus helps:

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

Magnesium sulphate/magnesium sulphate, intravenous solution only, to reduce uterine tonus it is currently used only when other drugs are contraindicated for one reason or another

Drotaverine (no-shpa, spazmonet) 1-2 tablets. 3 times a day (120-240 mg of drotaverine). The appointment of the drug during pregnancy and lactation is not contraindicated. Prescribed with caution during pregnancy (I trimester) and lactation

Among other things, a pregnant woman who has an increased tone of the uterus is not recommended to have sex. This is due to the fact that the muscles of the uterus are strongly contracted during orgasm, which can cause a miscarriage.

To avoid problems associated with increased uterine tone, it is necessary to observe its prevention. To do this, a pregnant woman should avoid overwork, stress, nervous strain, and should also master some yoga techniques necessary for relaxation. Also, for the prevention of hypertension, you should go to an appointment with an endocrinologist, a gynecologist, and preferably a neuropathologist.

Muscle hypertonicity - dangerous phenomenon, it can lead to serious consequences. Increased uterine tone in the early stages of pregnancy is the cause of fetal death, termination of its further development and termination of pregnancy. In addition, it can lead to poor blood supply to the placenta and oxygen starvation.

In order to avoid problems, how to remove the tone of the uterus in the early stages of pregnancy, you must follow all the recommendations of gynecologists, take care of yourself and observe the prevention of muscle hypertonicity.

Why is it dangerous for the fetus, what are the symptoms and treatment? Doctors diagnose uterine tone during pregnancy in 60% of cases.

What is uterine tone during pregnancy

Uterine tone- This is an indicator of the state of the muscles of the uterus, which expresses the degree of its tension. The tone of the uterus is measured in millimeters of mercury.

The following options for the state of the muscles of the uterus are possible:

• Decreased tone of the uterus- a pathological condition that occurs in the early postpartum period, characterized by excessive relaxation of the uterine muscles. Decreased tone may be the cause of hypotonic uterine bleeding.
• Normal uterine tone- the physiological state of the uterus, regardless of the presence of pregnancy, in which the muscles are at rest.
• Increased uterine tone during pregnancy- the state of tension of the muscles of the uterus. It can be permanent and temporary (contractions during childbirth). The increased tone of the uterus can be complete (covers the uterus completely) or local (manifested in one specific place).
• Uterine hypertonicity- pathology of labor activity, in which more than four contractions occur within 10 minutes. Often, both doctors and patients use the term "hypertonicity" to refer to the high tone of the uterus in pregnant women - this is not entirely correct, since hypertonicity manifests itself precisely in the process of childbirth.

Normal and pathological uterine tone

During pregnancy, the norm of tone are indicators within 8-12 mmHg st. A slight and short-term increase in these values ​​\u200b\u200bmay be normal and physiological if, for example, it occurs in response to fetal movements. But if such tension of the uterus is prolonged and accompanied by painful sensations, then this is a dangerous sign of an increased risk of premature birth and miscarriage. If uterine contractions become periodic and repeat at regular intervals, which leads to the opening of the cervix, these are alarming symptoms of incipient preterm labor (with a period of weeks) or spontaneous abortion (with a period of up to 22 weeks). This situation requires emergency hospitalization and medical intervention.

Causes of increased uterine tone

There are many reasons for increased uterine tone. Most often, these are infections in the mother's body, such as: infections of the oral cavity, urinary tract, gastrointestinal tract, skin diseases. An important role is played by socio-economic factors:

• too young or vice versa mature age(under 18 and over 35 years old);
• bad habits (alcohol, smoking, drug use);
• the presence of severe chronic diseases, especially such as obesity or arterial hypertension;
• complex relationships in the family;
• poor living conditions;
• emotional overload;
• difficult working conditions, chronic fatigue syndrome.

All these factors or their combination can adversely affect the development and course of pregnancy.

Also, an increase in the tone of the uterus can provoke complications of pregnancy:

• incorrect position of the fetus (oblique or transverse);
• various pathologies of the placenta (hypoplasia, placenta previa, premature aging);
• anomalies in the development of the uterus (bicornuate or saddle shape, uterus with an incomplete septum);
• and scars after its removal;
• scars after a previous caesarean section;
• a history of premature birth, miscarriage, abortion;
• nephropathy;
• the occurrence of fetal malformations, as a rule, incompatible with life.

