Eritroblastosis fetal como modelo de interacción inmunohematológica materno-fetal: Una revisión desde las ciencias básicas.
Palabras clave:
Eritroblastosis fetal, hemólisis, inmunoglobulina G, hiperbilirrubinemia, intercambio materno-fetal.Resumen
La eritroblastosis fetal, también conocida como enfermedad hemolítica del feto y del recién nacido (EHRN), constituye un ejemplo representativo de las interacciones entre los sistemas inmunológicos materno y feto-placentario. Esta condición se presenta cuando los anticuerpos maternos de tipo IgG atraviesan la barrera placentaria e inducen la destrucción de los eritrocitos fetales, lo cual puede desencadenar anemia, hidropesía fetal e incluso la muerte intrauterina en los casos de mayor gravedad. Si la hemólisis persiste tras el parto, puede derivar en hiperbilirrubinemia severa y kernícterus, lo que resalta la relevancia de un diagnóstico oportuno. Herramientas como el genotipado fetal mediante ADN libre circulante y la prueba de Coombs indirecta permiten una detección temprana y no invasiva, contribuyendo a minimizar los riesgos asociados a los procedimientos invasivos tradicionales. En cuanto al manejo, la inmunoglobulina anti-D continúa siendo la estrategia preventiva más eficaz, mientras que terapias emergentes como el nipocalimab ofrecen alternativas al bloquear la transferencia placentaria de anticuerpos previamente formados. Con una mortalidad perinatal que aún puede alcanzar el 25%, esta patología no solo pone de manifiesto la fragilidad del equilibrio inmunológico durante la gestación, sino que subraya la necesidad de implementar estos avances científicos en entornos clínicos con recursos limitados.
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Derechos de autor 2026 Ana Sofia Lascarro-Sánchez
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