Uterine tone—is it really that scary?

Uterine tone is a concern for every other pregnant woman.

Often, so-called uterine hypertonicity becomes a source of anxiety for women after visiting a gynecologist. This is because the uterus contracts during a gynecological exam (the psychological component plays a role here), and the doctor notes the presence of uterine tone. Western specialists do not even diagnose this symptom in their patients, let alone prescribe any treatment. Uterine tone is viewed exclusively as a physiological phenomenon.

It is noteworthy that in domestic textbooks on obstetrics and gynecology, you will also not find a definition of “hypertonicity” or increased uterine tone. If uterine tone is mentioned at all, it is exclusively in the context of labor. Incidentally, Professor Berezovska E.P. also confirms that the concept of “hypertonicity” does not exist in obstetrics, and that increased tone is nothing more than the physiological state of the uterus during pregnancy due to improved blood supply to the uterine walls (which is why the posterior wall is thicker than the anterior one) and the “implantation” of the fertilized egg (hence the frequent diagnosis of uterine tone).

Despite such a fundamental difference in views on this issue, we propose to understand the essence of uterine tone, in which cases it should be a cause for concern, and what to do to prevent this condition.

So, what is uterine tone?

Uterine tone refers to the muscular contractions of the uterus that facilitate childbirth, i.e., the expulsion of the fetus and placenta into the external environment. Since the uterus is a hollow smooth-muscle organ that naturally contracts, uterine tone is a very natural state.

It is considered normal for the uterus to be in a certain state of tone (med. normal uterine tone), rather than completely relaxed or, conversely, overly tense and rigid. However, it is clear that uterine tone, as a physiological necessity, should occur only during labor; if uterine tone is observed during pregnancy, you should consult a doctor to determine the cause of this phenomenon.

It should be noted right away that uterine tone is a diagnosis; it is a symptom. In this regard, pay attention to your body’s behavior and sensations so that you can understand and sense when you should be concerned about uterine tone and when you should not.

Can you determine uterine tone on your own?

Yes, you can feel uterine tone on your own at any stage of pregnancy.

In the early stages of pregnancy, if you experience uterine tone, you will feel a pulling pain in the lower abdomen, lower back pain, or pain in the sacrum. In general, these sensations will be very similar to menstrual symptoms. Think back to how you felt before or during your period. If you experience similar or even more intense painful sensations in the early stages of pregnancy, see a doctor.

In the second and third trimesters, these sensations will be accompanied by a “hardening” of the abdomen. Your abdomen becomes hard, like a rock—this indicates that the uterus is contracting. After 36 weeks of pregnancy, abdominal hardening and uterine tone may also indicate the onset of so-called false (practice) contractions. At this stage, they usually no longer pose a threat to the pregnancy.

However, if at any stage you notice, in addition to uterine tone, spotting or light bleeding, we recommend that you see a doctor immediately.

Let’s summarize briefly. When is uterine tone considered a normal physiological condition?

When there are no other symptoms causing discomfort;
When uterine tone is short-lived and irregular;
When there is no spotting.

By the way, uterine tone can occur during sneezing, laughing, orgasm, or physical exertion.

Even if you feel great, it’s worth knowing about methods for preventing uterine tone.

The main method of preventing uterine hypertonicity is leading a healthy lifestyle! Remember that rest, calm, and a daily routine are the best prevention for most potential pregnancy issues.

We recommend:

Avoid excessive physical exertion (walks in the fresh air – YES!, gym workouts – only with your doctor’s permission). We recommend taking swimming classes.
Say NO to stress and anxiety! Only calmness and inner peace. This state of mind will benefit your baby.
Give up harmful habits (smoking and alcohol), as they also contribute to uterine tone, especially in the early stages of pregnancy.
Regular visits to the gynecologist during pregnancy, and even better—during the pregnancy planning stage. Learn about your body’s characteristics before pregnancy and be prepared for possible surprises!

Uterine tone—a threat of miscarriage? Is that true? What is the danger of uterine tone?

Premature active contractions of the uterine muscles before the onset of labor (i.e., actual childbirth) in the early stages of pregnancy—specifically during the first and second trimesters—pose a risk of spontaneous miscarriage, and in the third trimester, a risk of preterm labor. (Author’s note: the first trimester is the period up to and including the 14th week, the second trimester is from the 15th to the 26th week, and the third trimester is from the 27th to the 40th week).

Read about what premature labor is in the following article.

At the same time, if uterine tone is detected in time and its cause is eliminated, the pregnancy can be saved, and any issues that arose early on will not affect the baby’s development or health. Despite the common misconception, there is no direct link between uterine hypertonicity and pregnancy loss. Uterine tone, as one of the symptoms, merely indicates the need to address (possibly through medication) the health and condition of the pregnant woman.

If, however, uterine tone is caused by somatic diseases, pathologies, or developmental abnormalities of the female reproductive organs, it can be significantly reduced or prevented if these conditions are detected during the planning stage or early in pregnancy. Therefore, it is very important to conduct a comprehensive examination of the expectant mother during the pregnancy planning stage.

Indeed, increased uterine tone poses a danger to the baby as well, since during uterine contractions, the umbilical cord is compressed, and less oxygen and nutrients reach the fetus, which in turn can contribute to the development of fetal hypoxia and hypotrophy. However, it is worth noting that fetal hypotrophy and hypoxia are very serious conditions and can develop in the event of significant physiological abnormalities in the pregnant woman’s condition.

If you have identified increased uterine tone in yourself, the first thing you should do is consult a doctor. Uterine tone can be diagnosed during a gynecological examination, but it is better to undergo an ultrasound scan, as an ultrasound will help identify pathologies (uterine tone along the posterior or anterior wall, grade 1 or 2).

What causes uterine tone?

Remember that increased uterine tone is not a disease; it is a symptom indicating the presence of certain abnormalities in a woman’s body. Thus, the causes of uterine tone may include:

Hormonal imbalances. These most often manifest as a deficiency of the hormone progesterone or an excess of certain male hormones.
Severe morning sickness in the first trimester, especially when accompanied by frequent and profuse vomiting. Contractions of the gastrointestinal tract muscles contribute to uterine contractions.
Physiological characteristics of the woman—the presence of uterine developmental anomalies. Uterine developmental anomalies are changes in the anatomical structure of the organ resulting from disturbances in intrauterine development. They account for 1–2% of all congenital anomalies of the female reproductive organs. They are detected during a gynecological examination and ultrasound.
Structural changes in the uterine walls (tumors, for example).
Somatic diseases (heart, liver, kidney diseases, etc.).
The presence of Rh incompatibility. Uterine tone occurs when an Rh-negative mother rejects an Rh-positive fetus. Modern medicine is capable of managing this process.
Infectious diseases and inflammatory processes. Note that other symptoms must also be present (itching and burning, pain, changes in the nature of discharge).
Macrosomic or multiple pregnancy. Polyhydramnios. In such pregnancies, natural stretching of the uterus occurs, which triggers the development of uterine hypertonicity.
Intense physical exertion.
Stress and central nervous system disorders.
Abortions and surgical procedures prior to pregnancy.
Harmful working conditions (toxic substances, heavy physical labor).
Harmful habits—smoking and alcohol.

In general, there can be many causes depending on how our body reacts to any of these factors (internal or external). Therefore, listen to yourself and your body, give it the opportunity to cope with the stress that has already arisen, and carry a healthy and happy baby to term!

Stay healthy! Always yours, Sun Flower Family