Papaverine suppositories during pregnancy in the third trimester

What is uterine tone

Nature has prepared a special hollow organ for bearing a baby. The uterus, consisting of several layers, has muscle tissue that protects the growing fetus and is capable of contracting during childbirth, helping the child to be born. In a normal state, she is relaxed. Unfortunately, there are many reasons why dangerous muscle fiber contractions occur.

What is uterine hypertonicity during pregnancy? This is a symptom that requires accurate diagnosis of the causes of the pathology and immediate treatment. The appearance of dangerous signs means:

• there is a strong compression of the muscle layer;
• pressure in the uterine cavity increases;
• there is a threat to bearing a baby;
• there is a high probability of premature birth.

Possible contraindications and side effects

The instructions for the use of suppositories with papaverine say that their use is contraindicated if the patient’s medical history contains records of:

• heart rhythm disorder caused by impaired AV conduction;
• increased intraocular pressure (glaucoma);
• liver, kidney failure, adrenal dysfunction (with caution);
• violation of bronchial obstruction;
• inflammation of the rectum.

In addition, a woman’s body during pregnancy can react in an unexpected way even to a familiar and safe drug. Therefore, known or identified intolerance to the components of papaverine suppositories is also considered a contraindication to their use.

More serious consequences may occur due to exceeding the prescribed dose: severe sedation, cardiac dysfunction, difficulty urinating and defecating, hypotension, dizziness, etc.

Why is uterine tone dangerous during pregnancy?

Expectant mothers should carefully monitor their condition throughout pregnancy. It is useful for women to know why the uterus is toned, what symptoms there are, so that if they appear, consult a doctor. This will help avoid serious problems. Uterine activity is dangerous in all trimesters of pregnancy. In the early stages, high tone can:

• cause difficulties in the process of implantation of the fertilized egg;
• lead to placental abruption, disrupting the nutrition of the fetus, causing a frozen pregnancy;
• cause a miscarriage.

A toned uterus during pregnancy in subsequent periods is no less dangerous:

• In the second trimester, contraction of muscle fibers reduces blood flow in the vessels of the placenta, limits oxygen supply to the fetus, which leads to slow development.
• In the third trimester, termination of pregnancy is possible - premature birth due to early dilatation of the cervix. The baby develops hypoxia due to compression of the umbilical cord vessels.

Contraindications for the use of Papaverine suppositories, side effects

Any medicine has its own contraindications and side effects. Papaverine is contraindicated in women who suffer from hypotension (low blood pressure).

The use of Papaverine by pregnant women is prohibited if:

• Ocular glaucoma is present.
• Heart rhythm is disturbed.
• Atrioventricular block is present.
• A pregnant woman complains of kidney or liver failure.
• There is a risk of intolerance to some component that is present in Papaverine.

Sometimes Papaverine suppositories can be used, but with caution.

There are also prohibitions for use

The medicine also has some similar effects:

• Skin hyperemia resulting from greatly dilated blood vessels.
• The occurrence of severe itching.
• Feeling drowsy, as the drug is considered a sedative.
• Dizziness.
• Malfunctions of the heart.
• Decreased pressure.
• Constipation and so on.

Despite the fact that Papaverine is considered safe, it is prescribed exclusively by a doctor. Therefore, after the occurrence of any ailments, colic, or increased uterine tone, you should urgently consult a doctor. Suppositories will alleviate the general condition, but only if the pregnant woman follows all the doctor’s advice.

Norms of uterine tone by stage of pregnancy

In order for the baby to develop correctly in the womb, the uterus must be pliable and relaxed. Like any muscular organ, it has physiological contractions. What contractions of the uterine walls are considered normal? Experts highlight tone, which occurs in the early stages of pregnancy and is conditionally safe. In this case, uterine contraction:

• occurs no more than 6 times a day;
• promotes activation of blood circulation and normal development of the child;
• may be caused by mild physical exertion.

The following stages of pregnancy have their own characteristics:

• In the second trimester, starting from the 20th week, painless contractions are observed, which are considered training contractions, in preparation for future childbirth, and occur several times a day.
• With the beginning of the third trimester, the contractions of the uterus are helped by the baby, who begins to move actively. By the end of the term, hypertonicity is difficult to distinguish from the onset of labor.

When is it prescribed for pregnant women?

During pregnancy, Papaverine is most often recommended in the form of rectal suppositories or injections. Rectal administration is considered the safest for the expectant mother and fetus. When administered through the rectum, the medicine has a mild effect and is not concentrated in the blood. Papaverine is administered intravenously in a hospital setting, since the risk of a rapid decrease in blood pressure increases.

In the first trimester

In the 1st trimester, medications can affect the development of the baby in the placenta. In this regard, medications are used that have minimal effects on the fetus. Papaverine suppositories are one of the safest antispasmodics in early pregnancy.

The main reason for using the drug at the beginning of pregnancy is the threat of miscarriage due to uterine tone. Rectal suppositories are prescribed to be placed for 7–10 days up to 4 times a day. The intervals between the administration of Papaverine should be different. In some cases, the duration of the course increases.

