Doença hemolítica perinatal: aspectos atuais
Palabras clave:
anemia hemolítica congênita, diagnóstico pré-natal, eritroblastose fetal, isoimunização RhResumen
Após a introdução e o amplo uso da imunoprofilaxia anti-D, houve um evidente decréscimo na incidência da aloimunização das mulheres de risco nos países desenvolvidos. Entretanto, a taxa de incidência tem se mantido constante nos últimos anos, contribuindo de forma significativa para a morbimortalidade perinatal e configurando-se ainda como um desafio para a medicina materno fetal. A doença hemolítica perinatal é caracterizada por anemia fetal de diferentes graus com seqüelas neuropsicomotoras, hidropisia e óbito fetal. Nenhum método propedêutico pré-natal isolado foi altamente indicativo de prognóstico perinatal das gestações complicadas por doença hemolítica perinatal. A transfusão intra uterina é o único tratamento específico disponível atualmente para a doença hemolítica perinatal durante o período pré-natal. A mortalidade perinatal é de cerca de 16% para os fetos não hidrópicos e 58% para os hidrópicos. A tipagem RhD fetal permite a identificação de "fetos de risco" para a doença hemolítica perinatal, e pode ser realizada atualmente no nível molecular. Este artigo faz uma revisão de alguns aspectos da doença hemolítica perinatal, com um breve histórico, fisiopatologia, quadro clínico, aspectos diagnósticos e terapêuticos e atuais avanços, com ênfase na utilização de técnicas da biologia molecular.
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