Symptoms of increased uterine tone during pregnancy

How to determine the tone of the uterus during pregnancy yourself? Most often elevated tone during pregnancy manifested by pulling or aching pain in the lower abdomen, similar to menstrual pain. Periodically, there may be sensations that the uterus is "stiffening", a feeling of tension in the stomach, increased urge to urinate, and sometimes an increase in the fetal motor activity. In a more rare case, it can be observed from the genital tract, softening and shortening of the cervix.

• Rare and painful fetal movements can signal that placental blood flow is disturbed due to tension in the muscles of the uterus, and the fetus experiences oxygen deficiency, which leads to hypoxia, developmental delay, and placental pathologies.

Diagnosis of uterine tone

Increased uterine tone is not a diagnosis as such, it is only the main symptom. To diagnose the tone of the uterus, sometimes palpation of the abdominal wall is quite enough, but it should be remembered that this assessment is not always objective. A more accurate diagnostic method is KTG(cardiotocography - registration of the fetal heartbeat and uterine contractions), which gives an objective assessment of the situation during uterine contractions and between them, which allows you to track the effectiveness of treatment and the dynamics of uterine activity.

Treatment of increased tone

If a uterus in good shape during pregnancy what to do? To prevent an unfavorable outcome of pregnancy (miscarriage or premature birth), increased uterine tone must be normalized. Since there is a real threat of abortion, it is necessary to seek medical help at the first sign of increased uterine tension.

The tone of the uterus impairs oxygen saturation and nutrition of the fetus, so treatment is necessary.

To reduce the activity of the uterus, prescribe the use of special drugs called tocolytics. This is a series of drugs that belong to different pharmacological groups, but have the same effect - they reduce the muscular activity of the uterus.

These include:

• Ginipral, Partusisten, Salbutamol. Currently, the most effective and safe drug in this group is Ginipral. In extreme cases, drugs are prescribed in the form of intravenous injections, and as the condition improves, they switch to the form of tablets.
• Nifedipine- the drug exists only in the form of tablets, it is prescribed in exceptional cases strictly under the supervision of a physician.
• Magnesium sulfate as a solution for intravenous infusion. It is used only in the presence of objective contraindications to other drugs.
• Indomethacin- is prescribed in the form of suppositories, as a rule, as maintenance therapy.

Predictions for increased tone

A favorable outcome depends on many factors: the duration of pregnancy, the condition of the fetus and its position in the uterus, the condition of the cervix, the integrity of the mucous membranes (rupture of the membranes), complications during pregnancy, the presence of concomitant diseases, the timeliness of contacting a doctor and, accordingly, the time of treatment started. . And, of course, it is very important to remain optimistic and not panic.

Prevention

A very important and crucial stage is the planning of pregnancy and the preparation of the body for conception. It is advisable to go through a complex even before the onset of pregnancy, to cure possible foci of infection of the genitourinary system, oral cavity. You should pay close attention to the hygiene of work and rest, as well as strictly follow all the appointments and recommendations of your doctor.

The body needs a sufficient amount of magnesium. With the onset of pregnancy, the daily requirement for magnesium increases to 400 mg per day! Magnesium has a direct effect on the ability of the uterus to relax, and in addition, reduces nervous excitability, which is of great importance for a pregnant woman and an unborn child. Magnesium is found in nuts, green vegetables, bread, bran, buckwheat and oatmeal.

For the expectant mother, her new state becomes fantastic, new sensations, habits, desires and emotions appear. But in addition to enjoying the cosmic feelings of bearing a small life, one has to constantly monitor the state of health. The tone of the uterus during pregnancy is a frequent diagnosis that a woman can hear at different times. It is necessary to reduce all the risks and dangers associated with this pathology for the viability and development of the baby.

Uterus, structural features

It is very simple to imagine how conception occurs with subsequent gestation. After the fusion of the egg and sperm, a special cell is formed - a zygote. It is she who is the basis of all future internal systems and organs. A week after fertilization, the amniotic egg is attached to the uterus.

This body consists of 3 layers. The perimetrium is the outer shell, the myometrium is the muscle tissue that performs such dangerous contractions, and the endometrium is the inner layer, during pregnancy, its vessels will be part of the placenta to supply the baby with oxygen and nutrients.