Sometimes experts advise placing a suppository with Papaverine once if a pregnant woman experiences discomfort in the abdominal area after physical exertion or stress. Injections are prescribed for increased uterine tone. Injections are given intramuscularly. After the hypertension is relieved, they switch to suppositories.

To maintain pregnancy, treatment with Papaverine is carried out in combination with other drugs. Usually the cause of threatened miscarriage is a lack of progesterone. Papaverine is well compatible with hormonal therapy. The main substance of the drug helps restore a woman’s normal hormonal levels.

In the second trimester

In the second trimester, Papaverine can be used in all dosage forms. However, doctors prefer suppositories and injections, since the tablets dissolve slowly and the active ingredient is only half absorbed by the body.

When uterine tone increases, the medicine is prescribed in the form of intravenous or intramuscular injections. Injections allow you to quickly relieve muscle tension. The drug is administered for 3–5 days up to 3 times a day. From the moment the danger to the fetus and mother is eliminated, other drugs are prescribed in tablets.

Candles are used to reduce blood pressure and mild fever when spasms of internal organs occur, leading to colic. Papaverine suppositories are also prescribed for inflammatory diseases of the genitourinary system. How much to use and dosage are determined depending on the diagnosis, but no more than 4 suppositories per day.

In the third trimester

Indications for the use of Papaverine:

• uterine tone;
• recognition of false and true contractions;
• softening of the cervix in the last weeks of pregnancy;
• increased blood pressure;
• pain during childbirth.

If there is a threat of premature birth, papaverine hydrochloride cannot independently eliminate contractions. However, it is used in complex therapy. The form of the drug and the method of administration are determined by the doctor depending on the diagnosis.

In the later stages, tablets with Papaverine are recommended to reduce blood pressure. For pain relief - injections, to soften the cervix - suppositories, injections and droppers.

Papaverine suppositories when carrying a child are prescribed if there are the following indications:

1. Hypertonicity of the uterus and the threat of miscarriage as its consequence. This is the most common reason why papaverine is prescribed to expectant mothers. In acute conditions, injectable forms of the drug are required to maintain pregnancy.
2. Arterial hypertension as an independent pathology or as a manifestation of gestosis. Papaverine helps reduce blood pressure without negatively affecting the fetus.
3. Colic: intestinal, renal, hepatic. The action of the drug is aimed at relaxing spasmodic structures, thereby eliminating pain and restoring the functionality of the affected organ.
4. Bronchospasm. Papaverine helps relax the bronchi, restore breathing and improve well-being.

First trimester

Suppositories with papaverine during early pregnancy are used in case of increased uterine tone. You should not start using the drug without a medical prescription, so as not to provoke side effects.

In acute clinical situations, when there is a threat of miscarriage, injectable forms of papaverine are used. In other cases, if necessary, suppositories with papaverine are prescribed during early pregnancy. The form of the drug for rectal administration is characterized by high bioavailability and prolonged action.

Second trimester

The drug papaverine in the form for rectal administration in the second trimester is prescribed for abdominal pain, increased blood pressure and in the presence of other indications that have already been listed above. At this stage, not only papaverine is used; suppositories for pregnant women are combined with other medications, depending on the clinical situation.

Third trimester

In the later stages of pregnancy, it is rational to use papaverine in case of excessive tone of the uterine walls. Also, closer to the preliminary date of birth, the medication is prescribed to prepare the cervical canal for opening. At the beginning of labor, the drug helps reduce the intensity of pain during contractions.

Thus, papaverine hydrochloride in the form of rectal suppositories is an effective antispasmodic drug that can be used to relieve various pathological conditions during the period of pregnancy.

The medicine is safe for the fetus, but can cause some side effects in the mother’s body, so it should be used with caution.

It is important to monitor blood pressure in order to take timely measures to correct it

Signs of tone

Only a gynecologist can accurately determine the tone. When the first symptoms of a threat appear, you need to visit a doctor to rule out dangerous consequences. What signs of uterine tone can be observed during pregnancy? The pathology is accompanied by:

• aching, squeezing pain in the lower abdomen;
• contractions of the uterine muscles;
• feeling of heaviness, discomfort;
• bloody discharge;
• tension, petrification of the abdomen;
• pain in the lumbar region, sacrum;
• feeling of contractions.

Causes

There are a large number of reasons for the appearance of tone. They are related to the state of the body and external factors. The following are the causes of uterine tone:

• reduced amount of the hormone progesterone, which relaxes smooth muscles;
• severe toxicosis with vomiting, causing muscle contractions;
• increased levels of prolactin and male sex hormones;
• pathologies of the thyroid gland;
• abnormalities of the uterus;
• Rhesus conflict of parents' blood;
• infectious diseases;
• pathologies of the placenta;
• uterine fibroids;
• inflammatory processes of the reproductive organs.

