Is fetal pain a real evidence?

  title={Is fetal pain a real evidence?},
  author={Carlo Valerio Bellieni and Giuseppe Buonocore},
  journal={The Journal of Maternal-Fetal \& Neonatal Medicine},
  pages={1203 - 1208}
Due to the progress in fetal surgery, it is important to acquire data about fetal pain. Material and methods: We performed a Medline research from 1995, matching the following key words: “pain” and “fetus”, with the following: “subplate”, “thalamocortical”, “myelination”, “analgesia”, “anesthesia”, “brain”, “behavioral states”, “substance p”. We focused on: (a) fetal development of nociceptive pathways; (b) fetal electrophysiological, endocrinological and behavioral reactions to stimuli and… 
New insights into fetal pain.
  • C. Bellieni
  • Medicine
    Seminars in fetal & neonatal medicine
  • 2019
Use of fetal analgesia during prenatal surgery
Fetal direct analgesia is performed only in a minority of cases and no study gives details about fetal reactions to pain, so more research is needed to assess or exclude its possible long-term drawbacks, as well as the actual consequences of pain during surgery.
Analgesia for fetal pain during prenatal surgery: 10 years of progress
The human fetus can feel pain when it undergoes surgical interventions and direct analgesia must be provided to it.
Compassionate Treatment of Fetal Pain
It is the duty of the profession to adopt a compassionate attitude to alleviate pain and suffering of the unborn child, starting at 18-20 weeks' gestation, as the authors do for their neonates.
Pain Assessment in Human Fetus and Infants
The aim of this paper is to gather from scientific literature the available data on the signals that the human fetus and newborns produce, and that can be interpreted as signals of pain, to create specific and sensible pain assessment tools used to rate the level of pain.
On the feasibility of accessing acute pain–related facial expressions in the human fetus and its potential implications: a case report
This is the first description of a recordable acute pain model in the human fetus by the use of a facial expression–based tool and may pave the way for objective assessments of pain in fetuses, should it endure the steps of formal validation studies.
Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study
  • T. Hata
  • Medicine, Psychology
    The journal of obstetrics and gynaecology research
  • 2016
Four‐dimensional ultrasound has opened the door to new scientific fields, such as ‘ Fetal neurology’ and ‘fetal psychology’, and fetal neurobehavioral science is at the dawn of a new era.
Fetal Stress: Ultrasound Study of Fetal Behavior
4D ultrasound may be a valuable tool for assessing fetal neurobehavioral development during gestation and the follow-up of fetal activity by 4D ultrasound could allow distinction between normal and abnormal fetal behavior, which would help in early identification of fetal brain impairment.


The importance of ‘awareness’ for understanding fetal pain
Neurodevelopmental changes of fetal pain.
Although evidence for conscious pain perception is indirect, evidence for the subconscious incorporation of pain into neurological development and plasticity is incontrovertible, it seems prudent to avoid pain during gestation.
Fetal pain: a systematic multidisciplinary review of the evidence.
Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester, and limited or no data exist on the safety of such techniques for pregnant women in the context of abortion.
Effect of Direct Fetal Opioid Analgesia on Fetal Hormonal and Hemodynamic Stress Response to Intrauterine Needling
It is concluded that intravenous fentanyl attenuates the fetal stress response to intrahepatic vein needling in alloimmunized fetuses undergoing intravascular transfusion between 20 and 35 weeks.
Fetal Plasma Concentrations after Intraamniotic Sufentanil in Chronically Instrumented Pregnant Sheep
The sheep fetus absorbs sufentanil after intraamniotic instillation, and significantly greater PCs were obtained in the fetal lamb as compared with the ewe, suggesting that investigation of intraamniotics opioids for fetal analgesia might be worthwhile.
Fetal myelomeningocele: natural history, pathophysiology, and in-utero intervention.
  • N. Adzick
  • Medicine
    Seminars in fetal & neonatal medicine
  • 2010
Fetal pain perception and pain management.
Does parenchymal brain injury affect biobehavioral pain responses in very low birth weight infants at 32 weeks' postconceptional age?
It is suggested that cerebral injury predominantly to the central white matter leaves brainstem responses intact in the neonatal period, and the injured brain of the preterm infant has not yet expressed the identifiable differences in pain display and the functional impairment observed at later ages.
Fetal vibroacoustic stimulation
Although further research is needed, the ability of vibroacoustic stimulation to elicit FHR accelerations has been established, thus decreasing the falsepositive rate associated with nonreactive nonstress testing.