Neurodevelopmental Changes of Fetal Pain

Lowery, Curtis L.; Hardman, M; Manning, Nirvana; Clancy, Barbara; Hall, Richard; Anand, K.J.S.

doi:10.1053/j.semperi.2007.07.004

Cited by 130 publications

(98 citation statements)

References 73 publications

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“…Nociceptive reactions such as withdrawal reflexes can be recorded from the 19th wk (35). By the 20th wk, fetuses were found to increase the levels of cortisol, beta-endorphin, and noradrenaline in umbilical blood when a needle was inserted into the abdomen (38).…”

Section: Sensory Perceptionmentioning

confidence: 99%

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The Emergence of Human Consciousness: From Fetal to Neonatal Life

2009

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A simple definition of consciousness is sensory awareness of the body, the self, and the world. The fetus may be aware of the body, for example by perceiving pain. It reacts to touch, smell, and sound, and shows facial expressions responding to external stimuli. However, these reactions are probably preprogrammed and have a subcortical nonconscious origin. Furthermore, the fetus is almost continuously asleep and unconscious partially due to endogenous sedation. Conversely, the newborn infant can be awake, exhibit sensory awareness, and process memorized mental representations. It is also able to differentiate between self and nonself touch, express emotions, and show signs of shared feelings. Yet, it is unreflective, present oriented, and makes little reference to concept of him/herself. Newborn infants display features characteristic of what may be referred to as basic consciousness and they still have to undergo considerable maturation to reach the level of adult consciousness. The preterm infant, ex utero, may open its eyes and establish minimal eye contact with its mother. It also shows avoidance reactions to harmful stimuli. However, the thalamocortical connections are not yet fully established, which is why it can only reach a minimal level of consciousness. (Pediatr Res 65: 255-260, 2009)

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Section: Sensory Perceptionmentioning

confidence: 99%

“…3). There are several indications that various sensory modalities are processed in the developing brain befor birth (35)(36)(37)(38).…”

Section: Sensory Perceptionmentioning

confidence: 99%

The Emergence of Human Consciousness: From Fetal to Neonatal Life

2009

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“…Se sabe que el desarrollo embriológico del sistema nervioso ya muestra receptores sensoriales cutáneos en el área perioral a las 7 semanas, los que se extienden al resto de la cara, las palmas de las manos y las plantas de los pies por la semana 11, el tronco, las partes proximales de los brazos y las piernas en la semana 15 y para todas las superficies cutáneas en forma abundantes a las 20 semanas 20 . Las vías nociceptivas alcanzan las astas medulares posteriores tan precozmente como a las 8 semanas de gestación; los haces espino-talámicos se completan a las 20 semanas y finalmente los haces tálamo-corticales se desarrollan entre las 26 y 30 semanas 21 . Aunque la corteza cerebral no ha terminado su desarrollo al final del embarazo, se ha observado que otras zonas cerebrales como hipotála-mo y placa subcortical ya están activas y su maduración es a través de un proceso de plasticidad que es estímulo dependiente.…”

Section: Dolor Fetalunclassified

Untitled

2017

Rev Chil Anest

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AntecedentesLa administración de anestesia para la reparación prenatal del mielomeningocele revela condiciones que están ligadas a esta nueva forma de tratamiento: el bienestar fetal, el contexto quirúr-gico y la perfusión uterina.La descripción, el análisis y la comprensión de las distintas variables que están involucradas permitirá disminuir el elevado riesgo que carga esta cirugía.Objetivo: Esta revisión entrega un enfoque sistemático a los nuevos desafíos que plantea la cirugía fetal. IntroducciónEl estudio comparativo sobre el manejo del mielomeningocele (MMC), tan apropiadamente llamado "MOMS" (Management of myelomeningocele study, por su sigla en inglés), fue publicado por primera vez en el New England Journal of Medicine en Marzo 2011 1 . Los hallazgos de este estudio demuestran los beneficios del tratamiento prenatal y sus conclusiones desplazan las fronteras del conocimiento más allá de los convencionales paradigmas de la terapia en Medicina y abren las puertas a un nuevo desafío para los Anestesiólogos: La Cirugía Fetal.Así como la descripción de Vandam 2 sobre las consideraciones anestésicas para el trasplante renal o la de Aldrete 3 en el trasplante hepáti-co o la reciente publicación de Klein 4 sobre las implicancias anestesiológicas en la inserción de la válvula aortica por cateterismo, el trabajo de Adzick 1 da inicio a una nueva era en el desarrollo de la anestesiología donde deberemos contestar preguntas que no nos habíamos formulado y donde deberemos profundizar en áreas que esta emergente técnica nos obligará a desarrollar.Esta publicación esta basada en la experiencia adquirida en los primeros 29 casos realizados en Chile. Se describen los defectos del tubo neural y se analizan las principales variables a considerar:• El dolor fetal.• La técnica anestésica.• La monitorización.• La relajación uterina.• La reposición de fluidos. Epidemiología de los defectos del tubo neuralEn Chile ocurren alrededor de 250.000 nacimientos por año, con una tasa de natalidad de

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“…It is the relationship between the stimulus to the nervous system and the registration of that stimulus in the brain that causes the experience of pain. Pain includes not only the perception of an uncomfortable stimulus but also the response to that perception (Lowery et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Pain Perception Within Consciousness

Mordeniz

2016

Neuroquantology

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As a psychological state, pain is perceived by the affected individual and it corresponds to a form of conscious awareness as a subjective conscious experience mediated in part by beliefs or emotions. Regardless of its 'physical' origins, pain, like all other perceptions, is a mental experience at different degrees of consciousness. The experience of pain requiring a stimulus, a feeling or emotion, and an effect or result, consists of an intermingling of chemical, biological, psychological, physiologic, socioeconomic, cultural, ethnic backgrounds, and emotional and cognitive factors. Not only the activation but also the connections are involved in conscious pain perception. Moreover, interconnectivity between the periaqueductal matter and orbitofrontal cortex is the key to cognitive-emotional responses associated with pain. Thus, the central pain control processes arising from interactions among the cognitive-evaluative, motivational-affective, and sensory-discriminative systems characterize the pain response, being also influenced by both noxious input and cognitive self-regulation. Neuroimaging studies (Davis et al., 2015) in healthy volunteers showed that pain cannot be localized in an isolated "pain center" in the brain, but it rather encompasses a neural circuitry.

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Neurodevelopmental Changes of Fetal Pain

Cited by 130 publications

References 73 publications

The Emergence of Human Consciousness: From Fetal to Neonatal Life

The Emergence of Human Consciousness: From Fetal to Neonatal Life

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Pain Perception Within Consciousness

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