Hypertonicity of the uterus during pregnancy is provoked by:

• psychological problems;
• constant stress;
• physical exercise;
• long journeys;
• playing sports;
• air travel;
• lack of sleep;
• strong gas formation;
• poor nutrition;
• obesity;
• age after 35 years;
• incorrect position of the fetus;
• disturbance of intestinal motility;
• uterine distension during multiple pregnancy;
• polyhydramnios or large baby size;
• sex before 12 weeks of pregnancy;
• previous miscarriages;
• tumors;
• abortions.

Products

Improper nutrition can provoke increased tone. There are foods that cause this condition. These include:

• legumes, cabbage, which provoke increased gas formation;
• blue cheese containing a fungus that is dangerous for pregnant women;
• coffee, which quickly removes fluid from the body and increases blood pressure;
• raw eggs that can cause the development of salmonellosis - heat treatment is recommended;
• black tea containing a lot of caffeine.

Spices cause an increase in uterine tone. Doctors recommend limiting the consumption of basil, bay leaves, fennel, cinnamon, nutmeg, and cumin during pregnancy. Danger comes from dishes that have not undergone long-term heat treatment. They can become a source of infectious diseases. These include:

• rare meat steaks;
• dried delicacies;
• pates;
• quickly cooked liver;
• sushi;
• salo.

Diagnostics

The first unpleasant symptoms should be identified by the pregnant woman herself and consult a doctor. Increased tone is detected with great accuracy during examination by a gynecologist. Diagnostics include:

• external control, recording of complaints;
• palpation of the abdomen while lying on your back;
• Ultrasound, revealing thickening of smooth muscle tissue, tone of the anterior or posterior wall, depending on the site of attachment of the fetus;
• tonometry using special sensors.

How to determine the tone of the uterus during pregnancy yourself

A woman should be able to diagnose uterine tone herself. This will help to timely identify the causes of the pathology and prescribe treatment to moderate it. It is important to recognize the symptoms that indicate a problem is occurring. You can find out if there is muscle tone at home. To do this, you need to lie on your back, relax, gently feel your stomach, and check the condition of your muscles. In this situation:

• a feeling of softness indicates a lack of tone and reasons for concern;
• A hard, elastic abdomen is characterized by increased muscle contraction and requires doctor's intervention.

Method of using suppositories with papaverine during pregnancy

Features of the method of using papaverine depend on the trimester and clinical situation. The answer to the question of where papaverine suppositories are inserted during pregnancy is clear: these suppositories are used rectally, that is, they are inserted into the rectum. Under the influence of body temperature, suppositories dissolve and the active substance enters the bloodstream.

How to insert papaverine suppositories

Suppositories with an antispasmodic substance should be inserted while lying on your side, in this sequence:

1. You must first wash your hands thoroughly and wipe them dry with a clean towel;
2. then you should separate one candle from the contour packaging and carefully remove it from the cell;
3. lie on your side, slightly raise the leg that is on top, and insert the suppository into the rectum;
4. Then you need to lie down for a while so that the active substance is released and enters the blood vessels.

More often the drug is prescribed 2-3 times a day at equal time intervals. The duration of their use ranges from several days to three weeks. The duration of the course of treatment depends on the specific clinical situation.

What to do

How should a woman behave, what should she do if dangerous symptoms arise? To relax muscles, gynecologists recommend following a regimen and taking medications that will reduce tone. To avoid the threat of miscarriage, pregnant women need:

• stress relief;
• complete cessation of sexual activity;
• exclusion of physical activity;
• provision of bed rest;
• aromatherapy, which promotes relaxation;
• using warm baths and showers;
• acupuncture;
• treatment of Rh conflict;
• normalization of nutrition;
• psychotherapy sessions.

How to avoid uterine tone during pregnancy

Prevention of hypertension helps to avoid the appearance of unpleasant symptoms. Simple measures contribute to the normal course of pregnancy without pathologies. A woman needs:

• avoid stress;
• start eating right;
• do not drink alcohol;
• maintain a daily routine;
• ensure proper sleep;
• avoid physical overload;
• worry less;
• no smoking;
• Visit your gynecologist regularly.

What is uterine tone during pregnancy?

This term refers to tension in the muscles of the uterus. Normal tone is necessary to maintain a certain position/pressure in the organ cavity, and hypertonicity is considered pathological - excessive muscle tension and contraction. A short-term increase in the indicator occurs when sneezing, laughing, during orgasm, does not cause discomfort to the woman and does not threaten the health of the child.

Sustained muscle tension can lead to early miscarriage or premature birth in the 2nd-3rd trimester of pregnancy. At best, the pathological condition will negatively affect the development of the fetus, since the muscles of the uterus are too tense and compress the blood vessels, resulting in a deterioration in the delivery of nutrients and oxygen to the child. This threatens hypoxia and delayed development of the baby, so women with high uterine tone need close attention and observation from doctors.

Composition, release forms and principle of action of Papaverine

The main component of the drug is papaverine hydrochloride.
This substance is a derivative of a plant alkaloid. Upon penetration into the body, it relaxes smooth muscles, and therefore the medicine is classified as an antispasmodic. The drug is produced in tablet form, suppositories, and solutions. The table describes the composition of different types of medicine.

