Abstract
Genetic polymorphisms play a critical role in the interindividual variability of pain perception and opioid response. These variations become relevant during pregnancy and the postpartum period, where managing pain effectively while ensuring maternal and fetal safety is a clinical priority. Polymorphisms in genes such as OPRM1, CYP2D6, COMT, UGT2B7, and ABCB1 have been linked to differences in opioid efficacy, dosing requirements, and adverse event profiles in obstetrical settings. This review synthesizes current evidence on the impact of pain-related genetic polymorphisms during labor, cesarean section, and postpartum recovery and also in onco-gynecological surgery. The article highlights the risks of under- medication or over-medication, especially in ultra-rapid and poor metabolizers, and evaluates how pharmacogenomic insights could guide safer, more personalized analgesic strategies in perinatal care and surgery, in general.