Hypertension during pregnancy: causes, symptoms, prescribed treatment, possible risks and consequences

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Hypertension during pregnancy is not so rare, it occurs in 60% of women. Of this number, only 5% of this condition takes a pathological form and requires proper treatment. As for all other women, the hypertonicity of the reproductive organ does not pose a threat to the favorable bearing of the child. Nevertheless, the expectant mother still needs to adhere to the daily routine and observe bed rest.

What kind of phenomena is this? What are the reasons for its occurrence? But the most important thing that interests many expectant mothers is how the treatment is carried out? Let's try to figure it all out…

What is hypertonicity?

To answer the question of what is uterine hypertonicity, you need to understand what it is. This is a female hollow reproductive organ, consisting of several layers of tissue:

• Endometrium is the inner mucosa.
• Myometrium is the middle muscle layer.
• Perimetry - outer mucosa.

What causes hypertonicity during pregnancy? Due to the fact that the muscle tissue is able to lengthen and thicken, the uterus, in turn, can also increase or decrease in size. Thanks to its contraction, the organ, in medical terms, is brought into tone. In other words, the uterus is in a state of tension.

Under normal conditions, this organ is completely relaxed, which allows the child to develop calmly in proper conditions until the end of the prescribed period of pregnancy. As the due date approaches, the uterus begins to shrink slightly, which should be regarded as training for the upcoming labor activity.

However, in the case when the uterus begins to contract prematurely, this indicates an increased tone of the reproductive organ, which is precisely called hypertonicity. Sometimes a local form of tone may occur, in which some part of the anterior or posterior wall of the uterus is strained.

Cause of increased uterine tone

We now have an idea of what hypertension is during pregnancy, but what could be the reason for such a phenomenon? Now let's figure it out. In most cases, increased tone appears in early pregnancy. The woman's body has not yet adapted to its new state and, as before, is trying to start the process of menstruation.

But at the same time, hypertonicity may occur at a later datepregnancy, and each trimester has its own reason.

Causes of hypertension in the 1st trimester

The main cause of hypertonicity for the period of the 1st trimester of pregnancy is the lack of progesterone. This hormone plays an important role, due to which the fertilized egg is attached to the wall of the uterus. But besides this, he is also responsible for the safety of the fetus and does not allow the embryo to be destroyed by the forces of the female body, thereby preparing it for the development of a new life within itself.

Therefore, it is precisely its lack that leads to uterine hypertonicity during pregnancy in the 1st trimester. But besides this, existing problems with the intestines can provoke its activity. The gases that are formed as a result of fermentation put pressure on the reproductive organ, thereby forcing it to tone up.

Why is the tone of the uterus increased in the 2nd trimester

Such a phenomenon in most cases is typical at this time. In this case, its occurrence is associated not only with the reproductive organ itself, but also with concomitant diseases. To begin with, consider those that relate directly to the uterus. And this is, first of all, the presence of a tumor, cyst, endometriosis, fibroids.

As for concomitant diseases, we are talking about hormonal disorders, inflammation of a different nature, previous abortions, which actually led to the pathological condition of the uterus.

Causes of pathological contractions in the 3rd trimester

The reasons why pathologicaluterine contractions are closely related to fetal development:

• polyhydramnios;
• large baby;
• two or more fetuses.

In this case, there is too much pressure on the walls of the reproductive organ, which leads to its hypertonicity during pregnancy. Regardless of the reasons that contributed to the increased tone of the uterus, self-medication is strictly prohibited here.

When symptoms are detected, it is worth contacting a antenatal clinic, otherwise a woman can only harm her child. And now it is worth getting acquainted with the clinical picture of the manifestation of hypertonicity.

Symptoms of Manifestation

Increased tone of the reproductive organ is not difficult to determine, there are several ways to do this. Moreover, each for each period of pregnancy is characterized by its own signs.

I trimester

In the early stages of pregnancy, the uterus is still impossible to feel during palpation of the woman's abdomen. At the same time, the signs of hypertonicity are bright:

• Painful sensations of a pulling nature in the lower abdomen, which radiate to the lower back or sacrum. Which often happens during the menstrual cycle.
• You can feel the tension in the pubis.
• In some cases, the discharge becomes red or brown.

These symptoms of uterine hypertonicity during pregnancy in the 1st trimester should not be ignored, because they are just dangerous due to the fact that the manifestation of hypertonicity at such an early stage can provoke the risk of interruptionpregnancy.

But the highest risk is at the time when the characteristic signs are found in the period from 4 to 12 weeks. At this time, it is better to immediately contact a specialist for advice.