The action of Papaverine is due to its ability to influence the mechanisms of muscle excitability. The substance reduces the concentration of calcium ions in smooth muscles, which leads to a decrease in smooth muscle tension in all internal organs, dilation of blood vessels and improved blood flow.

Since only the smooth muscle system is affected by the drug, patients are not subject to a general weakening of the body. The medicine also does not remove calcium from the bones. Auxiliary components ensure delivery of the main substance and maintain the required shape.

Symptoms

Hypertonicity of the uterus during pregnancy manifests itself differently at different stages. In the first trimester, the characteristic symptoms of the pathology are:

• nagging pain in the lower abdomen;
• pain syndrome radiating to the lower back and crosses.

Signs of uterine tone during pregnancy in the second and third trimesters:

• the stomach becomes dense, hard;
• bloody discharge appears;
• Braxton Hicks contractions may occur.

The purpose of the latter is to prepare the uterus for the upcoming birth. Training contractions appear in the last stages of pregnancy and are characterized by painlessness (relative pain) and short duration. In the last weeks of pregnancy, it becomes more difficult to determine hypertonicity: the baby kicks hard, and the uterine walls contract in response to this. In this case, you should pay attention to the degree of pain and regularity of such contractions. As a rule, uterine contractions with hypertonicity are accompanied by pain comparable to:

• with cramps on the first day of menstruation;
• lower back pain;
• intestinal colic.

How to determine

The main symptom of uterine hypertonicity in the early stages is nagging pain in the lower abdomen (as during menstruation), pain in the lower back and in the sacral area. In the second trimester and later, there are cramping pains and hardening of the abdomen, which is clearly felt when palpating it.

The increased tone of the uterus in the early stages is aggravated by spotting blood from the genital tract. Then there is a risk of spontaneous miscarriage, since it is difficult for the fertilized egg to attach to the wall of the uterus due to the increased tone of the muscular layer of the uterus.

In the second trimester of pregnancy, when the placenta has already fully formed, there is a risk of its detachment due to increased uterine tone.

In the later stages of pregnancy, hypertonicity of the uterus can lead to premature birth, because such contraction of the uterus occurs during labor to help the baby be born.

Also, a negative consequence of uterine hypertonicity is fetal hypoxia, when the uteroplacental blood flow is disrupted due to the tone of the muscular layer of the uterus. Thus, the fetus receives insufficient amounts of oxygen and nutrients necessary for its normal development. Typically, such a fetus lags behind in weight and size, its development is also slowed down, and if treatment is not timely, malformations of the fetal organs may develop, or even this may lead to a missed abortion, i.e. to the death of the fetus.

A state of increased uterine tone is normal if pregnancy has reached its peak and labor occurs. It also occurs during the menstrual cycle and during orgasm. But if a woman is in the early stages of pregnancy, then this is a serious sign of concern.

Uterine tone in early pregnancy: how to know if this is a problem?

When conception occurs, the body undergoes global changes. He is preparing for a new role. And a woman, thinking about the future, worries and worries accordingly. Perhaps the relationship with her husband is changing, moving to a new stage. And all these events affect the emotional state, which affects the degree of uterine tone.

In the first trimester of pregnancy, increased tone is especially dangerous for a woman. In some cases, because of it, the pregnancy stalls and the fetus dies. At the same time, a woman sometimes may not even know this. The main sign of a frozen pregnancy is the disappearance of other signs: the heaviness in the chest ceases to be felt, toxicosis no longer torments in the morning, etc.

Therefore, a woman needs to relieve herself of some of her household responsibilities and relax more, both mentally and physically. This is necessary so that the first months of bearing a baby pass without complications, and the body can prepare for further changes without stress.

To avoid uterine tone in early pregnancy, you need to pay attention to the following symptoms:

1. Bloody issues. They can be red, brown or pink. They indicate that a miscarriage or chorionic detachment has already begun.
2. Nagging pain in the lower back, lower abdomen or pelvis. Pain irradiates to the perineal area. The pain is especially felt after physical exertion or sexual intercourse.
3. The general condition is similar to menstrual malaise.
4. Pulsation in the abdomen.
5. At later stages – hardening of the abdomen.
6. Spasms similar to contractions.

With careful attention to her feelings, a woman is able to understand that the condition of the uterus is disturbed. When you feel a pressing pain under the abdomen or in the lumbar region. In the second half of pregnancy, the stomach becomes hard.

If this happens rarely, when changing position or after physical activity, then this is a normal physiological process. Perhaps the woman was nervous, walked a lot, or had sexual intercourse.

How to determine the tone of the uterus yourself? In most cases this will not be difficult to do. Symptoms of uterine tone during pregnancy are simple and understandable, although they vary at different stages.

Symptoms of increased uterine tone in the early stages of pregnancy are heaviness in the lower abdomen, nagging pain, as during menstruation, sometimes these pains radiate to the lower back or sacral area. Symptoms of uterine tone in the second and third trimester are almost the same, in addition, at such times hypertonicity can be noticed even visually: the abdomen contracts, becomes hard, the uterus “turns to stone.” In general, every woman can easily understand how the tone of the uterus feels during pregnancy.

