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Related Concept Videos

Proliferative Phase01:20

Proliferative Phase

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The proliferative phase typically occurs after menstruation and lasts between 6 to 13 days in a standard 28-day cycle. This phase involves the reconstruction of the endometrium, guided by estrogen produced by the developing ovarian follicle.
Notably, the stratum basale, the basal layer of the endometrium, including the basal parts of the uterine glands, remains unaffected by menstruation. Stem cells in this layer undergo mitosis, regenerating the stratum functionalis and thickening the...
599
Secretory Phase01:19

Secretory Phase

951
The secretory phase of the menstrual cycle, spanning from day 14 to 28 in a typical 28-day cycle, is a period of significant physiological changes in the female reproductive system. This phase commences immediately after ovulation and is characterized by the preparation of the endometrium for potential embryo implantation.
Following ovulation, the corpus luteum, a temporary endocrine structure, produces progesterone and estrogens. These hormones stimulate the growth and coiling of endometrial...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Menses Phase01:18

Menses Phase

347
The uterine cycle begins with the menstrual phase, which is considered day one of the cycle and typically lasts about five days. This phase is characterized by the degeneration and shedding of the stratum functionalis, the functional layer of the endometrium.
When fertilization does not occur, the corpus luteum deteriorates, causing a significant drop in the levels of estrogen and progesterone in the body. This hormonal decrease triggers the release of prostaglandins, which cause the uterine...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

894
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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The Menstrual Cycle01:19

The Menstrual Cycle

986
The menstrual cycle is a recurrent sequence of changes in the uterine endometrium, specifically its functional layer, the stratum functionalis. This cycle prepares the uterus for potential pregnancy. This cycle typically spans 21–35 days, averaging 28 days, and aligns with the ovarian cycle, regulated by fluctuating levels of ovarian hormones, primarily estrogen and progesterone.
The menstrual phase occurs from days 1 to 5 and involves the shedding of the stratum functionalis, as a...
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Updated: Aug 4, 2025

Author Spotlight: Advancing Labor Management Through Electromyometrial Imaging for Understanding Uterine Contractions
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The active phase of labor.

Emanuel A Friedman1, Wayne R Cohen2

  • 1Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA.

American Journal of Obstetrics and Gynecology
|March 30, 2023
PubMed
Summary

The active phase of labor is defined by accelerating cervical dilatation, with disorders like protracted labor or arrest potentially requiring cesarean delivery. Understanding these patterns is crucial for effective labor management and preventing complications.

Keywords:
abnormal laboractive phasearrest of active-phase dilatationcephalopelvic disproportioncervical dilatationcesarean deliveryclinical practice guidelinesdeceleration phaselatent phaseprolonged deceleration phaseprotracted active phasetransition to active phase

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • The active phase of labor is characterized by a transition to rapid cervical dilatation, but its onset lacks definitive diagnostic markers beyond acceleration.
  • Aberrant labor patterns, including protracted dilatation, arrest of dilatation, prolonged deceleration, and failure of descent, can occur during the active phase.

Purpose of the Study:

  • To review the characteristics of the active phase of labor, including its onset and termination.
  • To discuss aberrant labor patterns, their underlying factors, and implications for management.
  • To examine issues related to new clinical practice guidelines for labor management.

Main Methods:

  • Literature review of labor patterns and management guidelines.
  • Analysis of factors contributing to aberrant labor.
  • Discussion of clinical implications and diagnostic challenges.

Main Results:

  • The active phase of labor is identified by accelerating cervical dilatation, ending with a deceleration phase.
  • Factors contributing to active-phase disorders include cephalopelvic disproportion, uterine factors, fetal malpositions/malpresentations, and maternal conditions.
  • Cesarean delivery is indicated for active-phase disorders with compelling evidence of disproportion; prolonged deceleration is linked to disproportion and second-stage abnormalities.

Conclusions:

  • Active-phase labor disorders necessitate careful evaluation, with cesarean delivery being a justifiable option when disproportion is evident.
  • Prolonged deceleration and second-stage abnormalities are strongly associated, potentially leading to shoulder dystocia.
  • The review highlights the importance of updated clinical practice guidelines for optimizing labor management.