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What do we know about fetal pain?

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2021. Sujet(s) : Ressources en ligne : Abrégé : Questions and research about fetal pain and its consequences follow on from those about neonatal pain and its management in the 1980s. Traditional definitions of pain cannot be applied to the fetus. Fetal pain is currently defined as the response to nociceptive stimulation. Nociceptors are widely present at the cutaneous level in the fetus. Nociceptive stimulation does not mean that the fetus has the ability to “feel.” The fetus is equipped to perceive nociceptive stimulation. The question is whether this system is operational. The maturation of the central nervous system is a complex process that is difficult to study. The practice of potentially painful invasive procedures for the fetus triggered research on fetal analgesia in the 1990s. Various situations were identified as potentially painful during the antenatal period. Although the fetus does not experience pain as a conscious being, it does show an adaptive stress response to nociceptive stimulation resulting in hemodynamic and hormonal changes. These changes, if they occur at a critical stage of CNS development, may have immediate but also long-term consequences. New imaging techniques are opening up new possibilities for research both in the accuracy of brain development at each gestational age and in a functional approach. The complexity of brain development, the consequences of the fetal environment, and the consequences of different stimuli, including pain, require transdisciplinary research.
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Questions and research about fetal pain and its consequences follow on from those about neonatal pain and its management in the 1980s. Traditional definitions of pain cannot be applied to the fetus. Fetal pain is currently defined as the response to nociceptive stimulation. Nociceptors are widely present at the cutaneous level in the fetus. Nociceptive stimulation does not mean that the fetus has the ability to “feel.” The fetus is equipped to perceive nociceptive stimulation. The question is whether this system is operational. The maturation of the central nervous system is a complex process that is difficult to study. The practice of potentially painful invasive procedures for the fetus triggered research on fetal analgesia in the 1990s. Various situations were identified as potentially painful during the antenatal period. Although the fetus does not experience pain as a conscious being, it does show an adaptive stress response to nociceptive stimulation resulting in hemodynamic and hormonal changes. These changes, if they occur at a critical stage of CNS development, may have immediate but also long-term consequences. New imaging techniques are opening up new possibilities for research both in the accuracy of brain development at each gestational age and in a functional approach. The complexity of brain development, the consequences of the fetal environment, and the consequences of different stimuli, including pain, require transdisciplinary research.

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