Society for Maternal-Fetal Medicine Consult Series #59: The use of analgesia and anesthesia for maternal-fetal procedures.

@article{Norton2021SocietyFM,
  title={Society for Maternal-Fetal Medicine Consult Series \#59: The use of analgesia and anesthesia for maternal-fetal procedures.},
  author={Mary E. Norton and Arianna G. Cassidy and Steven J. Ralston and Debnath Chatterjee and Diana L. Farmer and Anitra D Beasley and Monica Dragoman},
  journal={Contraception},
  year={2021}
}
1 Citations
Fetal Pain in the First Trimester
TLDR
Current neuroscientific evidence indicates the possibility of fetal pain perception during the first trimester (<14 weeks gestation), and the use of fetal analgesia suppresses the hormonal, physiologic, and behavioral responses to pain.

References

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Anesthesia for Maternal-Fetal Interventions: A Consensus Statement From the American Society of Anesthesiologists Committees on Obstetric and Pediatric Anesthesiology and the North American Fetal Therapy Network.
TLDR
This consensus statement describes the comprehensive preoperative evaluation, intraoperative anesthetic management, and postoperative care for the different types of maternal-fetal interventions.
Fetal pain: a systematic multidisciplinary review of the evidence.
TLDR
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.
Anesthesia for Fetal Surgery
Fetal endoscopic surgery: indications and anaesthetic management.
Fetal Pain: Do We Know Enough to Do the Right Thing?
Remifentanil for Fetal Immobilization and Maternal Sedation During Fetoscopic Surgery: A Randomized, Double-Blind Comparison with Diazepam
TLDR
It is concluded that remifentanil produces improved fetal immobilization with good maternal sedation and only minimal effects on maternal respiration.
Effect of Direct Fetal Opioid Analgesia on Fetal Hormonal and Hemodynamic Stress Response to Intrauterine Needling
TLDR
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.
Is fetal pain a real evidence?
  • C. Bellieni, G. Buonocore
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2012
TLDR
Most studies disclose the possibility of fetal pain in the third trimester of gestation, though this evidence becomes weaker before this date, though it cannot exclude its increasing presence since the beginning of the second half of the gestation.
Anesthesia for fetal surgery
TLDR
The anesthetic management should focus on maintaining uteroplacental circulation, achieving profound uterine relaxation, optimizing surgical conditions, monitoring fetal hemodynamics, and minimizing maternal and fetal risk.
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