PERINATAL HEMOLYTIC DISEASE (ERYTHROBLASTOSIS FETALIS) IN AMAZONAS: ANALYZING THE IMPACT OF MATERNAL-FETAL BLOOD INCOMPATIBILITY AND THE IMPORTANCE OF ANTI-D IMMUNOGLOBULIN IN PREVENTION

Abstract

Introduction: Perinatal Hemolytic Disease (PHD) is a condition characterized by the destruction of fetal or neonatal red blood cells resulting from maternofetal blood incompatibility, particularly involving the Rh factor. In cases of RhD incompatibility, the disease occurs when an RhD-negative mother becomes sensitized to the D antigen present on fetal red blood cells; this leads to the production of maternal antibodies that can cross the placenta and cause the destruction of fetal red blood cells. Such sensitization may occur following a previous pregnancy or in other situations allowing the passage of fetal red blood cells into the maternal circulation. This Rh-negative incompatibility arises because the red blood cells lack the D antigen protein. During a first pregnancy, maternal sensitization is uncommon, and the initial response is mediated by IgM-type antibodies, which do not cross the placental barrier. However, exposure to fetal blood (usually during delivery) induces a secondary immune response. In subsequent pregnancies, the maternal immune system produces IgG-type antibodies capable of crossing the placenta and causing fetal hemolysis, leading to complications such as anemia, generalized edema, jaundice, or life-threatening risks. This study aims to analyze the impact of maternofetal blood incompatibility and the importance of anti-D immunoglobulin in preventing Perinatal Hemolytic Disease (PHD). The methodology consists of quantitative, exploratory research utilizing secondary data regarding the number of recurrent cases of Perinatal Hemolytic Disease in the State of Amazonas over the past five years. Results: It was found that for every 100 pregnant women in the North Region, approximately 5 to 11 are Rh-negative (presenting a risk of sensitization), while 89 to 95 are Rh-positive (free from this risk). Without prophylaxis, the rate of maternal alloimmunization reaches approximately 12%; however, with the proper administration of anti-D immunoglobulin, the risk drops drastically to approximately 0.1% to 2%. Regarding the literature, searches were conducted using up-to-date scientific articles.