The practice of using Duphaston for uterine tone shows good results. This drug is prescribed independently or used together with antispasmodics and sedatives. More than 30% of women in an interesting position in the early stages experience increased uterine tone, which Duphaston can cope with. If the patient believes that the drug can harm the baby or negatively affect the process of its formation, then she will be mistaken. Taking Duphaston to treat increased uterine tone is not only possible, but also necessary. The duration of therapy and daily dose of the drug are determined individually.
Conditions of muscle tone
The tone of the uterus is the degree of tension of its muscles. Like any muscle, it can be in two states: tension and relaxation.
A state of relaxation is a normal physiological state of a healthy, non-pregnant uterus.
A state of mild tension (tone) – observed during menstruation, orgasm, pregnancy.
Increased uterine tone - normally appears in the second half of pregnancy in the form of spontaneous muscle tension (local or total) and is temporary (up to 1-2 minutes). The peak of tension is observed during childbirth and the postpartum period.
A pathological increase in the tone of the uterus or spontaneous premature contractile activity of the uterus is indicated when muscle tension persists for a long time, covers the entire surface, is accompanied by bloody discharge and severe pain in the lower abdomen.
Normally, the tone of the uterus during pregnancy ranges from 8 to 12 mm Hg. It can be measured using a transducer during vaginal ultrasound. After performing an ultrasound, the doctor is obliged to indicate these values in the conclusion, only then can one judge about hypertonicity.
Uterine tone in the first trimester
Increased uterine tone at the beginning of pregnancy is an extremely rare phenomenon. During this period, she is strongly influenced by progesterone, which relaxes her muscles. Until 12 weeks, a woman should feel practically nothing in her stomach: no pain, no tension - no discomfort.
Uterine tone in the second trimester
From week 20, the muscles of the uterus begin to train. Short-term cramping contractions and tension in her muscles occur quite often. Their sudden appearance is unpleasant, but they should not frighten a woman.
You should pay attention to prolonged and painful muscle tension. Tone during this period (up to 22 weeks) is dangerous due to spontaneous abortion. But don't rush to sound the alarm. The true pathology can be discussed after examination. It is necessary to measure the amount of tone and compare them with the length of the cervix.
Uterine tone in the third trimester
It is from the 28th week that increased tone becomes a common occurrence. It is provoked by the child himself. Sudden movements of the arms and legs cause the muscles to tense. The longer the period, the more sensitive the uterus is to various irritants: turning the fetus, touching cold objects, hands or sensors to the abdomen or cervix, when stimulating the nipples.
The uterus is preparing for childbirth; short preparatory contractions are increasingly occurring. The hormonal background is changing. It is during this period that doctors often present false hypertonicity when there is no cause for concern. Here, more than at any other time, a diagnostic examination is very important. Increased uterine activity in the period of 22-37 weeks can threaten premature birth.
Composition of the drug
The use of this drug is explained by the need to normalize the condition of the reproductive organ and thereby prevent the negative consequences of its deviation from the norm. That is, reduce the tone of the uterus and relax its muscles.
Most often, pathological conditions of this kind are provoked by an insufficient amount of the sex hormone - progesterone. Therefore, to normalize hormonal levels, Duphaston is widely used, the main component of which is progestogen - an analogue of the necessary natural hormone.
Properties of progesterone
Progesterone is a substance necessary for many processes in the body of the expectant mother. This:
- participation in the process of conception;
- attachment of the egg to the wall of the uterus;
- preparing the mammary glands for lactation.
Its special role is that it relieves the tone of the uterus, suppressing the activity of its muscles and thereby preventing the possibility of miscarriage. The greatest effectiveness of the drug is observed in the early stages of pregnancy.
Reasons for increased uterine tone
Hormones. Progesterone levels have a powerful effect. Until the 10th week, it is actively synthesized and calms the contractile work of the uterus. With its deficiency, the uterus comes into a state of tension. A decrease in the hormone is observed in various diseases: endometriosis, genital infantilism, hyperprolactinemia and hyperandrogenism.
In addition, progesterone affects the intestines, constipation appears, which can provoke an increase in tone. Atony of the ureters causes stagnation of urine and the addition of infection - another undesirable reason.
