A local increase in uterine tone often occurs during gestation and in most cases is not a dangerous complication. But sometimes this is a pathological condition that can be a threat to abortion. The following describes the symptoms and causes of uterine hypertonicity, what it is, diagnostic methods and treatment tactics.
Increased uterine tone
The uterus is the main organ of the female reproductive system. It consists of the muscles forming three layers: the external serous, internal epithelial and the myometrium located between them. Myometrium fibers branch out in three different directions, which allows the uterus to stretch during pregnancy and contract well during childbirth. Too early contraction or excessive tension of the muscles of the organ is called hypertonicity.
An increased tone of the uterus is most often not a serious complication of pregnancy, but you should not completely ignore this symptom. Muscles can strain locally or over the entire inner surface of an organ. Locally, stress can spread along the anterior or posterior wall of a muscle organ. Accurately diagnose the problem is possible only with the help of ultrasound. Minor pulling pains in the abdomen and discomfort in the lower back do not always indicate the presence of pathology.
Reasons for the development of pathology
The causes of uterine hypertonicity along the posterior wall during pregnancy are divided into conditionally physiological and pathological. Expectant mothers often complain of drawing pains that give back, with multiple pregnancy or with a large mass of the fetus. In this case, the muscles are overstretched and greatly stretched. Sometimes the body simply does not have time to readjust to the “new mode of operation” and experiences a serious load. Stress and constant fatigue can lead to complications during pregnancy.
Serious risk factors are bad habits, especially if a woman is not ready to give up smoking and alcoholic beverages for the period of gestation. The pathological condition is often diagnosed in expectant mothers under the age of 18 and older than 35 years. The reason for the increased tonus of the posterior wall of the uterus in pregnant women in the early stages may be the attachment of the fetus to the posterior wall (which happens in most cases), because the blood supply there is better and the wall is thicker, as well as local inflammation caused by implantation. Moreover, inflammation does not mean the presence of infection. This is a temporary tone on the back of the uterus, caused by physiological reasons.
Gynecological and general diseases
If a woman is diagnosed with hypertonicity, sometimes an additional examination should be carried out (most often it is recommended to do this in a hospital setting) to determine if the clinical condition is caused by pathology. In the uterus, pathological changes, for example, endometriosis or myoma, general infections and viral diseases (especially accompanied by fever), too much or small amount of amniotic fluid, inflammation in the ovaries or in the uterus can be detected.
Low progesterone
Uterine hypertonicity can become a serious complication of pregnancy if it is caused by a low level of progesterone, the hormone necessary for successful bearing of the fetus. Progesterone is produced in the ovaries and provides the most favorable conditions for conception. During pregnancy, the hormone promotes prolonged relaxation of muscle fibers so that a miscarriage does not occur. After the fifteenth week of gestation, progesterone begins to be produced by the placenta. Inadequate hormone levels can cause hypertonicity on the back of the uterus.
Tone on the back of the uterus: genetics
In one of the most serious cases, the tone is caused by genetic incompatibility between the mother and the fetus. Eliminating the genetic incompatibility of drugs is quite difficult. Such a pregnancy will be difficult. In some cases, doctors recommend a woman an artificial interruption. The patient's body perceives the fetus as a foreign body and tries to get rid of it on its own. As a result, there is a tone that can lead to a miscarriage.
Symptoms of uterine hypertonicity
Drawing pains in the lower abdomen occur with hypertonicity on the front wall or in general, tone on the back wall of the uterus during pregnancy is more often marked by lower back discomfort. A woman may notice spotting on her underwear. In some cases, this is a variant of the norm (dark red slight discharge after examination in the early stages or implantation of the embryo), but sometimes it is seriously life threatening (with bleeding, the discharge is abundant and bright red, often this is the beginning of a miscarriage). In any case, it does not hurt to once again consult with an observing gynecologist.
Tone on the back of the uterus during pregnancy is manifested by back pain, most often in the sacrum and lower back, lower abdomen. At the end of the second and third trimesters, that is, from about the twenty-second week until the birth, you can not only feel the hypertension, but also see it. The stomach hardens, "stiffens", can change shape. With the appearance of bloody discharge, urgent hospitalization is necessary, because this indicates the detachment of the placenta. In some cases, hypertension in the first trimester may be asymptomatic or occur in response to medical manipulation (gynecological examination).
Possible effects of hypertension
What is dangerous uterine tone during pregnancy? Doctors often talk about the threat of interruption if hypertension is detected on an ultrasound scan. In fact, this condition is not always dangerous for the health of the mother and the normal development of the fetus. But in any case, with the appearance of pulling pains in the lower back or lower abdomen, spotting and any changes in well-being, it is necessary to consult a gynecologist to change the tactics of pregnancy in the future.
