Pathophysiological bases of pain syndrome during labor

Close metadata

Recommended articles:

Acute respiratory infections in pregnant women with respiratory diseases. Obstetric and perinatal outcomes. Russian Bulletin of Obstetrician-Gynecologist. 2024;(1):76-82

Adverse perinatal outcomes in COVID-19. Analysis of a series of clinical observations. Russian Bulletin of Obstetrician-Gynecologist. 2024;(2):86-90

The problem of diabetes mellitus in obstetrics. Russian Bulletin of Obstetrician-Gynecologist. 2024;(3):25-29

Clinical observation of successful pregnancy and delivery of patients with giant placental chorioangioma. Russian Bulletin of Obstetrician-Gynecologist. 2024;(3):103-107

Assessment of risk factors for breast cancer development in women living in the Saratov region. Russian Bulletin of Obstetrician-Gynecologist. 2024;(6):100-106

Ginkgolide B: mechanisms of neurobiological effects, prospects for use in the therapy of Alzheimer’s disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;(4):22-27

Recovery of consciousness under therapy with benzodiazepines. A case report and literature review. Burdenko's Journal of Neurosurgery. 2024;(3):81-89

Treatment of atopic dermatitis considering assessment of neurotransmitters in blood. Russian Journal of Clinical Dermatology and Venereology. 2024;(4):368-376

Neurochemical mechanisms of tremor in Parkinson’s disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;(11):64-72

Clinical case of successful pregnancy in a patient with ectopic ACTH syndrome after radical surgical treatment. Russian Journal of Human Reproduction. 2024;(6):118-123

The paper gives the results of published papers on the pathophysiological bases of pain syndrome during labor. The anatomical and physiological bases, including the visceral and somatic components of a pain response, are outlined in detail. The main theories of pain and their interpretation regarding pain during labor are considered. The basic control mechanisms of pain sensitivity and the significance of neurotransmitters, opioid receptors, and endogenous morphine are analyzed; the role of another important structure of pain modulation, such as the brainstem periaqueductal gray matter, is considered. Relevant studies dealing with the ability of oxytocin to modulate pain and to induce analgesia are presented; the mechanisms through which these effects are achieved are described.

Keywords:

labor

visceral pain component

somatic pain component

substantia gelatinosa

brainstem periaqueductal gray matter

pain theory

neurotransmitters

endogenous morphines

oxytocin

Authors:

Upriamova E.Iu.

Moskovskiĭ oblastnoĭ NII akusherstva i ginekologii

SPIN RSCI: 5925-0041
Scopus AuthorID: 57203117137
ResearcherID: M-8044-2016

Krasnopol'skiĭ V.I.

Moskovskiĭ oblastnoĭ NII akusherstva i ginekologii

SPIN RSCI: 9537-1147
Scopus AuthorID: 16406760000

Shifman E.M.

M.F. Vladimirsky Moscow Regional Research Clinical Institute, Ministry of Health of the Moscow Region, Moscow, Russia

SPIN RSCI: 4582-8494
Scopus AuthorID: 6507655298
ResearcherID: AAY-3981-2020
ORCID: 0000-0002-6113-8498

List of references:

