Foetal pain reviewed
When should we call a foetus a human being? When can we accept that the foetus experiences pain? According to this latest study by Mellor and colleagues, the current understanding of pain perception during development is still poorly understood. The importance of ‘awareness’ for understanding fetal pain by Mellor DJ, Diesch TJ, Gunn AJ, Bennet […]
When should we call a foetus a human being? When can we accept that the foetus experiences pain? According to this latest study by Mellor and colleagues, the current understanding of pain perception during development is still poorly understood.
The importance of ‘awareness’ for understanding fetal pain
by Mellor DJ, Diesch TJ, Gunn AJ, Bennet L in Brain Res Brain Res Rev. 2005 Nov ; 49(3): 455-71
Abstract
Our understanding of when the fetus can experience pain has been largely shaped by neuroanatomy. However, completion of the cortical nociceptive connections just after mid-gestation is only one part of the story. In addition to critically reviewing evidence for whether the fetus is ever awake or aware, and thus able to truly experience pain, we examine the role of endogenous neuro-inhibitors, such as adenosine and pregnanolone, produced within the feto-placental unit that contribute to fetal sleep states, and thus mediate suppression of fetal awareness. The uncritical view that the nature of presumed fetal pain perception can be assessed by reference to the prematurely born infant is challenged. Rigorously controlled studies of invasive procedures and analgesia in the fetus are required to clarify the impact of fetal nociception on postnatal pain sensitivity and neural development, and the potential benefits or harm of using analgesia in this unique setting.