How to determine the tone yourself? Not all women feel anything with this pathology, but many complain of the following sensations with uterine tone:

• “Pulling” in the lower back or lower abdomen, reminiscent of menstrual or premenstrual pain.
• The abdomen becomes “stony”, hard and elastic. To determine the tone of the uterus, a woman should lie on her back and bend her knees; in normal condition, the abdomen should be soft, otherwise it will be hard and tense.
• The pain may resemble contractions - the stomach contracts periodically.
• A “bad” sign of uterine tone during pregnancy is spotting.
• The tone of the uterus is also manifested in the unusual behavior of the child: he either becomes very active - he beats or kicks in the tummy, or, on the contrary, the woman does not feel his movements.
• After the 20th week, Braxton-Hicks contractions may periodically occur, which do not threaten the fetus in any way, but are simply training the body before the upcoming birth; they may resemble tone, but they do not need to be treated in any way.

Causes

The factors that provoke increased tone during pregnancy are varied. They often appear as a consequence of other problems that accompany pregnancy. The main causes of the pathological condition are:

1. Lack of progesterone. The most common cause of hypertension in the early stages. The main function of the hormone is to prepare the walls of the uterus for the implantation of the fertilized egg. With insufficient progesterone production, increased tone of the muscle layer of the organ develops.
2. Toxicosis. Hypertonicity can occur as a result of severe vomiting, since contractions of the peritoneum during this act also affect the uterus.
3. Malformations of the uterus. Irregular shape or abnormal arrangement of the muscle fibers of the organ can cause hypertonicity in the first trimester.
4. Rhesus conflict. If the mother and child have different Rh factors, then the pregnant woman’s body perceives the baby as a foreign object, and the immune system will begin to produce antibodies aimed at eliminating it. It is noteworthy that the first pregnancy with Rh-conflict is usually easy, since antibodies are produced in small quantities to trigger rejection.
5. Stretching of the uterus. Pathology may appear against the background of polyhydramnios or multiple pregnancies. Under such conditions, the protective mechanism of the uterus is triggered, as a result of which its muscles contract strongly. The problem often occurs in the 2nd and 3rd trimester of pregnancy.
6. The presence of inflammatory processes and infections. The body produces bioactive substances that stimulate contraction of muscle fibers, which leads to hypertonicity.
7. Malposition. At the end of pregnancy, the transverse position of the baby can lead to increased uterine tone and, as a result, premature birth.
8. Previous abortions, miscarriages. These factors affect the contractility of the organ.
9. Social aspects. Heavy physical activity, harmful working conditions, frequent stress, poor nutrition, lack of sleep are unfavorable factors that can adversely affect a woman’s central nervous system, which disrupts uterine contractions and increases tone.

In the early stages

During the first trimester, a woman's body undergoes significant changes, so the internal reaction to such stress can be unpredictable. At the beginning of the period, hypertonicity may be temporary, but it is considered normal. Common causes of the symptom:

1. The woman got nervous. In this case, the uterus begins to contract during the experience. Stress factors can be the upcoming changes in life associated with upcoming motherhood. To normalize tone, the expectant mother should calm down and relax.
2. Overwork. The body spends a significant amount of resources on restructuring, so the expectant mother needs to rest a lot and relieve herself of some household chores.
3. Recent sexual intercourse. During orgasm, the uterine walls become toned. If a woman does not have health problems, then intimacy with her husband will only benefit her and the baby, otherwise she should refuse sex during pregnancy.

In approximately 60% of pregnant women, hypertonicity in the first 3 months of pregnancy is a dangerous condition that signals the presence of abnormalities. The symptom may indicate:

1. Threat of spontaneous abortion. In this case, along with uterine contractions, women experience bloody or brown discharge. To avoid this, you need to go to a hospital for treatment.
2. Frozen pregnancy. Sometimes the development of the fetus stops, and the woman does not notice for some time that there is no longer life in her. An indirect sign of this is hypertonicity against the background of the disappearance of other symptoms inherent in pregnancy.

In the later stages

In the second trimester, an increase in the size of the child is added to the causes of hypertension listed above. From 3 to 7 months of gestation, increased uterine tone is often accompanied by isthmic-cervical insufficiency (the inability of the cervix to keep the organ cavity closed), which together leads to spontaneous abortion, therefore, when symptoms of hypertonicity appear, it is important to immediately undergo an examination by a gynecologist. In the third trimester, uterine activity periodically increases as the body prepares for childbirth.

Braxton-Hicks training contractions differ from real contractions in the following ways:

• they are irregular;
• short-lived;
• do not bring unbearable pain;
• they stop if you take a shower, change your position, or take an antispasmodic.

What foods cause tone?

Food has a slight effect on the tone of the uterus during pregnancy, and its increase occurs due to the abuse of certain foods. These products include:

• onion;
• legumes;
• apples, pears;
• mushrooms;
• turnip;
• cabbage;
• radish;
• Chinese salad;
• bread;
• porridge;
• peaches;
• carbonated drinks.

Separately, it is worth listing products that will reduce the tone of the uterus - these are:

For what purpose is papaverine prescribed during pregnancy?

