Among the possible complications of the gestation process, uterine tone during pregnancy occupies a separate position. This condition often causes miscarriage or premature birth. Timely and correct treatment can eliminate such an outcome.
What it is
The uterus is an organ of the female reproductive system, which consists of three types of tissue:
- The endometrium is the mucous tissue that is found inside the uterine cavity.
- The myometrium is smooth muscle that is located in the middle, between the endometrium and the perimeter.
- Perimetry is the outer mucous tissue, the upper layer of the organ.
In normal condition, the muscle tissue of the uterus is relaxed. It is called normal tone.
In some cases, during pregnancy, long before the date of birth, a pregnant woman’s uterus begins to contract slightly. This is increased tone, or hypertonicity. It can be either natural or pathological.
If the contractions are light and short in duration and do not cause pain or any discomfort in the expectant mother, they can be natural.
The danger is increased tone, which lasts for a long time. This condition is dangerous for the baby and requires treatment so that the woman can maintain the pregnancy.
What is tone and its consequences for the body?
The uterus is a dense muscular organ with a hollow base, which is endowed with three layers:
- The perimeter is a “strong” protective mucous membrane, which is the first and main layer.
- The myometrium is a layer that consists of muscles responsible for contractions of the uterus.
- The endometrium is a thin mucous membrane that forms the basis of the organ.
When conception occurs, the load on the uterus increases every day as a result of the rapid growth of the fetus, and the size of the muscles changes upward, becoming 10 times longer and 4-5 times thicker. These changes cannot occur asymptomatically, so the woman often feels severe stabbing pain.
During a normal and healthy pregnancy, the muscles of the uterus are calm and relaxed. However, already in the 7th month of gestation, the expectant mother may feel “training” contractions, which must be paid attention to. The main purpose of these contractions is to prepare the uterus for childbirth, which will come very soon.
It is important to note that such contractions are often detected in the first trimester. This means that the tone of the uterus is very high, which poses a certain problem for the baby’s health.
Constant uterine tone, which lasts for a long time, threatens not only disturbances in the development of the fetus, but also carries the risk of premature birth.
For example, due to constant compression of the vessels of the uterus, the supply of oxygen to the child is disrupted, which can often cause hypoxia. If the baby receives too few nutrients, malnutrition may develop, as well as growth arrest. In this regard, it is clear how the tone of the uterus affects the condition of the fetus, so any woman should take timely measures to eliminate it.
Every expectant mother should not be too careless about the health of her baby, because the consequences of hypertension and the lack of treatment for it can be quite disastrous, namely miscarriage (in the early stages) and premature fetus in the later stages.
Uterine tone during pregnancy: symptoms
Symptoms of hypertension manifest themselves in different ways and largely depend on the trimester:
- The first months of pregnancy or the first trimester. A woman complains of pain in the lower abdomen, as well as in the perineal area. Pain may also occur in the back, closer to the lower back. Sometimes accompanied by nausea, the woman may feel dizzy.
- Second half of pregnancy or second and third trimesters. The same manifestations are characteristic as those described above, but in addition a “fossilization” of the abdomen occurs. The tension in the reproductive organ can even be felt from the outside if you put your hand on a woman’s stomach.
Important! The most dangerous manifestation of hypertension, regardless of gestational age, is bloody vaginal discharge. It is necessary to urgently consult a doctor.
But a tense stomach is not always a symptom of hypertonicity. In later stages, this condition may be caused by the fact that the fetus is cramped in the mother’s womb. He begins to roll over and stretch out to his full height, which leads to tension in the uterus. At the same time, the expectant mother feels not only a hard belly, but also that it changes its shape in the place where the child is retracted into the wall. This condition lasts only a few seconds and does not pose a danger to either the woman or the baby.
Causes
The reasons that cause uterine hypertonicity during pregnancy are different. This condition can appear even if the expectant mother did not complain about anything and did not have any health problems before pregnancy.
Doctors call the following risk factors:
- Severe toxicosis in the early stages.
- Deficiency of the hormone progesterone in a woman’s body.
- Negative Rh factor of the blood of the expectant mother - in this case, embryo rejection is possible.
- Polyhydramnios during pregnancy.
- More than one fetus in the uterus - two or more babies provoke excessive stress on the walls of the organ.
- Physical abnormalities of the uterus, that is, deviation from normal development.
- Uterine fibroids are a benign tumor.
- Infections that are sexually transmitted. These include chlamydia, mycoplasmosis, ureaplasmosis and others.
- Bad habits are bad if the expectant mother does not give up smoking or drinking alcohol.
- History of abortion.
- Frequent stressful situations.
- Diseases of the digestive system. Flatulence—increased gas production—has a particularly bad effect on the uterus.
- Staying in one position for a long time. For example, work requires constant sitting or standing throughout the day.
Uterine tone - what is it?
The definition of “uterine tone” is usually used to denote the state of tension in the muscular layer of the reproductive organ. It is worth noting that the uterus is normally in a relaxed state, which obstetricians call normotonus. In this case, the muscle fibers do not contract, but are in an unstretched state. During pregnancy, as the size of the fetus and uterus increases, they stretch. Its replacement by a rapid, sudden contraction of muscle fiber is called hypertonicity.
For various reasons, myometrial fibers may contract, resulting in increased muscle tone. In this case, a woman can record sharp rhythmic painful sensations, similar to those that arise with the beginning of the birth process. When delivery is still far away, such a situation can provoke abortion or premature birth.