Val’dman AV, Ignatov YuD. Tsentral’nye mekhanizmy boly. [Central pain mechanisms]. L.: Nauka. 1976;194. (In Russ.)
Fiziologicheskie mekhanizmy regulatsii bolevoi chuvstvitel’nosti. [Physiological mechanisms of pain sensitivity regulation]. M.: Meditsina. 1984;211. (In Russ.)
Epiduralnaya anesteziya i analgeziya v akusherstve. [Epidural anesthesia and analgesia in obstetrics]. M.: Meditsina. 1990;238. (In Russ.)
Tingaker B.K., Irestedt L. Changes in uterine innervation in pregnancy and during labour. Curr Opin Anesthesiol. 2010;23:3:300-303. https://doi.org/10.1097/aco.0b013e328337c881
Bonica JJ, Chadwick HS. Labour pain. In: Wall PD, Melzack R, eds. Textbook of Pain. New York: Churchill Livingstone. 1989;482-499.
Arendt-Nielsen L, Madsen H, Jarrell J, Gregersen H, Drewes AM. Pain evoked by distension of the uterine cervix in women with dysmenorrhea: evidence for central sensitization. Acta Obstet Gynecol Scand. 2014;93:8:741-748. Epub 2014 May 24 https://doi.org/10.1111/aogs.12403
Garfield RE Maner WL. Physiology and electrical activity of uterine contractions. Semin Cell Dev Biol. 2007;18:3:289-295. https://doi.org/10.1016/j.semcdb.2007.05.004
Ness TJ, Gebhart GF. Visceral Pain — A Review of experimental studies. Pain. 1990;41:2:167-234. https://doi.org/10.1016/0304-3959(90)90021-5
Julius D, Basbaum AI. Molecular mechanisms of nociception. Nature. 2001;413:6852:203-210. https://doi.org/10.1038/35093019
Eisenach J. Neurophysiology of labour pain, 2010. http://www.esahq.org/~/media/ESA/Files/Refresher%20Courses/2010/Neurophysiology%20of%20labour%20pain%20(2010).ashx (accessed 5 February 2017)
Bonica JJ, McDonald JS. The pain of childbirth. In: Bonica JJ. (Ed.). The management of pain (2^nded.p.1313-1343). Philadelphia: Lea and Febiger. 1990;1313-1343.
Lowe NK. The pain and discomfort of labor and birth. J Obstetric, Gynecologic & Neonatal Nursing. 1996;25:1:82-92. https://doi.org/10.1111/j.1552-6909.1996.tb02517.x
Hector NA, Mitchell BF. Physiological pathways and molecular mechanisms regulating uterine contractility. Human Reproduction Update. 2010;16:6:725-744. https://doi.org/10.1093/humupd/dmq016
Byron KL, Brueggemann LI. Labour pains: giving birth to new mechanisms for the regulation of myometrial contractility. J Physiol. 2009;587:10:2109-2110. https://doi.org/10.1113/jphysiol.2009.173641
Eltzchig HK, Lieberman ES, Camann WR. Regional anesthesia and analgesia for labor and delivery. N Engl J Med. 2003;348:4:319-332. https://doi.org/10.1056/nejmra021276
Labor S, Maguire S. The pain of labour. British Journal of Pain. 2008;2:2:15-19. https://doi.org/10.2307/27508260
Sandkuhler J. Learning and memory in pain pathways. Pain. 2000;88:2:113-118. https://doi.org/10.1016/s0304-3959(00)00424-3
Blackburn ST. Maternal, fetal, & neonatal physiology: A clinical perspective, 2nd ed. St. Louis. MO: Elsevier. Science. 2003;781. https://doi.org/10.1016/s1526-9523(04)00014-5
Corder G, Siegel A, Intondi AB, Zhang X, Zadina JE, Taylor BK. A novel method to quantify histochemical changes throughout the mediolateral axis of the substantia gelatinosa after spared nerve injury: characterization with TRPV1 and substance P. J Pain. 2010;11:4:388-398. https://doi.org/10.1016/j.jpain.2009.09.008
Auvray M, Myin E, Spence C. The sensory-discriminative and affective-motivational aspects of pain. Neurosci Biobehav Rev. 2010;34:2:214-223. https://doi.org/10.1016/j.neubiorev.2008.07.008
Yang Y, Raine A. Prefrontal structural and functional brain imaging findings in antisocial, violent, and psychopathic individuals: a metaanalysis. Psychiatry Research. 2009;174:2:81-88. https://doi.org/10.1016/j.pscychresns.2009.03.012
Alvarez JA, Emory E. Executive function and the frontal lobes: a meta-analytic review. Neuropsychology Review. 2006;16:1:17-42. https://doi.org/10.1007/s11065-006-9002-x
Millan MJ. The induction of pain: an integrative review. Prog Neurobiol. 1999;57:1:1-164. https://doi.org/10.1016/s0301-0082(98)00048-3
Vein AM, Avrutskii MYa. Bol’ i obezbolivanie. (Pain and pain relief). Moscow: Meditsina. 1997;280. (In Russ.)
Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:3699:971-979. https://doi.org/10.1126/science.150.3699.971
Melzack R. From the gate to the neuromatrix. Pain. 1999; 82:(Suppl):S121-S126. https://doi.org/10.1016/s0304-3959(99)00145-1
Melzack R. Pain: An overview. Lancet. 1999;353:1964:1607-1609. https://doi.org/10.1016/s0140-6736(99)01311-2
Douglas SD. Substance P and sickle cell disease-a marker for pain and novel therapeutic approaches. Br J Haematol. 2016;175:2:187-188. https://doi.org/10.1111/bjh.14299