What is uterine tone? These are muscle contractions that occur before the expected delivery date. As the fetus grows, the main reproductive organ will also increase; by 40 weeks, its weight reaches 2 kg. By nature, tension occurs only during menstruation, when fertilization has not occurred, and particles of the endometrium (blood vessels) come out.

After the onset of conception, the uterus should normally be in a calm, relaxed state for all 9 months. Also, the tone will increase immediately before childbirth, for 1-2 weeks, such conditions are called training contractions, they do not pose a danger.

How to determine the tone of the uterus

You can independently determine the increased tone of the uterus at different stages of pregnancy. It is enough just to diagnose the expectant mother in what condition the reproductive organ is. When the first signs appear, it is necessary to consult a doctor.

Symptoms of uterine tone during pregnancy:

• the most dangerous contractions are considered in the 1st trimester, during this period, heaviness can be felt as during menstruation, accompanied by lingering pain in the lower abdomen, radiating in the lower back, if you ignore this condition, there is a threat of spontaneous miscarriage, up to 12 weeks you need to closely monitor any sensations that arise;
• the symptoms in the 2nd trimester are similar to the signs that appear in the 3rd trimester, visually one can notice the contraction of the abdomen, when pressed, it becomes hard, like a stone, urination becomes more frequent, dizziness is observed, and the woman easily recognizes an increase in tone;
• the pulling pain that appeared and noticeable contractions after 36 weeks signal the beginning of the preparation of the body for the birth process, false contractions may appear in a week, quite intense and prolonged;
• in some cases, the tone may be asymptomatic, the expectant mother feels great, leads an active lifestyle, and the doctor's diagnosis is surprising, to obtain confirmation of the condition, it is worth conducting the recommended studies.

If pain occurs in the lower abdomen, along with red or brown discharge at any gestation period, it is urgent to contact a gynecologist.

Reasons for the appearance

If you independently determine the tone of the uterus by the uncomfortable sensations that have arisen in the lower abdomen is quite simple, then you have to understand the provoking factors only with the help of a doctor.

Main reasons:

• in the early stages it is caused by a hormonal background, a lack of progesterone leads to the rejection of the embryo by the mother's body;
• anatomical pathologies of the uterus - incomplete development or deviations in the formation of the organs of the reproductive system;
• with the predominance of male hormones in a pregnant woman, the accompanying signs of hyperandrogenism are hair growth above the upper lip and chin, frequent mood swings, an irregular cycle, poor skin condition;
• if the pituitary gland produces a large amount of prolactin, this can only be detected by a blood test, before pregnancy it manifests itself in the irregularity of the cycle;
• inflammatory diseases of the reproductive system, which were transferred long before the onset of conception;
• uterine fibroids - a benign formation, during the gestation period, treatment is carried out with drugs with a high iron content, a special diet is prescribed, only after childbirth is therapy with hormonal medications possible;
• polyhydramnios, bearing several fetuses, as well as the large size of the child leads to an increase in pressure, and naturally the muscular organ begins to contract;
• chronic diseases of internal organs, malfunctions of the cardiovascular, excretory, endocrine systems provoke an increase in tone, often in such cases a woman is recommended to go to the hospital.

Of great importance is the lifestyle that a pregnant woman leads. Bad habits, no rational nutrition, physical and mental stress lead to the emergence of pathological conditions.

Diagnostics

In medicine, there are several ways to detect such deviations. Women often wonder - how to understand that the uterus is in good shape during pregnancy? To do this, you can go through another examination by a gynecologist, the doctor will quickly determine whether there is a threat or not. Ultrasound is used to determine the extent and location.

• Grade 1 - a slight compaction of the uterus, which is asymptomatic, passes on its own in a relaxed, calm state, possible pain in the lower abdomen, they are of a short-term nature, restrictions in the mode of activity and rest are recommended;
• Grade 2 - the tension of the reproductive organ is higher, and therefore the pain in the sacrum, lower abdomen, lower back is more pronounced, drug therapy is required;
• Grade 3 - with any slight pressure, the uterus becomes stone, pain in the abdomen and lower back intensifies, the woman cannot perform her usual duties, the condition requires complete rest and qualified treatment.