II trimester

If hypertonicity caught a woman at this stage of pregnancy, then to the above signs is added the feeling that the uterus has become "stone". Any expectant mother can independently conduct a simple diagnosis, for which you should follow these steps:

• Lie down in a relaxed position.
• Now with one hand you need to touch the front of the thigh, and put the other on the stomach in the area of the uterus.
• If the surface has the same density, the tone of the reproductive organ is normal. However, with a divergence of sensations, this indicates the opposite - the stomach is palpated more dense.

As it was mentioned at the very beginning of the article, uterine hypertonicity during pregnancy in the 2nd trimester is not such a rare phenomenon. This is due to the fact that the uterus begins to prepare itself for childbirth from the 20th week. Normally, periods of tension and relaxation are rare and are not accompanied by pain. Otherwise, this indicates a serious pathology, it is necessary to seek medical help as soon as possible.

III trimester

At this stage of pregnancy, the signs of hypertonicity are the same as can be observed during the second period. However, there is one difficulty here, due to which it is self-diagnosing such a phenomenon.almost impossible. During this period of time, training contractions may appear, which can be confused with the manifestation of hypertonicity. This is especially true for women who are pregnant for the first time.

To understand exactly what is what, you need to know how false contractions differ from hypertonicity of the posterior wall of the uterus during pregnancy (or anterior):

• During false contractions, the tension of the reproductive organ lasts for several minutes. If the stone sensations of the uterus remain and do not go away for a long time, with a high probability this indicates excessive tone.
• Unlike hypertonicity, there is no pain when training contractions appear.
• The surest sign: increased uterine tone can be felt throughout the day, while false contractions can be felt no more than 3-4 times a day.

Usually, doctors with the onset of the third trimester recommend that women undergo cardiotocography (CTG) as often as possible.

Other characteristic features

In addition to the symptoms characteristic of each period of pregnancy, specialists can learn about the hypertonicity of the reproductive organ in relation to the anterior and posterior walls. And here there are some manifestations that are slightly specific from each other.

With hypertonicity of the anterior wall of the uterus during pregnancy, a woman feels aching pain in the lower abdomen, as well as discomfort in the perineum. In case of hyperactivity of the posterior wall of the genital organ, the expectant mother also feels pain in the lower abdomen,only it is of low intensity. At the same time, in the perineum, you can feel a feeling of fullness against the background of the heaviness of the lumbar.

It is also worth considering that in pregnant women, tone can manifest itself in varying degrees of intensity. According to experts, there are only three of them:

• I degree - pain in the lower abdomen is short-term, there is a thickening of the uterus. They disappear at rest.
• II degree - the reproductive organ is already quite dense, and the pain in the lumbar region, abdomen and sacrum is already pronounced.
• III degree - even under the influence of minor mental and physical stress, the pain is very strong, and the uterus becomes stone.

But there are situations when hypertonicity of the anterior wall during pregnancy (or posterior) does not manifest itself as symptoms. But, regardless of the degree of intensity of the tone of the uterus, if a pregnant woman detects the presence of spotting spotting, you must immediately call an ambulance, and try not to move once again before her arrival. This phenomenon is often a characteristic sign of a miscarriage.

What is the danger

Even slight strength hypertonicity can pose a threat to the child. Due to the increased contractile activity of the uterus in early pregnancy, the embryo may die or an undeveloped pregnancy may occur. But besides this, the increased tone of the genital organ can provoke spontaneous abortion (miscarriage).

In case of hypertonicity in later pregnancy, allat risk of premature birth. In this regard, in most cases, those women who have been diagnosed with this are sent for preservation in a hospital.

In addition, uterine hypertonicity during pregnancy in the 2nd trimester or at any other time leads to impaired circulation of the placenta. As a result, not only oxygen starvation occurs in the fetus, but also the intake of all the necessary nutrients is significantly hampered.

For this reason, do not underestimate such a state of the uterus as its increased tone! It is necessary to get qualified advice from a specialist, as well as follow all the recommendations of the gynecologist who leads the pregnancy. And, if he directs to go to the hospital for preservation, then there were good reasons, and in this case it is extremely undesirable to refuse.

Diagnostics

Excessive activity of the muscle tissue of the genital organ can be detected by a gynecologist during the examination of the patient. This is done by the most common and simple way of diagnosis - palpation of the abdomen. The woman is in a supine position on the couch.

But the other method is much more informative. This, as you might immediately guess, is about ultrasound, which allows you to identify hypertonicity in the early stages of pregnancy. A qualified specialist according to the data made will be able to determine not only the presence of an increased tone of the genital organ, but also identifythe degree of this phenomenon (1, 2 or 3), as well as the localization of uterine hyperactivity (posterior or anterior wall).

Only a doctor can establish an accurate diagnosis after an examination and a number of necessary studies. Ignoring the characteristic signs of uterine hypertonicity threatens with sad consequences, as already mentioned above. Therefore, do not hesitate and, if necessary, immediately seek medical help to avoid losing a child.

