Hyper tone of a uterus
the Uterus in a tone, a uterus hyper tone, the raised uterus tone... These terms at least once for the entire period of pregnancy were heard, probably, by each woman who is going to become mother. Let`s talk about what is a uterus hyper tone what main reasons for its emergence and as to fight against them.
It is known that the uterus represents the hollow muscular body consisting of three layers:
- the serous cover, or “perimetry“, is the thin “film“ covering outside a uterus;
- a muscular layer, or “miometriya“, - the center of a uterus, the most powerful which consists of gladkomyshechny fibers and connecting fabric. Muscle fibers in miometry are located not in one direction: is vertical (outside), helicoid (average) and circular (in) fiber;
- the internal mucous membrane, or “endometriya“, covers a uterus cavity from within.
Muscle fibers are characterized by contractility. In this regard property of muscular tissue also speak about a uterus tone. During pregnancy such condition of muscles of a uterus when they are not reduced is normal, are completely weakened: then it is about a normotonus. When muscles in the excited, reduced state, the muscular layer of a uterus contracts, its tone and respectively - pressure in a uterus cavity raises, speak about the raised tone (hyper tone). Muscular layer which reacts to external and internal irritants “is responsible“ for a tone of a uterus.
the Uterus increases during pregnancy, gradually grows and by the end of pregnancy occupies all abdominal cavity. Increase in a uterus happens due to increase in number (quantity) and increase in the weight, volume of muscle fibers. Each muscle fiber is extended by 10 - 12 times, thickened by 4 - 5 times. Content of calcium, the minerals, glycogen, enzymes necessary for reduction grows in a wall of a uterus; synthesis of an aktomiozin - protein which is responsible for reduction of a uterus amplifies. Thus the uterus gets ready for the forthcoming childbirth.
the Mechanisms providing a normal tone of a uterus
In a uterus it is a lot of nervous receptors from which impulses go to links of the central nervous system (CNS) and vegetative nervous system of mother. From the moment of approach of pregnancy the pulsation stream comes to TsNS of mother that leads to formation of a dominant of pregnancy in a cerebral cortex. Around a site of a dominant of pregnancy the zone of braking of nervous processes therefore other interests which are not connected with pregnancy fade into the background is created. At fear, a strong emotional overstrain, severe stresses in TsNS there can be other centers of excitement that can weaken a pregnancy dominant, the uterus tone as a result can raise.(till 39 weeks) excitability of a spinal cord and receptors of a uterus is lowered by
During all pregnancy that provides the correct course of pregnancy. Excitability of a cerebral cortex reaches the greatest degree by the time of childbirth, excitability of certain structures of a head and spinal cord increases.
Till 10 weeks of pregnancy the leading role in preservation of pregnancy is played by women`s hormone progesterone which is produced in an ovary by the “yellow body“ (YB) which is formed on the place of the ovulating ovum - the place in an ovary from where the ovum leaves and gets into a uterine tube, and then into a uterus cavity. Ovary ZhT at approach of pregnancy turns into pregnancy ZhT, intensively synthesizing hormones progesterone and estrogen till 9 - 10 weeks of pregnancy. Then ZhT begins the return development, also production of progesterone decreases. By then the fetoplatsentarny system (FPS) consisting of bark of adrenal glands and the pregnant woman`s liver, and also a placenta, bark of adrenal glands and a liver of a fruit is formed. The FPS main hormone - estriol which regulates matochno - placentary blood circulation. Estriol is developed in a placenta from hormone which is formed in adrenal glands of a fruit and mother.Malfunction of FPS leads
to violation of pre-natal development of a fruit, not incubation or a perenashivaniye of pregnancy.
Progesterone which is produced in an ovary and then in a placenta, promotes decrease in sokratitelny ability of a uterus, at the same time reducing an intestines tone (causing locks in pregnant women), mochetochnik (from - for it there can be a stagnation of urine - the factor contributing to infections of urinary tract). It exerts also braking impact on TsNS that provides some block, drowsiness.
Excitability and mechanical activity nervously - the muscular device of a uterus are in certain dependence on degree of permeability of cages for ions (positively or negatively charged particles). Calcium ions activate excitement of a uterus. At the normal course of pregnancy hormones of pregnancy support the due level of permeability for these ions.
the Main reasons for emergence of a hyper tone of a uterus
On early terms of pregnancy can lead hormonal violations of reproductive system to increase of a tone of a uterus. Most often as the reason of the raised tone of a uterus serve the states connected with the lowered production of hormone of pregnancy - progesterone .