Schlereth T, Schukraft J, Krämer-Best HH, Geber C, Ackermann T, Birklein F. Interaction of calcitonin gene related peptide (CGRP) and substance P (SP) in human skin. Neuropeptides. 2016;59:57-62. https://doi.org/10.1016/j.npep.2016.06.001
Loyd DR, Murphy AZ. The role of the periaqueductal gray in the modulation of pain in males and females: Are the anatomy and physiology really that different? Hindawi Publishing Corporation Neural Plasticity. 2009;1-12. https://doi.org/10.1155/2009/462879
Millan MJ. Descending control of pain. Prog Neurobiol. 2002;66:6:355-474. https://doi.org/10.1016/s0301-0082(02)00009-6
Koyyalamudi V, Sidhu G, Cornett EM, Nguyen V, Labrie-Brown C, Fox CJ, Kaye AD. New labor pain treatment options. Curr pain headache rep. 2016;20:2:11. https://doi.org/10.1007/s11916-016-0543-2
Ekblom A, Rydh-Rinder M. Pain mechanisms: Anatomy and physiology. In Rawal N. Management of acute and chronic pain. London (UK): BMJ Books. 1998.
Oyama T, Matsuki A, Taneichi T, Ling N, Guillemin R. beta-Endorphin in obstetric analgesia. Am J Obstet Gynecol. 1980;137:5:613-616. https://doi.org/10.1016/0002-9378(80)90706-1
Palatiniuk RJ, Schnider SM, Eger EI. Pregnancy decreases the requirement for inhaled anesthetic agents. Anesthesiology. 1974;41:1:82-83. https://doi.org/10.1097/00000542-197407000-00021
Xin Q, Bai B, Liu W. The analgesic effects of oxytocin in the peripheral and central nervous system. Neurochemistry International. 2017;103:57-64. https://doi.org/10.1016/j.neuint.2016.12.021
Condes-Lara M, Zayas-Gonzalez H, Manzano-Garcia A, Cordova-Quiroz E, Granados-Mortera J, Garcia-Cuevas M, Morales-Gomez J, Gonzalez-Hernandez A. Successful pain management with epidural oxytocin. CNS Neurosci Ther. 2016;22:6:532-534. https://doi.org/10.1111/cns.12551
Hobo S, Hayashida K, Eisenach JC. Oxytocin inhibits the membrane depolarization-induced increase in intracellular calcium in capsaicin sensitive sensory neurons: a peripheral mechanism of analgesic action. Anesth Analg. 2012;114:442-449. https://doi.org/10.1213/ane.0b013e31823b1bc8
Gutierrez S, Liu B, Hayashida K, Houle TT, Eisenach JC. Reversal of peripheral nerve injury-induced hypersensitivity in the postpartum period: role of spinal oxytocin. Anesthesiology. 2013;118:152-159. https://doi.org/10.1097/aln.0b013e318278cd21
Breton JD, Poisbeau P, Darbon P. Antinociceptive action of oxytocin involves inhibition of potassium channel currents in lamina II neurons of the rat spinal cord. Mol Pain. 2009;5:1744-8069-5-63. https://doi.org/10.1186/1744-8069-5-63
Breton JD, Veinante P, Uhl-Bronner S, Vergnano AM, Freund-Mercier MJ, Schlichter R, Poisbeau P. Oxytocin-induced antinociception in the spinal cord is mediated by a subpopulation of glutamatergic neurons in lamina I-II which amplify GABAergic inhibition. Mol Pain. 2008;4:1744-8069-4-19. https://doi.org/10.1186/1744-8069-4-19
Condes-Lara M, Rojas-Piloni G, Martinez-Lorenzana G, Lopez-Hidalgo M, Rodriguez-Jimenez J. Hypothalamospinal oxytocinergicanti nociception is mediated by GABAergic and opiate neurons that reduce A-delta and C fiber primary afferent excitation of spinal cord cells. Brain Res. 2009а;1247:38-49. https://doi.org/10.1016/j.brainres.2008.10.030
Yang J, Pan YJ, Zhao Y, Qiu PY, Lu L, Li P, Chen F, Yan XQ, Wang DX. Oxytocin in the rat caudate nucleus influences pain modulation. Peptides. 2011;32:10:2104-2107. https://doi.org/10.1016/j.peptides.2011.08.021
Russo R, D’Agostino G, MattaceRaso G, Avagliano C, Cristiano C, Meli R, Calignano A. Central administration of oxytocin reduces hyperalgesia in mice: Implication for cannabinoid and opioid systems. Peptides. 2012;38:81-88. https://doi.org/10.1016/j.peptides.2012.08.005
Yu SQ, Lundeberg T, Yu LC. Involvement of oxytocin in spinal antinociception in rats with inflammation. Brain Res. 2003;983:13-22. https://doi.org/10.1016/s0006-8993(03)03019-1
Engle MP, Ness TJ, Robbins MT. Intrathecal oxytocin inhibits visceromotor reflex and spinal neuronal responses to noxious distention of the rat urinary bladder. Reg Anesth Pain Med. 2012;37:515-520. https://doi.org/10.1097/01.aoa.0000436295.46263.d6
Tan ZJ, Wei JB, Li ZW, Shao M, Hu QS, Peng BW. Modulation of GABA-activated currents by oxytocin in rat dorsal root ganglion neurons. Sheng Li Xue Bao. 2000;52:381-384. PMID: 11941391
Juif PE, Poisbeau P. Neurohormonal effects of oxytocin and vasopressin receptor agonists on spinal pain processing in male rats. Pain. 2013;154:1449-1456. https://doi.org/10.1016/j.pain.2013.05.003

Close metadata