Why is papaverine prescribed during pregnancy, what kind of remedy is it and is it possible to do without it?
These questions very often arise among women bearing a child for the first time. In Russia, it is customary to prescribe many different medications to the expectant mother, including papaverine during pregnancy, and many of these medications are contraindicated during pregnancy. A group of drugs designed to treat and prevent the threat of miscarriage and premature birth deserves special attention. In the first and early second trimester, papaverine is often recommended for uterine tone during pregnancy. This drug is an antispasmodic. It relieves spasm of smooth muscles, including the uterus, which is also a muscular organ.

Why relieve this spasm? The fact is that it, coupled with other factors, for example, low levels of progesterone, can provoke detachment of one egg. If there is a threat of miscarriage, papaverine is an emergency medicine. A woman should use the suppository of the same name rectally and lie down for pain in the lower abdomen and lower back. If the pain has passed, you just need to visit a doctor as soon as possible and tell about this case. If bleeding begins, and a heartbeat is detected on ultrasound in the embryo, not only suppositories with papaverine during pregnancy are prescribed, but also a hemostatic agent, for example, “Dicinon” or “Tranexam”, as well as “Duphaston” orally and (or) vaginally “ Utrozhestan" - the last two drugs will compensate for the lack of progesterone in the body, which often provokes miscarriages in the short term.

Papaverine in the 2nd trimester of pregnancy is often used in conjunction with another drug - magnesium sulfate. A woman is given IVs with it, usually in hospitals. Both drugs in combination have a good effect on the uterus and “calm” it. This is especially important for women who are diagnosed with ICI - isthmic-cervical insufficiency. That is, the cervix is ​​short and soft, perhaps even slightly open. In this case, stitches are placed on it or a pessary is installed. And at the same time, be sure to give no-shpu or papaverine injections during pregnancy, so as not to worsen the situation or provoke even greater dilation of the cervix.

But if this drug is not suitable, and the situation is not so acute, then what can replace papaverine, what drug is suitable for long-term use at home? Doctors usually recommend magnesium tablets. But they are much less effective than those administered by drip. Only a small effect is possible. But if there is ICI and a real threat of premature labor, then magnesium tablets will not help. Just as the use of papaverine during pregnancy will not help, in difficult situations when there are regular contractions, Ginepral is prescribed, less often - Indomethacin, if the woman is intolerant to the first drug.

Papaverine tablets are rarely prescribed during pregnancy, since suppositories act faster and are much more effective. After all, they are administered rectally and almost immediately relax the uterus. The recommended dosage of papaverine during pregnancy is 1 suppository at a time; you can use up to 3 suppositories per day, if necessary. Sometimes doctors prescribe such dosages to women who are at risk of miscarriage, but for some reason they do not want to go to the hospital.

This dosage is quite high and the side effects of papaverine during pregnancy are felt more often. This may be a decrease in blood pressure, sweating, constipation, drowsiness. And some women experience diarrhea. It's individual.

There are also contraindications to the use of papaverine during pregnancy. These are glaucoma and severe liver diseases, primarily hypersensitivity to the drug. There may also be disagreements about whether papaverine can be taken in any form in the early stages of pregnancy if a woman suffers from severe pathology of the kidneys, adrenal glands, hypothyroidism or supraventricular tachycardia. So, even such a popular remedy for expectant mothers should be taken carefully and preferably under the supervision of a doctor.

It remains to deal with one more controversial issue - can papaverine be used safely in late pregnancy, namely in the third trimester? This issue is controversial because it is believed that this drug prepares the cervix for childbirth. At least in hospitals, it is often prescribed to women who are about to give birth to speed up the onset of labor. Doctors respond to this that papaverine is prescribed when there is a threat of premature birth at any stage and is a safe means of relieving hypertension if taken under the supervision of a doctor, that is, in permitted, not excessive dosages.

Both no-spa during pregnancy and papaverine hydrochloride can have some effect on the cervix if the process of preparing it for childbirth has already begun. If it is already smoothed out and ready to open.

Why is uterine tone dangerous during pregnancy?

A diagnosis of hypertonicity can lead to dangerous consequences if its initial symptoms are ignored. In this case, pregnancy may end in spontaneous miscarriage or fetal death in the early stages. In the last weeks of pregnancy, premature birth may occur. In addition, increased uterine tone can lead to the development of fetoplacental insufficiency, as a result of which the baby’s nutrition and oxygen supply will deteriorate. The result of this condition will be delayed development of the child or intrauterine hypoxia.

Doctors' opinions on the use of papaverine

The use of papaverine will help improve the condition of the expectant mother if indicated.

According to experts, papaverine in the form of a drug for rectal use is safe for the health of the expectant mother and child. However, self-medication and dose adjustments should not be allowed without the advice of a specialist. Exceeding the prescribed dosage can lead to a deterioration in the woman’s well-being, including the need for hospitalization.

Papaverine does not have any negative effects directly on the fetus. This drug is approved for use at any stage of pregnancy if there are indications and no contraindications. While carrying a child, prescribing any kind of medication always raises many questions and concerns for the expectant mother.