The tone of the uterus along the back wall during pregnancy can be a short condition. But if the clinical symptom persists for a long time, serious fetal oxygen starvation may occur due to constriction of the vessels that are involved in the blood supply to the fetus. It threatens with oxygen starvation. There is a shortage of nutrients and oxygen, vital for the timely growth and development of the child.
The most serious complication of hypertonicity is premature placental abruption. Even with a small amount of bloody discharge, an urgent consultation of a gynecologist is necessary, which will solve the issue of treatment in a hospital. Most likely, the treatment will be carried out there, that is, under the constant supervision of specialists. This will help to maintain pregnancy and convey the baby to a period that is acceptable for childbirth.
Methods for the diagnosis of pathology
The tone of the uterus during pregnancy along the back wall or the front is diagnosed by ultrasound. If the patient complains of drawing pains and spotting, then an ultrasound scan is performed according to indications at any time. Hypertonicity, characterized by an asymptomatic course, can be diagnosed with a routine examination or ultrasound. The diagnosis is made if the patient complains of cutting pains in the lower abdomen, which become stronger during physical exertion, lower back discomfort, tension in the uterus.
During ultrasound diagnostics, the doctor assesses the condition of the uterus, how thick the walls of the organ are, how the placenta develops, and how well it provides the baby with all the necessary nutrients and oxygen. During the procedure, the diagnostician will evaluate the condition and length of the cervix to detect possible symptoms of disclosure. The gynecologist may prescribe additional studies. This is usually a blood test for progesterone and other hormones.
Treatment
How to treat hypertonicity of the posterior uterine wall? Based on the results of diagnostic tests, the gynecologist will evaluate the possibility of treatment at home, but it is usually recommended to spend several days in a hospital so that qualified doctors make sure that they are pregnant or prescribe the appropriate treatment in a timely manner. All women diagnosed with hypertension are recommended strict bed rest, antispasmodics, and sedatives.
General recommendations of doctors
Treatment of hypertonicity of the posterior wall of the uterus during pregnancy is selected strictly individually. A woman is recommended to observe a strict bed rest for some time, which is not always possible at home, to abandon any physical activity. You need to try to take a position in which the uterus is as relaxed as possible. It can be a pose on one side or even on all fours. Stress should be excluded, more rest and sleep at least eight hours a day. Usually, doctors also recommend temporarily excluding sex.
Drug therapy
If the tone of the uterus along the back wall during pregnancy is diagnosed, the doctor will prescribe a woman several medications that will help stabilize the condition. Antispasmodics are usually recommended, which help reduce the contractility of the body (No-Shpa, Papaverine suppositories), and general sedatives (tincture of valerian or motherwort).
Magnesium preparations are often prescribed ("Magne B6" in combination with vitamin B), which eliminate muscle tension and normalize metabolic processes. After sixteen weeks of pregnancy, it is possible to use special drugs that normalize the tone, but only under the supervision of a doctor.
The causes and treatment of uterine hypertonicity during pregnancy are interrelated. So, if the pathological condition is caused by general diseases or gynecological problems, additional drugs are prescribed that normalize the state of health of the woman. With a lack of progesterone, the gynecologist will recommend taking "Dufaston", "Utrozhestan". Dosage and duration of medication are selected individually.
Prevention of excessive tonus
Spouses who want to become parents should take a responsible approach to pregnancy planning. Timely preparation and early registration in the antenatal clinic is required so that the gynecologist can monitor the condition of the woman. Before conception, it is advisable to treat inflammatory diseases in the gynecological part and visit genetics. This is especially important for women who are planning a pregnancy over the age of 35 years.
During the period of bearing a child, you should regularly visit an observing gynecologist, exclude intense physical exertion, but do not forget about moderate activity, which will only benefit the expectant mother, and avoid stress and nervous strain. It is necessary to follow the doctor's recommendations, because otherwise you can face serious complications of pregnancy: fetal hypoxia, premature birth, impaired functioning of the placenta, spontaneous interruption.
Opinion of Dr. Komarovsky
The pediatrician, a doctor of the highest category, Evgeny Olegovich Komarovsky, whose opinion is heard by many future and already held parents, argues that the very concept of "hypertonicity" in obstetrics does not exist (except for rare cases in childbirth). This term began to be used by diagnosticians in Soviet times, which were based on an erroneous understanding of what they see when performing pelvic ultrasound.
The uterus is the muscular organ of the reproductive system, and the muscles should normally be in a certain tone. Local stress is not hypertonicity. This can be caused by the release of a certain amount of hormones into the blood, attachment of the embryo, mechanical pressure on the front wall of the abdomen or cervix with an ultrasound probe, movements of the baby, normal physiological activity of the organ, bloating, and so on, that is, completely natural causes.
Minor pain during pregnancy is a normal option. “Normal” pain does not increase, is not accompanied by atypical discharge with an admixture of blood, does not look like contractions (rhythmic contractions), occurs haphazardly, and may increase slightly with physical exertion. Pregnancy is a new quality condition for the female body, so the reaction can be different.