Polyhydramnios. This phenomenon is typical for the third trimester. A significant amount of intrauterine water accumulates in the uterus, which puts pressure on its walls. When the muscles are overstretched, a persistent spasm occurs.
State of the nervous system. Stress leads in 30% of cases to excitation of the sympathetic system and hypertonicity.
Infection. The leading role is played by odontogenic and urogenital infections. They cause increased uterine tone in 40% of cases.
Toxicosis. The danger comes from toxicosis with frequent vomiting. It increases intra-abdominal pressure and affects the muscle tone of the uterus.
Strong physical activity. Squats, running and lifting weights are undesirable for a woman during this period.
Contraindications
Despite the pronounced therapeutic effect, in some situations the drug is not prescribed if there are certain contraindications:
- Hypersensitivity to the constituent components.
- Lactic sugar intolerance.
- Glucose-galactose disorders.
Experts also identify a risk group of patients to whom Metacin is prescribed with caution. This applies to women with a history of:
- severe toxicosis;
- cardiovascular failure: arrhythmia, tachycardia, high blood pressure;
- severe symptoms of fever;
- nonspecific ulcerative colitis;
- renal or liver failure;
- intraocular pressure;
- chronic diseases of the pulmonary system (asthma, pneumonia);
- hematopoietic pathologies;
- disturbances in the functioning of the urinary system.
Before prescribing the drug, the doctor is obliged to study the patient’s medical history and, taking into account her condition, determine the exact dosage and duration of treatment.
Clinical picture
With hypertonicity, the abdomen in the area of the uterus becomes “stone-like.” A woman talks about the appearance of an unpleasant “lump” in the abdominal cavity. In addition, there is aching pain in the lower abdomen and lower back, very similar to pain before menstruation. Unlike pathologically increased tone, they do not increase in strength and duration, and are not accompanied by bloody discharge. They go away on their own after rest.
Treatment for threatened miscarriage
The threat of miscarriage in early pregnancy can arise due to various predisposing factors. In some cases, spontaneous abortion occurs due to the mother's health status and bad habits (drinking alcohol, smoking, drug addiction). Genetic disorders in the fetus, as well as a malfunction in the hormonal system of the expectant mother, often cause miscarriage. To prevent miscarriage, you need to take responsibility for planning your pregnancy, register with the antenatal clinic on time and regularly visit the gynecologist.
Diagnostics
Inspection
During the initial examination, the doctor is able to assess the tone of the uterus, the length of its cervix, and the position of the fetus. If there is a threat of miscarriage or early labor, the cervix is shortened from three to one centimeter. If it is long and closed, the woman is not bothered by increasing pain, there is no discharge, then there is no reason to worry.
Cervicometry
A reliable method for determining the length of the cervix. Indicates her readiness for miscarriage or childbirth.
Ultrasound
shows local or total thickening of the walls of the organ. The true size of the cervix and the condition of the internal os are determined only with a vaginal ultrasound examination.
Tonuometry
A method that determines the exact amount of uterine tone. A special sensor is applied to the anterior wall of the abdominal cavity and guided into the projection of the organ.
Indications for use
There are different indications for taking Duphaston medication. The drug is prescribed for the treatment of gynecological pathologies that are dependent on hormonal levels:
- endometriosis - proliferation of cells of the inner layer of the uterus outside the functional layer;
- fibroids - single or multiple tumors of the muscular layer of the uterus;
- infertility caused by a short second phase or low activity of the corpus luteum;
- severe premenstrual bleeding syndrome;
- disruptions in the menstrual cycle, caused by lack of ovulation;
- uterine bleeding of unknown origin.
During pregnancy, the medicine helps relieve the tone of the uterus. It is prescribed mainly in the first trimester of pregnancy, since progesterone deficiency is determined in the first 12 weeks.
Indications for prescribing the drug are:
- Uterine tone determined during ultrasound or bimanual examination.
- Discharge of blood from the genital tract with confirmed progressive pregnancy.
- Painful sensations in the form of spasms, localized in the lower abdomen or lower back.
- Partial detachment of the fertilized egg from the uterine wall with preserved cardiac activity of the embryo.
Hormonal support is mandatory for the treatment of infertility using assisted reproductive technologies - in vitro fertilization, artificial insemination, and the use of donor sperm.
