Increased tone of the uterus during pregnancy - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Pelvic Organs

Tonus of the uterus - is a characteristic of the state of the uterine muscle, which describes the extent of its voltage and is measured in millimeters of mercury.

are the following status options uterine muscles:

- uterus hypotonic - a pathological condition of the uterus, in which it overly relaxed muscles, it is a complication of the early postnatal period, the cause of hypotonic uterine bleeding.
- Uterus normotonuse - a physiological state of both pregnant and non-pregnant uterus, in which the muscles are at rest.
- uterus in an elevated tone - state voltage uterine muscles, which can be a constant, and be temporary (contractions during birth).Increased uterine tone can be in one specific location (local), so all uterine capture units (total).
- hypertonicity of the uterus - the anomaly of labor, in which the number of bouts over four, ie in 10 minutesthis pathology is found only in labor.

should be noted that the term "uterine hypertonus" who mistakenly use some professionals and their

patients, implying increase in tone of the uterus during pregnancy, is incorrect, sinceThis term describes a type of anomalies of labor activity.

Tonus uterus in normal and pathological conditions

The normal tone of the uterus during pregnancy ranges from 8 to 12 mm HgExceeding these values ​​during pregnancy can be worn as a physiological nature, for example when it occurs in response to fetal movements, and abnormal when such uterine activity has a permanent nature and / or accompanied by painful sensations, and in this case is a symptom of threatened preterm laboror threatening miscarriage.If such uterine activity becomes periodic nature and reduction are repeated at regular intervals, leading to the opening of the cervix, we speak of labor, ie,began preterm labor (if the period of 22-37 weeks) or about the beginning of a spontaneous abortion (up to 22 weeks).

Causes of increased uterine tone

There are many causes of increased uterine tone.Among them, the main role is played by infections that exist in the mother's body, such as: oral infections, urinary tract, gastrointestinal tract, skin infectious lesion.In second place in importance are socio-economic factors: age (less than 18 and more than 35 years), the presence of major background diseases (diabetes, hypertension, obesity), the presence of harmful habits (alcohol, smoking, drug use), loweducation, poor living conditions, the availability of psycho-emotional overload, poor working conditions, non-compliance with work and rest - all of these factors, either alone or together have a very strong influence on the course of pregnancy.

In addition, the increased tone of the uterus may be a complication of the pregnancy: malposition (breech, transverse position of the fetus), placental pathology (placental insufficiency, placenta previa), the development of anomalies and diseases of the uterus (two-horned shape of the uterus, uterine doubling, the presence of the partitions in the uterus, uterine fibroids, uterine scar from a previous caesarean section or removing myoma node), complications of the pregnancy (nephropathy, moderate and severe degrees of severity), the presence in the past, premature birth, abortion (both spontaneous and artificial), the presence ofmiscarriage have blood relatives in the family, the presence of congenital fetal malformations (particularly incompatible with life).

Symptoms of increased tone of the uterus during pregnancy

Increased uterine tone manifested by pain in the abdomen, especially in the lower divisions, pulling character, periodic "hardening of the abdomen," a feeling of tension in the stomach, sometimes frequent urination and sometimes an increase in the motor activity of the fetus.

Diagnostics

itself increased tone of the uterus is not a diagnosis, it is the main symptom of the threat of miscarriage.In order to diagnose a uterine tonic, sometimes quite normal palpation, but it should be remembered that it is not always objective, as opposed to the CTG (single-step recording of uterine contractions and fetal heart rate) which objectively assesses the situation and allows comparison between the earlierindicators and later, ie,to evaluate the effectiveness of the treatment and the dynamics of uterine activity.

increased tone of the uterus during pregnancy Treatment

To prevent miscarriage in early pregnancy and premature births later, an increased tone of the uterus must be reduced.Most often under the threat of termination of pregnancy pregnant it is recommended to go to the hospital and receive treatment. a uterine tonic worsens oxygenation and nutrition of the fetus, so treatment should be .To reduce uterine activity use special drugs called tocolytics.It
drugs belonging to various pharmacological groups, which have a different mechanism of action, but one effect: they reduce the increased uterine activity.Remove the increased tone of the uterus help:

- ginipral, partusisten, salbutamol, terbutaline.Currently, the most effective safe drug in this group is ginipral.In extreme cases, it is administered in the form of intravenous, and then switch to tablet form.

- nifedipine, a drug that exists only in tablet form.

- magnesium sulfate / magnesium sulfate, only as a solution for intravenous administration to reduce the uterus increased tone it is currently used only when other drugs are contraindicated for some reason or another

- indomethacin administered in the form of rectal suppositories.

forecast

favorable outcome depends on many factors: the state of the birth canal, gestational age, fetal status, including on its position in the uterus, the integrity of membranes (rupture of membranes), the presence of complications during pregnancy, presence of concomitant diseases, and alsoby timely treatment to the doctor.Of course, a very important positive attitude of the patient.

Prevention of increased tone of the uterus

First of all it should be noted the importance of preparing for pregnancy, early treatment of infections of the genitourinary system, rehabilitation (recovery) of the mouth, then you should pay attention to work and rest, then take into account the need for strict compliance with all recommendations of the attendingphysician.

Obstetrician-gynecologist Kondrashov D.