Deficiency of progesterone interferes with introduction of the impregnated ovum in mucous a uterus (endometriya). At a lack of progesterone the uterus comes to a tone therefore there can be a spontaneous abortion.
Deficiency of progesterone meets in the following cases:
- of of Giperandrogeniya (increase of development in a female organism of male sex hormones - androgens ovaries or adrenal glands). In classical option at such state before pregnancy violations of a menstrual cycle on type of delays of periods, the raised pilosis, porous grease skin, gnoynichka on face skin, the backs arising or amplifying during periods are characteristic. At the latent forms external signs of a giperandrogeniya are absent, a cycle normal; only at a hormonal blood test this state is diagnosed. Very often at a giperandrogeniye lack of an ovulation - an ovum exit from an ovary (that leads to infertility as a result of lack of a mature ovum capable to be impregnated) or a state at which the ovulation occurs comes to light, however from - for the reduced synthesis of progesterone in an ovary there can be an abortion.
- Genital infantility - an underdevelopment of genitals. At genital infantility increase of a tone can be caused also by the that insufficiently developed, small uterus is reduced in response to restretching when progressing pregnancy.
- of Giperprolaktinemiya . Prolactinum is a hormone which is synthesized by a hypophysis of a brain and directly influences reproductive system of the woman and mammary glands. At increase of content of Prolactinum also insufficiency of production of progesterone is noted. In this situation more often there is infertility, than an abortion. At a giperprolaktinemiya before pregnancy violations of a menstrual cycle on type of delays and allocation of droplets of milk from nipples could come to light.
Infertility of a hormonal origin before pregnancy, uterus myoma, endometriosis demonstrate hormonal violations in a maternal organism. These violations can become the reason of the raised uterus tone during pregnancy.
structural changes in a uterus wall can be One more cause :
- of uterus Myoma - a benign tumor of a uterus.
- Endometriosis - growth of an internal cover of a uterus - an endometriya in places uncharacteristic for this purpose.
- the Inflammatory diseases of a uterus and appendages of a uterus postponed before pregnancy and revealed during pregnancy. It is caused by the fact that any inflammatory process of a uterus does its wall defective, incapable of stretching. The inflammation of ovaries results in hormonal insufficiency.
Also increase of a tone of a uterus can arise at the uterus remuscle strain caused by polycarpous pregnancy, abundance of water, a large fruit.
also violation of the central mechanisms of maintenance of a tone of a uterus, that is failures of work of the central nervous system, regulation of a muscular tone can be the Cause of the raised tone of a uterus . It happens at a hard physical activity, a chronic stressful situation at work or at home, any acute infectious disease (flu, ORZ, quinsy, pyelonephritis, especially to temperature increase of a body, etc.) .
Risk factors of emergence of a hyper tone
- of Medical risk factors of not incubation of pregnancy : pregnancy pathology; diseases of internals and genitals; genetic factors. Abortions, inflammatory diseases of genitals in the anamnesis are among medical factors, pathology of a thyroid gland, other endocrine diseases, a SARS, flu during pregnancy etc.
- Age of women till 18 years and is more senior than 30 years . At the age of 35 years the uterus hyper tone remaining a long time is also more senior, meets by 3 times more often than at the age of 20 - 29 years that is connected with a large number of abortions and gynecologic diseases before this pregnancy in process of increase in age of the woman.
- Harmful factors of production : chemical agents, daily work, business trips, overdue transfer to easier work.
- the bad relations in a family : the dissolved marriage, psychological incompatibility of spouses.
- Small duration of a dream .
- Addictions (smoking, alcohol etc.) .
Diagnostics of a hyper tone of a uterus
Gipertonus of a uterus is a symptom of threat of an abortion or premature birth. In conversation with the pregnant woman the doctor always finds out whether her pains in the bottom of a stomach, in a waist or a sacrum disturb.nagging pains (in 60% of cases) in the bottom of a stomach, in a waist, in the field of a sacrum are characteristic
Of a hyper tone of a uterus. In later terms of pregnancy there can be skhvatkoobrazny pains, the woman can complain that the uterus “hardened“.
of Pain, connected with increase of a tone a miometriya (uterus muscles), pass at intake or an intramuscular injection of spazmalitik (BUT - ShPA takes off or reduces pain).
