Loading...
Publication
Importância da pesquisa de anti-M em grávidas
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 40360 | 815.87 KB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Resumo: A doença hemolítica do feto e do recém-nascido (DHFRN), é uma doença hemolítica onde a o sistema imunitário da mãe produz de forma rápida e maciça de anticorpos de um tipo diferente, que atravessam a placenta e se ligam aos eritrócitos fetais. Estes são, então, destruídos pelo sistema imunitário do feto ou do recém-nascido dando origem a um aumento de bilirrubina no sangue do feto ou recém-nascido. Na maioria dos casos, isto deve-se á incompatibilidade ABO ou Rh, mas há cada vez mais casos de outros tipos de antigénios que causam DHFRN como é o caso do sistema MNS. Neste trabalho será estudada a importância do anti-M e a eventual possibilidade de causar DHFRN.
Objetivos: Descrever na população de grávidas que apresentaram Prova de Antiglobulina Indireta (PAI) positiva com a presença de anti-M, nos anos de 2020 ao primeiro semestre de 2023 na população de grávidas do Centro Materno Infantil do Norte. Conhecer e identificar o número de casos positivos assim como a avaliação dos títulos de anti-M. Foi feita ainda a avaliação pós-parto; assim como avaliação do recém-nascido, nados vivos de puérperas com títulos de anti-M positivos.
Métodos e Materiais: O estudo decorreu entre o ano de 2020 a 2023 nas puérperas que são seguidas no Centro Materno Infantil do Norte (CMIN), do Centro Hospitalar Universitário de Santo António (CHUdSA). Foi feito a recolha de dados no programa informático “Gestão de Sangue” e nos processos clínicos que posteriormente foram anonimizados. Foram incluídas dez mulheres grávidas e dez recém-nascidos.
Resultados: Teste de PAI positivos em todas as grávidas, com títulos anti-M positivos de valor permanente (sendo ele alto ou baixo). Um recém-nascido apresentou Titulo de Antiglobulina Direta (TAD) positiva e foi submetido a fototerapia. Os restantes nove casos apresentavam TAD negativa ou não foi possível obter informação (dois foram submetidos a fototerapia, cinco não tinham critérios para fototerapia e três não se obteve informação).
Conclusões: Apesar do anti-M estar raramente associado a DHFRN existem atualmente cada vez mais provas da sua associação dados confirmados pela literatura. A investigação irá manter-se no sentido de perceber em definitivo quais os antigénios do sistema MNS, particularmente quais os antigénios anti-M podem ser causa de DHFRN.
Abstrat: Hemolytic disease of the fetus and newborn (DHFRN), is a hemolytic disease where the mother's immune system makes a rapid and massive production of antibodies of a different type, which cross the placenta and attach to fetal red blood cells. These are then destroyed by the immune system of the fetus or newborn giving rise to an increase in bilirubin in the blood of the fetus or newborn. In most cases this is due to ABO or Rh incompatibility, but there are increasing cases of other types of antigens causing DHFRN, such as the MNS system. In this paper we will study the importance of anti-M and the possible possibility that it causes DHFRN. Objectives: To describe in the population of pregnant women who had positive Indirect Antiglobulin Test (IAT) with the presence of anti-M, in the years 2020 to 2023 in the population of pregnant women of the Maternal and Child Center of the North.To know and identify the number of positive cases and how many had high titers. Postpartum evaluation; Newborn evaluation, live births of puerperal women with positive anti-M titers. Methods and Materials: Study between the year 2020 and 2023 in puerperal women who are followed at the, Centro Materno Infantil do Norte (CMIN) of Centro Hospitalar Universitário de Santo António (CHUdSA). Data were collected from the "Blood Management" computer program and from clinical records and subsequently anonymized. We included tem pregnant women and ten newborns, studied during 2022 and 2023. Results: Positive IAT test in all pregnant women, positive anti-M titers of permanent value (whether high or low). 1 newborn had positive Direct Antiglobulin Test (DAT) and underwent phototherapy. Another nine cases had negative TAD or no information was obtained (where two underwent phototherapy, five had no criteria for phototherapy and three no information was obtained). Conclusions: Although anti-M is rarely associated with DHFRN, there is now increasing evidence of its association confirmed in the literature. Research will continue in order to understand definitively which antigens of the MNS system, particularly which anti-M antigens may be the cause of DHFRN.
Abstrat: Hemolytic disease of the fetus and newborn (DHFRN), is a hemolytic disease where the mother's immune system makes a rapid and massive production of antibodies of a different type, which cross the placenta and attach to fetal red blood cells. These are then destroyed by the immune system of the fetus or newborn giving rise to an increase in bilirubin in the blood of the fetus or newborn. In most cases this is due to ABO or Rh incompatibility, but there are increasing cases of other types of antigens causing DHFRN, such as the MNS system. In this paper we will study the importance of anti-M and the possible possibility that it causes DHFRN. Objectives: To describe in the population of pregnant women who had positive Indirect Antiglobulin Test (IAT) with the presence of anti-M, in the years 2020 to 2023 in the population of pregnant women of the Maternal and Child Center of the North.To know and identify the number of positive cases and how many had high titers. Postpartum evaluation; Newborn evaluation, live births of puerperal women with positive anti-M titers. Methods and Materials: Study between the year 2020 and 2023 in puerperal women who are followed at the, Centro Materno Infantil do Norte (CMIN) of Centro Hospitalar Universitário de Santo António (CHUdSA). Data were collected from the "Blood Management" computer program and from clinical records and subsequently anonymized. We included tem pregnant women and ten newborns, studied during 2022 and 2023. Results: Positive IAT test in all pregnant women, positive anti-M titers of permanent value (whether high or low). 1 newborn had positive Direct Antiglobulin Test (DAT) and underwent phototherapy. Another nine cases had negative TAD or no information was obtained (where two underwent phototherapy, five had no criteria for phototherapy and three no information was obtained). Conclusions: Although anti-M is rarely associated with DHFRN, there is now increasing evidence of its association confirmed in the literature. Research will continue in order to understand definitively which antigens of the MNS system, particularly which anti-M antigens may be the cause of DHFRN.
Description
Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Análises Clínicas e Saúde Pública
Keywords
Grávidas Grupo MNS Anti-M Titulação de anticorpos Pregnant women MNS group Antibody titration