Suppositories with papaverine hydrochloride are safe for the child’s body and cannot harm him. You should accept the fact that compliance with the dosages recommended by the specialist minimizes the likelihood of adverse reactions from the mother’s body.

Therefore, the most important thing is to regularly consult with doctors and take any therapeutic measures only when prescribed by a gynecologist or other medical specialist.

Diagnostics

The examination of a woman is preceded by a survey, after which the gynecologist conducts an examination. These two measures are enough to make a diagnosis, however, even if the doctor is completely confident, the pregnant woman is given an ultrasound to confirm. With the help of this study, you can much more accurately determine the condition of the organ, exclude other diseases with similar symptoms (for example, uterine fibroids) and find out on which specific wall the tone is expressed. The strength of uterine contractions is measured with a special device with sensors (procedure - tonusometry).

How to determine the tone of the uterus during pregnancy yourself

You can diagnose a pathological condition that can provoke a miscarriage yourself at home. It is important to distinguish between the symptoms that are observed with hypertonicity. To determine the tone of the uterus, you need to:

• lie on your back and relax;
• gently palpate the abdomen with your fingers, checking the condition of the muscles;
• if the tissues are soft, then there is no reason to worry;
• An elastic, hard belly indicates increased muscle contraction, so it is important to consult a doctor immediately.

What to do

Doctors prescribe treatment for the problem based on the strength of the tone and the reason that caused it. In some cases, to maintain pregnancy, therapy is carried out on an outpatient basis. Women with this pathological condition are advised to remain in bed and drink antispasmodics such as No-shpa or Papaverine. How to get rid of uterine tone during pregnancy? Normalization of uterine contractions is promoted by:

• stress relief;
• exclusion of physical activity;
• cessation of sexual activity;
• acupuncture;
• aromatherapy.

In addition, it will be possible to normalize the condition of a pregnant woman if:

• remove from the diet foods that promote uterine tone;
• spend more time in the fresh air;
• lie down a lot, do less housework;
• reduce the likelihood of stress;
• take warm baths, showers;
• attend psychotherapy sessions.

With prolonged hypertonicity during pregnancy, doctors, as a rule, insist on hospitalization and treatment of the patient in an inpatient setting. Thus, the patient will not be able to break bed rest, as women do while at home. In addition, in the hospital, doctors will closely monitor the baby’s condition and will be able to promptly relieve muscle contractions if there is a risk of premature labor.

Drug treatment

Regardless of the causes of the pathology, a toned uterus during pregnancy is subject to treatment. Otherwise, contractions may begin, resulting in a miscarriage or premature labor. With timely, adequate therapy, you can easily achieve relief from tone, for which doctors prescribe drugs of different groups.

If the cause of the pathological condition is progesterone deficiency, the woman is prescribed hormonal drugs containing it. If there is an excess of male sex hormones in the blood, their antipodes are prescribed. If a pregnant woman has severe toxicosis, which stimulated uterine contractions, doctors take measures to alleviate her condition. Often, for uterine tone, sodalite medications, for example, motherwort, are prescribed.

Pills

In case of hypertonicity, mandatory treatment with sedatives is carried out, in addition, antispasmodics and, in some cases, progesterone preparations or other hormonal tablets that help reduce the intensity of uterine contractions are prescribed. Common medications for high uterine tone include:

1. Nozepam. An anxiolytic drug (tranquilizer) belongs to the group of benzodiazepine derivatives. The drug has a sedative effect, has a central muscle relaxant and anticonvulsant effect. The disadvantage of tablets is that they are absorbed very slowly, so the therapeutic effect occurs only after 1-2 days of taking the medicine. The advantage of Nozepam is its effectiveness and low cost.
2. Duphaston. The drug is an almost complete analogue of the natural hormone progesterone. Duphaston has a positive effect on the contractility of the uterus and many other physiological processes occurring in the body of the expectant mother. The main disadvantage of tablets is their high cost if long-term treatment is required. The advantages of Duphaston are its wide spectrum of action, effectiveness and extremely rare occurrence of side effects.
3. Partusisten. An effective remedy is used when there is a threat of premature birth or miscarriage; the tablets do not have a negative effect on the fetus. Partusisten relaxes the uterine muscles and belongs to the group of beta2-adrenergic stimulants. The disadvantage of the product is the possibility of some side effects, for example, increased sweating, weakness, hyperglycemia, spasms and muscle pain. The advantage of the medicine is its effectiveness in maintaining pregnancy.