Features of the course of treatment

It is not for nothing that doctors among themselves call the treatment course in case of uterine hypertonicity nothing more than "to lay out the pregnancy." But it is peace that is already half the success in the fight against this disease! For this reason, doctors recommend that pregnant women observe bed rest, regardless of the reasons that provoked uterine hypertonicity during pregnancy of the 2nd period (or any other trimester).

Among medicines, antispasmodics like "No-shpy" and "Papaverine" are mainly prescribed. These drugs, relieving the expectant mother of hypertonicity, do not harm the child. At the same time, the doctor may prescribe a course of taking sedatives. Valerian or motherwort tincture is highly effective in this regard.

The need for this is due to the fact that the mother's fear of losing her baby only exacerbates the situation and significantly slows down recovery. But, as you know, pregnant women are emotionally unstable, so taking sedatives will be justified.

In cases where hypertonicity is provoked by a hormonal imbalance, expectant mothers are prescribed progesterone-based drugs, for example, Duphaston, Utrozhestan. However, they can be taken throughout the entire period of pregnancy, but up to 36 weeks. After this period, they are no longer effective.

But if a woman feels cramping pain, she will be hospitalized without fail. In a hospital setting, she will be given appropriate treatment for hypertonicity during pregnancy using drugs such as Ginipral, Brikanil, Partusisten. These drugs should be taken before 16 weeks. Moreover, there may be different side effects that many women will not like:

• tremor;
• vomit;
• nausea;
• lower blood pressure;
• palpitations

When these signs appear, you should definitely notify your doctor. If hypertonicity caught the expectant mother by surprise with a manifestation of severe spasms, if it is not possible to get to a specialist, you should take "No-shpu" (2 tablets) or put "Papaverine" candles. After that, close your eyes, inhale deeply and exhale, imagining some pleasant image.

Then, when the pain subsides, you should contact the antenatal clinic.

Prevention measures

Such concepts as pregnancy and hypertonicity of the posterior wall of the reproductive organ (or anterior) are not compatible with each other, which should be rememberedevery woman. And therefore, in order to avoid the negative impact of uterine hyperactivity on the body of a pregnant woman and her child, you must follow the simple rules of prevention:

• Immediately before starting pregnancy planning, it is necessary to treat existing inflammations of the genitourinary system. In addition, it does not hurt to donate blood for analysis and, if necessary, bring the hormonal background back to normal.
• When carrying a baby under the heart, you should adhere to a balanced diet, supplementing the diet with multivitamin complexes.
• Avoid any situations that provoke stress, and try to maintain a supportive and friendly atmosphere in the family.
• Do not work in the evenings and on weekends. In addition, business trips during pregnancy are undesirable.
• Go to the toilet regularly to avoid pressure on the uterus.
• If bed rest has not been prescribed, and in the absence of contraindications, you should (if possible) spend most of the time in the fresh air.

If the hypertonicity of the uterine wall during pregnancy is temporary, then its manifestations can be removed with the help of special exercises. They can be performed regardless of the gestational age.

1. Relaxation of the face. The conducted studies prove the fact of the connection between the tension (relaxation) of the facial muscles and the reproductive organ. In this regard, to lower the tone of the uterus, you should take a comfortable position (preferably lying down) and to the maximumrelax the muscles of the neck and face. It is recommended to perform this useful exercise without haste, with each breath imagine how the problems go away, and the face takes on a calm and serene look.
2. "Cat". First you need to get into the position in which these pets are usually found (on all fours). Inhaling, you should arch your back as far as possible, and while exhaling, slowly bend it. Run 3-4 times, then rest for an hour or two. True, such an exercise, most likely, can be performed by women with uterine hypertonicity during pregnancy of the 1st period, that is, at an early stage.
3. Knee-elbow position. If the problem caught at a later date, then it will be difficult to perform the previous exercise. In this case, it will be useful to adopt this particular posture. You should kneel, leaning on your elbows. It is in this position for 5-15 minutes, and after half an hour lie down relaxed.

Summing up…

As we have now found out, hypertonicity will not spare if its symptoms are ignored. But it is better to try not to bring it to such a state at all, for which it is necessary to carry out regular prevention. This is not as difficult to do as it might seem at first glance. The main thing is to remain calm in any situation while carrying a child. Stress is not good for anyone.

But besides this, it is worth visiting the antenatal clinic on time and following all the recommendations of the specialist who leads the pregnancy. It is also important to know how hypertonicity during pregnancy differs from false contractions, so that whenneed to see a doctor in a timely manner.

As a result, you can save the pregnancy, avoid serious complications and hug the baby after he is born. But what could be more precious for any mother than the feeling of warmth of the very own baby?!