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  Fetal Pain: A Systematic Multidisciplinary Review of the Evidence
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Parent(s) News 
ContributorBrandonius Maximus 
Last EditedBrandonius Maximus  Jun 18, 2013 08:30am
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CategoryStudy
AuthorSusan J. Lee, JD; Henry J. Peter Ralston, MD; Eleanor A. Drey, MD, EdM; John Colin Partridge, MD, MPH; Mark A. Rosen, MD
News DateTuesday, June 18, 2013 02:00:00 PM UTC0:0
Description.....

Pain perception requires conscious recognition or awareness of a noxious stimulus. Neither withdrawal reflexes nor hormonal stress responses to invasive procedures prove the existence of fetal pain, because they can be elicited by nonpainful stimuli and occur without conscious cortical processing. Fetal awareness of noxious stimuli requires functional thalamocortical connections. Thalamocortical fibers begin appearing between 23 to 30 weeks’ gestational age, while electroencephalography suggests the capacity for functional pain perception in preterm neonates probably does not exist before 29 or 30 weeks. For fetal surgery, women may receive general anesthesia and/or analgesics intended for placental transfer, and parenteral opioids may be administered to the fetus under direct or sonographic visualization. In these circumstances, administration of anesthesia and analgesia serves purposes unrelated to reduction of fetal pain, including inhibition of fetal movement, prevention of fetal hormonal stress responses, and induction of uterine atony.
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