Kinds

Hypertonicity along the anterior wall is determined if the muscle fibers of the anterior wall of the uterus are in tension, this is a clear signal of complications. In the absence of qualified and timely treatment, spotting may occur, and pain intensifies, direct signs of a threatened miscarriage. Emergency assistance, consisting in hospitalization, is recommended for a woman if there is a tone on the anterior wall both in the 1st and 2.3 trimesters.

The tone along the back wall often does not have pronounced symptoms, the expectant mother may not feel contractions. In some cases, there is discomfort when walking, after performing physical exertion, or emotional experiences. Sometimes a pregnant woman feels pressure in the vagina or rectum, if there was an experience of childbirth, sensations similar to attempts.

Treatment and therapy

Grabbing your head in a panic is definitely not worth it. If the uterus is in good shape during pregnancy, what to do - the attending physician will tell you. Initially, diagnostics will be required to identify the causes - a blood test for infections, ultrasound of the pelvic organs, obtaining a reproductive hormonal panel, additional studies. And only after receiving the results, an action plan will be developed.

How to remove hypertension at different stages of pregnancy:

• in the 1st trimester, a woman is prescribed complete rest, including bed rest, therefore it is recommended to go to the hospital, it is also necessary to drink a complex of provitamins, if the reason lies in hormonal disruptions, the drugs appropriate to the diagnosis are individually selected;
• with signs of hypertonicity in the 2nd trimester, antispasmodics No-shpa are used (orally or intramuscularly) with Papaverine (suppositories), sparing sedatives, in particular motherwort and valerian tinctures, among medicines are Sibazol and Nozepam, they reduce muscle activity - Brikanil, Partusisten, sulfate magnesium;
• in the last trimester, the risk of the birth of a non-viable fetus is minimized with the help of drug therapy; tocolytics are used to inhibit preterm labor.

Simple but effective exercises will quickly relieve tension in the uterus:

• sit comfortably on a sofa or chair, close your eyes, relax the muscles of your neck and face, focus on even and deep breathing, hold in this position from 10 minutes to an hour;
• stand in the pose of a dog, tilt your head back, at the same time arching your back, your eyes are fixed on the ceiling, linger for 3 minutes, then lie down, rest for an hour;
• you need the uterus to be in limbo for some time, lean your elbows on the table or back of the chair, after standing for 5 minutes, you can go to bed.

In addition, pregnant women will be recommended a special sparing regimen, as well as a diet (vegetables, cereals, nuts). If there is a threat of tone, warm herbal baths are prescribed, from the second trimester it is recommended to wear a bandage. It is useful for the expectant mother to master the technique of self-massage - light relaxing stroking of the lower abdomen and preventive gymnastics.

Expectant mothers are often diagnosed with "uterine tone during pregnancy." Those who bear their first child do not recognize this danger and often do not understand how everything can end. But even more “experienced” pregnant women are usually afraid of tone in the 1st trimester and mistakenly believe that nothing terrible will happen in the later period.

Why does uterine hypertonicity occur, how to recognize it, why pain cannot be tolerated, what drugs can be taken to get rid of it? You will find answers to these and other questions in our article.

The organ of the female reproductive system - the uterus - consists of external and internal mucous membranes, between which there is a muscle layer (myometrium). Like all other human muscles, the myometrium has the ability to contract and relax. But if a woman can “control” the muscles on her arms and legs, then she cannot control the muscle layer of the uterus. For example, the uterine muscles contract when a woman laughs, coughs, or sneezes.

This process occurs imperceptibly and painlessly, but until the woman becomes pregnant. When a fertilized egg begins to grow inside the uterus, female body tries to reject it as a foreign (as it seems to him, completely unnecessary) body. The myometrium contracts, and the expectant mother is in pain at this moment. This is called hypertonicity of the uterine muscles.

Painful sensations can be weak or strong, last a few seconds or minutes, appear a couple of times or disturb constantly. If a woman does not yet know about her pregnancy, she often does not understand the danger that threatens her and her baby. And if the gynecologist knows and has already managed to scare her that there should be no pain during pregnancy, she begins to worry, and thereby only makes it worse.

In a woman who was absolutely healthy before the conception of a baby, during pregnancy, the uterus comes into tone for the following reasons.