What causes uterine tone?
The causes of uterine tone are so diverse that doctors are often unable to determine exactly what caused the disorder in a particular case. When the tone of the uterus increases during the current pregnancy, the primary task of doctors is to normalize it; the cause is determined later. Among the possible factors causing uterine hypertonicity, obstetricians identify:
- anomalies and malformations of the uterus (bicornuate, saddle-shaped);
- hormonal imbalances (progesterone deficiency, hyperandrogenism);
- infectious and inflammatory processes in the reproductive system;
- changes in the structure of the uterine walls (foci of endometriosis, fibroids);
- Rhesus conflict;
- early toxicosis;
- frequent and prolonged physical activity;
- stressful situations and overexertion;
- overdistension of the uterus due to multiple pregnancies, polyhydramnios;
- diseases of internal organs and systems (heart, liver, kidneys);
- age under 18 or over 30 years;
- bad habits (nicotine, alcohol).
Uterine tone - consequences
Increased uterine tone during pregnancy requires constant monitoring by doctors. When such a diagnosis is made, the woman is sent to a hospital, where she is monitored. Increased uterine tone during pregnancy leads to a decrease in the volume of blood flowing through the placenta. As a result, the baby does not receive enough oxygen. With prolonged oxygen starvation, the risk of developing gestational complications increases, including:
- placental insufficiency;
- fetal hypoxia;
- intrauterine growth retardation.
Increased uterine tone in early pregnancy in the absence of necessary therapy can lead to negative consequences:
- sudden termination of pregnancy;
- freezing of the fetus;
- isthmic-cervical insufficiency;
- premature placental abruption;
- uterine bleeding.
Why is it dangerous?
The danger of hypertonicity is that tense muscle walls negatively affect the growing fetus. If a woman does not receive treatment or refuses it, the following consequences are possible.
In the 1st trimester:
- involuntary interruption of gestation;
- the fertilized egg peels off;
- frozen pregnancy, as the fetus does not receive enough nutrients and oxygen.
In the 2nd and 3rd trimester - early discharge of amniotic fluid, dilatation of the cervix, which leads to premature birth.
Important! The fetus can survive if the gestation period is 36 weeks or more.
Diagnostics
How does a doctor determine whether the tone of the uterus is increased during pregnancy?
- examines the pregnant woman, palpates the uterus;
- performs an ultrasound.
Palpation of the uterus is possible in the second half of pregnancy through the anterior wall of the abdomen. The doctor places the woman on the couch, on her back. She needs to bend her knees. This position promotes complete relaxation of the abdominal muscles, so it is convenient to palpate the uterus.
Ultrasound examination is more of an auxiliary method. Using ultrasound, the doctor can identify hypertonicity of the posterior or anterior wall of the organ and the degree of threat.
Based on the data obtained, treatment is prescribed and the need to place the woman in a hospital is determined in order to maintain the pregnancy.
In the video about the reasons
How to remove
What to do if a pregnant woman has a toned uterus? Therapy depends on the degree and causes of the pathology.
If a woman is treated as an outpatient, she is recommended the following:
- rest most of the time;
- refuse sexual activity;
- take medications prescribed by your doctor.
What is prescribed:
- Antispasmodics.
- Gestagens.
- Sedatives.
- Various vitamin and mineral complexes to strengthen the body.
When prescribing therapy, doctors must take into account the reason that provoked the increased tone of the uterus. If a woman has problems with the gastrointestinal tract, anti-flatulence medications are prescribed.
If there is bloody discharge from the vagina, hemostatic drugs are indicated. Dosages are prescribed by the gynecologist individually.
In recent years, in Russia, a drug from the group of β-mimetics, Ginipral, is often prescribed for hypertension. The active substance relaxes the smooth muscles of the uterus. Under its influence, uterine contractions decrease and tone decreases. Prescribing Ginipral in most cases makes it possible to maintain pregnancy until the date of birth (source - article “Risk factors and basic principles of treatment of threatened preterm birth”, authors - Zaidieva Z.S., Mikhailova O.I., Lukyanova E.V.).
Why is Canephron prescribed during pregnancy? Read the article about the drug and indications for its use for pregnant women in the early and late stages, instructions for use, contraindications and possible side effects.
What are the causes of protein in urine during pregnancy? Information here.
The main signs and causes of uterine tone
Along with natural factors that cause uterine tone (severe coughing or sneezing), there are a number of other reasons for this phenomenon that are important to keep in mind:
- nervous disorder and constant stress;
- heavy loads on the body, including muscles;
- hormonal disorders;
- unbalanced diet;
- smoking, alcohol;
- pregnancy with twins or the development of a large baby, which causes increased growth of the uterus;
- endometriosis or uterine fibroids;
- early abortions;
- toxicosis, causing tension in the abdominal muscles (it is important that both early and late toxicosis are dangerous);
- uterine abnormalities;
- Rh conflict - if the father and mother have different Rh factors, the female body can constantly reject the fetus, as it believes that it is a foreign body;
- infectious pathologies of the genital organs, accompanied by itching and redness;
- polyhydramnios, causing distension of the uterus.
It is worth remembering that uterine tone is not a disease, but only a symptom, so it should not be treated independently, especially with medications. Those women who have any of the above factors, before pregnancy begins, must inform the gynecologist about this so that he can take the necessary measures in time to eliminate the causes of the disease.