Treatment
The first and necessary condition is peace. Try to lie down, relieve nervous tension, and relax. You can have a light massage. You need to clasp your stomach below with your palms, gently press and lift it up. Such movements create a supporting effect and relieve the load. We continue until the hardness goes away and a feeling of relaxation appears in the abdomen.
Important: such manipulations are carried out only if tension in the uterine area is not accompanied by increasing pain and bleeding.
All drugs have unwanted side effects. Therefore, before drinking them, you need to make sure that there is a threatening increase in uterine tone. Conduct a study (vaginal ultrasound measuring the length of the cervix) and only then make a decision on treatment. In Europe and the USA, they do not attach much importance to increased tone.
Among the recommendations of evidence-based medicine, the main drugs are tocolytics - Hexoprenaline (Ginipral), which is unsafe for the mother and fetus. Its tolerability profile is still more favorable than that of Partusisten.
First, the drug is administered dropwise into a vein. Then switch to 5 mg tablets 6 times a day for 2 weeks. In European guidelines, the tocolytic Atosiban is preferred in these cases.
In an acute condition, a solution of “Magnesia sulfate” is dripped and switched to “Nifedipine” tablets.
If the cause of tone is a decrease in progesterone levels, then natural progesterone (“Utrozhestan”) is prescribed. It has two dosage forms: oral and intravaginal. The intravaginal route of administration is preferable.
In the old fashioned way, doctors recommend “No-shpu”, injections of “Papaverine”, Magne B6.
Possible side effects
Negative consequences of using the hormonal drug Duphaston rarely occur. Typically, women who take pills for uterine tone report improved health. If you refer to the instructions for use, you can learn about the following adverse reactions:
- allergic manifestations on the skin and mucous membranes;
- rapid increase in body weight;
- digestive dysfunction;
- gas retention in the intestines, constipation;
- drowsiness and apathy;
- dizziness;
- headache;
- muscle weakness.
These manifestations may periodically appear and disappear during treatment of uterine tone with Duphaston. It is necessary to inform the doctor, but usually this is not a reason to discontinue the medication. During therapy, patients with impaired liver function may develop characteristic painful manifestations in the right hypochondrium. In such a situation, the doctor changes the drug to an alternative drug that does not have a toxic effect on the filter organ.
Taking Duphaston for uterine tone is not necessary for all women. The reason for prescribing long-term hormonal therapy is a decrease in progesterone levels in the body. To determine the need for this treatment, you should take a blood test and find out about the values of progesterone. With increasing gestational age, the level of the hormone should increase.
Features of taking Duphaston
The main active substance that characterizes the effect of the drug Duphaston is progestogen. This substance acts as an analogue of a natural hormone and does not affect metabolism.
In addition, Duphaston causes virtually no side effects. Its main feature is that it selectively affects the uterine receptors. It affects the level of muscle relaxation.
The drug is absorbed into the blood quite quickly. Its maximum concentration is observed after a few hours. The complete elimination period is 72 hours.
The composition of the drug and its relationship with biological processes in the early stages
Duphaston tablets are drugs that regulate hormonal levels. The medication contains dydrogesterone in an amount of 10 mg. This volume is present in one tablet. It is this component that determines the action of the medicine.
In healthy women, after ovulation, a temporary endocrine gland appears in the ovary. Doctors call it the corpus luteum, and if it is large, it is called a corpus luteum cyst. This formation produces progesterone, a second-phase hormone. This biological substance completes the preparation of the functional layer of the uterus for implantation and ensures the development of the embryo in the early stages. Thanks to the hormone of the second phase in women, the contractile activity of the myometrium decreases, blood vessels dilate, blood pressure decreases slightly and immunity is suppressed. These processes prevent the occurrence of uterine tone in the first weeks of pregnancy and, therefore, prevent miscarriage.
In some cases, completely healthy women experience progesterone deficiency. This happens for various reasons. As a result, the activity of the uterus increases in the early stages, and tone occurs. The composition of the drug Duphaston ensures the elimination of these processes. The tablets help increase progesterone levels in the body and create the illusion of a natural state that occurs in women in early pregnancy with a normally functioning corpus luteum.