To diagnostics of a hyper tone of a uterus are applied by the following methods:
- of Survey, palpation (palpation) . On big terms of pregnancy when the uterus leaves area of a small pelvis, it is possible to define the raised tone through a forward belly wall. Normal the uterus in the weakened state, a stomach soft, and at a hyper tone a uterus is condensed, strained, up to feeling of a stone near at hand. The palpation of a stomach is made in position of the pregnant woman on a back, with the legs bent in coxofemoral and knee joints that eliminates tension of a forward belly wall and promotes the best probing of abdominal organs and in particular a uterus and the fruit located in it. Besides determination of size of a uterus, its condition is estimated: whether there is no tone, tension at a palpation, and also the provision of a fruit in a uterus and prelying of a fruit (the doctor defines what part of a fruit is turned to an exit from a uterus - a head or the pelvic end).
- of ultrasonography - defined local (in one place - for example, a site on a forward or back wall) or a total thickening of a muscular layer of a uterus (all uterus). The local tone of a uterus is defined as a local thickening of a muscular layer of a uterus, the woman can not feel it. The pregnant woman will note a total tone of a uterus (when all uterus is strained). If on ultrasonography the tone is determined by that wall where the placenta or horion is attached (earlier terms), there is a danger of an otsloyka of a placenta (horion).
- of Tonusometriya . For this procedure the device defining a uterus tone is used; for this purpose put the special sensor to a stomach of the pregnant woman.
of Complication of pregnancy, connected with a uterus hyper tone
If a hyper tone of a uterus not to treat, then fights which will lead to an abortion or to premature birth can begin.Gipertonus a uterus can also lead
to sharp decrease matochno - a placentary blood-groove as a result of narrowing of a gleam of uterine vessels therefore at it is long the existing hyper tone there can be a hypoxia (shortage of oxygen) and/or a hypotrophy (growth lag) of a fruit as a result of a lack of oxygen, the nutrients arriving with blood to a fruit.to
Treatment of a hyper tone of a uterusby
Irrespective of the hyper tone reasons, to all pregnant women recommended a bed rest, the calming preparations, spazmalitik, means reducing activity of a uterus.Hospitalization is carried out by
in all cases when increase of a tone of a uterus is followed by the pulling or skhvatkoobrazny pains in the bottom of a stomach or in a waist.the Bed rest is provided to
or in stationary conditions, or (in rare instances) at home.Treatment by the calming preparations is carried out by
surely as the fear to lose the child only aggravates the existing hyper tone. Tincture of a pustyrnik and tincture of a valerian are usually applied. At inefficiency of a pustyrnik and a valerian the doctor appoints SIBAZOL, NOZEPAM, TRIOKSAZIN etc.
In cases of existence of the raised tone in the first trimester of pregnancy if deficiency of progesterone is the reason of threat of the raised tone, appoint progesterone preparations - DYuFASTON, UTROZhESTAN.by
To elimination of the raised tone usually apply spazmalitik: BUT - ShPA intramuscularly or inside, the PAPAVERINE in candles etc. These means can be used at manifestation of the raised tone and independently. In this case it is recommended to take 2 pill BUT - ShPY or / and to use a candle with the PAPAVERINE.by
At the raised tone of a uterus appoint the means reducing activity of a uterus:
- 25% solution of magnesium of sulfate which is entered intramuscularly or intravenously kapelno;
- of PARTUSISTEN, BRIKANIL, GINIPRAL. These preparations are not applied till 16 weeks of pregnancy. At introduction of these drugs there can be side effects: heartbeat, falling of arterial pressure, a tremor, excitement, nausea, vomiting, a headache etc.
under control of arterial pressure, heartbeat and sugar in blood.
If you are disturbed by pains in the bottom of a stomach, in a waist, in the field of a sacrum, do not ignore them - in time address experts. Perhaps, it manifestations of threat of an abortion or premature birth. Only the doctor, having talked to you, having examined you, propalpirovav your stomach, having made necessary inspections, will define the reason of pains and in case of need will appoint treatment.
If you became pregnant after treatment of infertility, you before pregnancy had hormonal violations, myoma, endometriosis, inflammatory diseases of female genitals, abortions, spontaneous abortions, premature birth, then probability of emergence of a hyper tone of a uterus and, respectively, threat of an abortion is big. Therefore you need to be registered from early terms and to accurately carry out all instructions of your obstetrician to prevent emergence of complications.
an Important role is played also by a way of life of the pregnant woman: take care, avoid stresses, business trips, in time be transferred to easier work, in time you go to bed.