1. "Sedentary" work or the need to stand on your feet for several hours, travel in public transport.
2. stressful situations.
3. Failure of the hormonal system in the 1st trimester: deficiency (it is produced by the ovary to relax the myometrium, in the 3rd trimester this task is performed by the placenta) or an excess of male hormones.
4. Toxicosis, which is accompanied by severe vomiting (in the 1st trimester). An increased tone of the myometrium occurs because the muscles of the organ tense during vomiting. Toxicosis is considered normal in the first trimester. But if a pregnant woman constantly experiences nausea at the mere sight of food, if she loses weight, the child will not receive the necessary nutrients. Is not in the best way affect its development.
5. The movement of the fetus at a later date (in this case, hypertonicity of the uterine muscles should not be afraid).

At risk are expectant mothers who have:

• harmful (smoking, addiction to alcohol);
• a large number of abortions;
• multiple pregnancy. A large load is created on the walls of the uterus. In some cases, she has to stretch to enormous sizes;
• special structure of the reproductive organ (bicornuate, saddle-shaped, baby uterus);
• negative Rh factor. If the pregnant woman has a blood type with a negative Rh factor, and the biological father of the child has a positive one, the mother's body tries to reject the fetal egg as a foreign body. But the first such pregnancy usually proceeds well;
• thyroid dysfunction;
• polyhydramnios;
• viral and infectious diseases, including those that are sexually transmitted (ureaplasma, chlamydia, mycoplasmosis, viruses);
• myoma;
• diseases of the gastrointestinal tract. Hypertonicity of the uterus appears with strong gas formation.

Some diseases, such as sexually transmitted infections, can only be treated in the third trimester, because antibiotics have to be taken. It is also impossible to refuse treatment: the placenta protects the child, but some substances can penetrate through it and adversely affect the development of the fetus.

Hypertonicity of the uterus throughout pregnancy manifests itself in different ways. In the 1st trimester it is:

• dizziness, nausea;
• dull pulling pain in the lower abdomen, as during menstruation, in the lower back or perineum (it can be of the same strength or “roll”, intensify, then weaken).

In the 2nd and 3rd trimesters, a “fossilized” abdomen is added to them. A tense uterus can be felt if you put your fingers on your stomach.

Another sign of increased tone is bloody discharge from the genital tract. They can be profuse or spotting, beige, brown, pink, or streaked with blood. Normally, only light discharge is observed. In all other cases, you should immediately contact a gynecologist.

At a later date, when there is little room for a large child in the womb, you can see how the baby is “stretched”. At this moment, the muscles of the uterus tense up, and the woman feels the fossil of the abdomen well, sees how it changes its rounded shape (one side of the abdomen seems to sink, while the other, on the contrary, begins to bulge more strongly). It lasts just a few seconds and does not pose any danger to either the mother or the baby.

Diagnostics

In order to understand whether the tone of the uterine muscles in a patient is increased, doctors use three methods:

• palpation (palpation with fingers);
• tonusometry.

In the 2nd trimester of pregnancy, the doctor can "feel" the tone of the uterus with his fingers through the anterior wall of the abdominal cavity. During the examination, the woman lies on her back and keeps her legs bent at the knees. In this position, the abdominal muscles relax, and the uterus, if it is dense, is well palpable.

Ultrasound is used as an auxiliary diagnostic method. The results obtained allow us to understand the degree of threat (complications, miscarriage) and the need for hospitalization.

With tonusometry, muscle tension is detected using special sensors. This method is rarely used, since the other two provide comprehensive information.

Elimination Methods

Increased uterine tone is treated on an outpatient basis and in a hospital. The first option is chosen when the expectant mother is concerned about mild pain in the lower abdomen or lower back. At the same time, she does not have spotting, and up to this point the pregnancy has proceeded without complications. Hospitalization is recommended in the case when it is not possible to remove the increased tone for a long time.

At home, a woman should rest more, forget about sexual activity for a while, take antispasmodics (No-shpu, Drotaverine, Papaverine - a solution for intramuscular injections or rectal suppositories), sedatives (motherwort, valerian) and progestogen (Utrozhestan) drugs, as well as Magne B6 .

Medicines have contraindications. You cannot self-prescribe medications. This must be done by a doctor. The dosage in each case, he selects individually.