Candles

Preparations in the form of rectal suppositories help to quickly relieve uterine tone. The suppositories are inserted into the rectum and left until completely dissolved. After the active substance enters the blood, the excitation of the uterine walls liquefies. Doctors often prescribe the following medications:

1. Papaverine. Suppositories are antispasmodic drugs and have a relaxing effect on smooth muscles. Papaverine can be used at any stage of pregnancy, which is its big advantage. Another advantage of the product is the absence of side effects (with the exception of isolated cases). The downside of Papaverine is its contraindications, including low blood pressure, glaucoma, and kidney problems.
2. Indomethacin. Anti-inflammatory suppositories help relieve hypertension and are usually prescribed together with other medications. The drug has a relatively low cost, which is its big advantage. The disadvantage is the possibility of an allergic reaction.
3. Viburcol. An antispasmodic, pain-relieving homeopathic drug that is often prescribed to reduce the tone of the uterus during pregnancy. Candles have an antipyretic and calming effect. A significant advantage of the drug is that, thanks to its composition, it does not put a strain on the kidneys and liver. The downside of the drug is its moderate effectiveness compared to other drugs.

Exercises

A woman can provide herself with emergency help if there are signs of hypertonicity with the help of special exercises. Effective techniques:

1. Knee-elbow pose. You need to kneel down, lean on your elbows, placing soft material under them. After a few minutes of being in this position, the discomfort goes away.
2. Cat pose. While on her knees, the pregnant woman needs to alternately arch and bend her back. Changing positions should take place while inhaling slowly, and you should stand in each position for 5 seconds.

Alternative

It is possible to prepare the cervix for childbirth without the use of medications. But if the doctor still insists on taking Papaverine, you should not refuse. Alternatively, the following methods are possible:

Sex life. Regular sex will perfectly prepare you for childbirth, and there is an explanation for this. During sexual intercourse, a kind of massage occurs - the walls of the vagina are stretched. Thanks to orgasm, the muscles of the reproductive organ are trained. On the eve of the PDR, you can actively have sex if you want to stimulate labor.

This option is more natural than treating the cervix with medications. In addition, semen also contains prostaglandins, which soften the cervix. It is important to check with your doctor whether labor can be induced in this way. If there is a slight opening in the throat, then the risk of infection during sexual intercourse is high.

Primrose oil. A preparation based on primrose oil can be quite effective if your gynecologist has nothing against it. It is produced in capsules. You can buy it without a prescription. Take primrose oil from 36 weeks. The first 7 days, one capsule, and starting from the 38th week, two. The fatty acids of this product affect the production of the hormone prostaglandin. That’s why the neck will ripen at the right time.

Fatty acid. You can stimulate labor and nutrition. About a month before the PDR, preference should be given to fish containing fatty acids.

Nipple massage. About three times a day, a woman can gently massage her nipples. The duration of the procedure is no more than five minutes. When nipples are stimulated, oxytocin is released. This hormone is responsible for the fullness of labor and its timely start.

After childbirth, when a woman puts her baby to her breast, oxytocin will be released so that the uterus contracts faster and returns to its previous size.

Let us remind you once again that all the recommendations outlined above can be tried if your gynecologist has no objections.

Herbs

Medicinal herbs can help prepare for childbirth. Their effectiveness has been proven by many years of experience. Traditional medicine often turns to the help of natural healers.

Raspberry leaves. You need to take 2 tablespoons of fresh leaves or 1 tablespoon of dried leaves. They should be crushed and filled with a liter of water. The dishes must be enameled. When the broth boils, cover it with a lid, turn off the stove and let it brew for several hours. After cooling, strain it and take 100 ml 3 times a day before meals. Therapy should begin no earlier than the 38th week and continue until labor begins.

Rose hip. Take 150 grams of dried fruits and pour boiling water (1 liter) over them. It is best to do this in a thermos with a glass flask. Infuse the drink for several hours, or better yet, all night. In the morning, strain and take 200 ml before breakfast. If the treatment of the cervix is ​​carried out only on the eve of the PDR, then you need to drink the rosehip infusion early - already from the 36th week.

Hawthorn. You can buy hawthorn tincture at the pharmacy. You need to calculate the dosage: every 10 kg of weight is 2 drops. Dissolve them in drinking water and take one hour before meals in the morning and evening. Treatment begins 14 days before the PDR.

Strawberries. You need to take fresh berries (100 grams) and leaves (2 tablespoons). Pour a liter of water and bring to a boil in an enamel bowl. After this, reduce the heat to low and cook for about an hour. Then you need to strain, add honey to taste and take it as a drink throughout the day. The optimal dosage is a liter divided into portions. They begin to enjoy the decoction no earlier than 37-38 weeks.

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Regular visits to the gynecologist during pregnancy will allow you to detect pathology in time and prevent it. You may be advised to treat the cervix, or you will be able to get by with the more gentle methods described in the article. In any case, you need to trust the doctor and believe that the birth will be easy and without unnecessary trauma to the cervix.

Normally, the process of preparing for childbirth in a woman begins at 36-38 weeks of pregnancy, but this does not always happen. If changes in the condition of the uterus are not observed until the 40th week, provided that the gestational age is determined correctly, doctors use techniques to artificially stimulate dilatation. To ensure such a reaction, many medications are used, the list of which includes Papaverine. It is used in the form of a solution for injection and in the form of suppositories for vaginal use. How does Papaverine act on the cervix, how does the active component of the drug accelerate the onset of labor, in what cases is it used and are there any contraindications and adverse reactions? Answers to the main questions that worry the expectant mother are presented in this article.