For many years we have been talking about a very special patient, the embryo; and the numerous and encouraging successes brought about by embryofetal medicine in the application of both noninvasive therapies and invasive ultrasound-guided tre- ment are well known. On the other hand, it is more and more often the case today that the small patients in neonatal care are premature babies who have come to the world at a particul- ly low gestational age. This allows us to observe the continuity between the ph- es of growth inside the maternal uterus and after birth, which arrives at the correct moment for some lucky fetuses, for others very early, and for some altogether too soon. The neonatologists have the arduous task of sustaining these little patients in their strivings to survive, registering their energy and their vital dynamism, stu- ing the progressive development of the anatomical structures and the improvement of their physiology, verifying day by day the presence – sometimes fragile, so- times extremely resistant, but always human – of a child. A long line research has shown how, from the first moment onwards in that process of perfectly coordinated development that characterizes the life of the embryo, a human being gradually emerges who is increasingly able to interact with his or her environment.
First book dealing with fetal pain and its consequences, and with pain in "premature babies"
International renowned authors contribute to the evaluation of fetal and neonatal pain from different points of view
Until the 1980s it was denied that fetuses and neonates feel pain. With the advent of a deeper understanding of the pathophysiology and new diagnostic tools, the last 30 years have seen great developments in this field, but the treatment of neonatal and fetal pain is still a controversial issue and a central topic, not only in specialties directly concerned with it, but also in bioethics. Some important issues are still under investigation. When does pain perception appear? Is it ethical to cure fetal pain? Does fetal pain have consequences for the developing brain? Can a fetus suffer?
This volume aims to give an overview of current knowledge in the field. An international team of specialists has been assembled to evaluate neonatal and fetal pain from various points of view – neurological, pediatric, gynecological, anesthesiological – and with regard to possible consequences of pain (including psychological) for the brain.
This book will be an invaluable resource for neonatologists, pediatricians, anesthesiologists, gynecologists, and other professionals involved in this field, and for postgraduate students in all disciplines.
Introduction: Pain and Suffering from the Womb Onwards?.- Part 1 Delivery and Pain: Gonad Hormones and Pain Modulation. Stress and Pregnancy: CRF as Biochemical Marker. Pain Control During Labour.- Part 2 Fetal pain: Ultrasound and Fetal Stress: Study of the Fetal Blink-Startle Reflex Evoked by Acoustic Stimuli. Prenatal Affective Exchanges and Their Subsequent Effects in Post-Natal Life. Pain In The Fetus. New Insights into Prenatal Stress: Immediate and Long-Term Effects on the Fetus and Their Timing.- Part 3 Neonatal pain: Pain Assessment and Spectral Analysis of Neonatal Crying. Analgesic Procedures in the Newborns. Nonpharmacological Treatment of Neonatal Pain. Sensory Saturation: An Analgesic Method. Pharmacologic Analgesia in the Newborn. Physical Stress Risk Agents in Incubators.- Part 4 Pain: a Risk Factor for Brain Damage: Neonatal Stressors. New Insights into Neonatal Hypersensitivity. From the Gate-Control Theory to Brain Programs for Neonatal Pain.- Part 5 Pain and Communication: Disclosure of Pathology to the Newborn's Family. Communication of Diagnosis: Pain and Grief in the Experience of Parents of Children with a Congenital Malformation. Invest in Prenatal Life: A High-Yield Stock.- Subject Index