• "Cat". It is performed as follows: kneel, rest your palms on the floor, carefully bend your back, then arch. Repeat 5-10 times. After that, it is better to lie down for half an hour or an hour, especially if the exercise is performed in the 3rd trimester of pregnancy.
• Tense facial muscles can cause uterine contractions. By relaxing the facial muscles, you can eliminate the hypertonicity of the uterus. To do this, the pregnant woman needs to get on all fours, lower her face down, relax her facial muscles. Breathe through your mouth.
• Knee-elbow posture. This exercise is performed as follows: a woman needs to kneel and rest her elbows on the floor, stand like this for 1-10 minutes. In this position, the uterus will be in a suspended position and will be able to relax.

Exercises should be performed carefully, at a slow pace. If the pain intensifies, you need to stop, rest, lie down. With severe persistent pain, it is better to call a gynecologist, consult or immediately call an ambulance.

If a pregnant woman has a high muscle tone for a long time that cannot be removed or spotting has appeared, doctors will insist on hospitalization. In the hospital, the expectant mother will have to observe bed rest.

In the 1st trimester, she will receive intramuscular injections of No-shpa, Papaverine, vitamins, sedatives, and Utrozhestan. If there is spotting, they will be stopped with Dicinon or Tranexam.

But all these remedies stop the symptoms and do not solve the main problem - the elimination of the cause.

In the 2nd trimester, a pregnant doctor may prescribe:

• electrophoresis with magnesia;
• droppers with Ginipral;
• vitamin and mineral complex.

In the 3rd trimester, the same drugs are used to treat increased uterine tone. If, according to the results of the ultrasound, it becomes clear that the tone is strong and the child receives little oxygen and nutrients, the expectant mother is prescribed Curantil or Trental.

These drugs are allowed to be taken only as prescribed by a doctor. For example, Curantyl can cause severe headaches. But if a woman takes several drugs, she will not be able to understand what exactly caused the adverse reaction. You need to tell your doctor about your condition. He will decide which medication to remove.

Possible negative consequences and prognosis

Uterine contractions are a pain that cannot be tolerated in the hope that everything will go away with time. The tone carries a great danger, first of all, for the developing fetus.

In the 1st trimester, spontaneous miscarriage (detachment of the fetal egg) can occur. Pregnancy may not be interrupted, but freeze due to the fact that the fetus did not receive oxygen and nutrients. In both cases, the pregnancy cannot be maintained.

In the 2nd and 3rd trimester, placental abruption does not occur, but another problem appears: the uterus, contracting, compresses the fetal bladder, as a result, the cervix opens and preterm labor begins. In some cases even if the cervix is ​​closed. It is most often possible to save a baby if the gestational age is 36-38 weeks.

Prevention

To prevent increased uterine tone, pregnant women are advised to follow a few simple rules.

1. Get tested for genital infections at the stage of pregnancy planning.
2. Get registered in a timely manner, regularly go to "appearances" to the gynecologist, follow his recommendations.
3. Sleep 8-10 hours a day.
4. Be sure to breathe fresh air, but it is better to refuse long walks.
5. Avoid stressful situations.
6. Do not create excessive physical activity for yourself.
7. Eliminate the use of alcoholic beverages at the stage of pregnancy planning.
8. Quit smoking.
9. Do not lift heavy objects, especially in the 3rd trimester.

A pregnant woman should eat right. In her diet, there must be foods rich in magnesium:

• vegetables, greens (cabbage, basil, spinach);
• cereal crops (wheat, barley, buckwheat);
• dairy products (cheese, natural yogurt).

This microelement helps to relax the smooth muscles of the intestines and myometrium (the muscle tissue of the uterus). In addition, it has a beneficial effect on the central nervous system.

Conclusion

The tone of the uterus during pregnancy is a diagnosis that gynecologists put 60% of women. Symptoms of hypertonicity - pain in the lower abdomen or lower back, "fossil" of the abdomen, spotting. Muscle spasm can cause placental abruption (miscarriage) or preterm labor.

There are many reasons for the appearance of increased tone, but you can prevent its occurrence if you perform simple rules prevention: get plenty of rest, be less nervous, eat right and listen to the doctor's recommendations. Self-medication can lead to sad consequences.