Cunha, Miriam Fragoso da2026-03-132026-03-132025-05-26http://hdl.handle.net/10400.5/117560Relatório de estágio; orient. Ana Teresa Gonçalves Azedo Gomes Barreto; pp. 15-60. Monografia: Doença hemolítica do feto e do recém-nascido; orient. Isabel Bettencourt Moreira da Silva; pp. 61-80. Tese de mestrado, Análises Clínicas, 2025, Universidade de Lisboa, Faculdade de Farmácia.O presente trabalho consiste no relatório de estágio curricular, incorporado no plano de estudos do Mestrado em Análises Clínicas da Faculdade de Farmácia da Universidade de Lisboa e é composto por duas partes. A primeira parte consiste na apresentação do local de estágio e no registo de conhecimentos teóricos e práticos que aí foram adquiridos. O estágio decorreu no Laboratório Dra. Elisabeth Barreto em Benavente. O relatório descreve os equipamentos e as metodologias utilizadas para avaliar parâmetros das áreas de Bioquímica, Imunologia e Microbiologia, assim como o processo pré-analítico, valências com as quais tive mais contacto no decorrer do estágio. A segunda parte é uma monografia sobre o tema “Doença Hemolítica do Feto e do Recém-Nascido”, revendo as principais análises clínicas realizadas para diagnosticar esta doença e possíveis abordagens terapêuticas. A doença hemolítica do feto e do recém-nascido, também conhecida por eritroblastose fetal, é resultante de uma incompatibilidade entre o grupo sanguíneo materno e fetal. Uma prévia aloimunização materna é responsável pela produção de anticorpos IgG, que atravessam a placenta e atingem a circulação fetal, provocando a destruição dos eritrócitos fetais que contêm o antigénio correspondente. A aloimunização materna pode ocorrer de várias formas, nomeadamente por transfusões ou hemorragia fetomaterna durante a gravidez ou o parto. A incompatibilidade relativamente ao grupo Rh é a principal responsável por casos graves de doença hemolítica do feto e do recém-nascido, particularmente quando envolve o antigénio RhD. Nos anos 70 do século passado, a implementação de tratamento profilático de mãe RhD negativo com pequenas quantidades de anticorpo anti-D reduziu acentuadamente o número de casos de doença grave associada a esse antigénio. Ainda assim, continuam a existir casos graves desta doença, associados a outros antigénios com elevado grau de imunogenicidade. As principais manifestações desta doença incluem anemia severa e hiperbilirrubinemia, que podem desencadear complicações graves como kernicterus ou hidropisia fetal. A determinação do grupo sanguíneo materno e o teste de Coombs indireto são as duas principais análises clínicas realizadas ao longo da gravidez para avaliar o desenvolvimento desta doença. No recém-nascido, o teste de antiglobulina direto é realizado para confirmar o diagnóstico. Abstract: The present work consists of the curricular internship report, incorporated in the study plan of the Master of Clinical Analysis at the Faculty of Pharmacy of the University of Lisbon, which is composed of two parts. The first part consists of the presentation of the internship location and a report on theoretical and practical knowledge acquired there. The internship took place at the Dr. Elisabeth Barreto laboratory in Benavente. The report describes the equipment and methodologies used to evaluate parameters in the areas of Biochemistry, Immunology and Microbiology, as well as the pre-analytical process, the skills with which I contacted the most during the internship. The second part is a monograph about the theme “Hemolytic disease of the fetus and the newborn”, reviewing the main clinical analyses performed to diagnose this disease and the possible therapeutic approaches. The hemolytic disease of the fetus and the newborn, also known as erythroblastosis fetalis, is consequence of an incompatibility between the maternal and fetal blood group. A previous maternal alloimmunization is responsible for the production of IgG antibodies, which cross the placenta into the fetal bloodstream, causing the destructing of fetal red blood cells containing the corresponding antigen. Maternal alloimmunization can occur in several ways, namely transfusion, fetomaternal hemorrhage during pregnancy or at birth. Rh group incompatibility is the main cause for severe cases of hemolytic disease of the fetus and the newborn, particularly the antigen RhD. In the 70’s of the past century, the implementation of prophylactic treatment of RhD negative mothers with small doses of anti-D antibody significantly reduced the number of cases of severe disease associated with this antigen. Even so, there still are cases of severe disease, however they are associated with other antigens with high degrees of immunogenicity. The principal manifestation of this disease includes severe anemia and hiperbilirrubinemia, which and trigger severe complications like kernicterus and fetal hydrops. The determination of the maternal blood group and the direct Coombs test are the main clinical analyses performed during pregnancy to evaluate the development of this disease. In the newborn, the direct antiglobulin test is performed to confirm the diagnoses.The present work consists of the curricular internship report, incorporated in the study plan of the Master of Clinical Analysis at the Faculty of Pharmacy of the University of Lisbon, which is composed of two parts. The first part consists of the presentation of the internship location and a report on theoretical and practical knowledge acquired there. The internship took place at the Dr. Elisabeth Barreto laboratory in Benavente. The report describes the equipment and methodologies used to evaluate parameters in the areas of Biochemistry, Immunology and Microbiology, as well as the pre-analytical process, the skills with which I contacted the most during the internship. The second part is a monograph about the theme “Hemolytic disease of the fetus and the newborn”, reviewing the main clinical analyses performed to diagnose this disease and the possible therapeutic approaches. The hemolytic disease of the fetus and the newborn, also known as erythroblastosis fetalis, is consequence of an incompatibility between the maternal and fetal blood group. A previous maternal alloimmunization is responsible for the production of IgG antibodies, which cross the placenta into the fetal bloodstream, causing the destructing of fetal red blood cells containing the corresponding antigen. Maternal alloimmunization can occur in several ways, namely transfusion, fetomaternal hemorrhage during pregnancy or at birth. Rh group incompatibility is the main cause for severe cases of hemolytic disease of the fetus and the newborn, particularly the antigen RhD. In the 70’s of the past century, the implementation of prophylactic treatment of RhD negative mothers with small doses of anti-D antibody significantly reduced the number of cases of severe disease associated with this antigen. Even so, there still are cases of severe disease, however they are associated with other antigens with high degrees of immunogenicity. The principal manifestation of this disease includes severe anemia and hiperbilirrubinemia, which and trigger severe complications like kernicterus and fetal hydrops. The determination of the maternal blood group and the direct Coombs test are the main clinical analyses performed during pregnancy to evaluate the development of this disease. In the newborn, the direct antiglobulin test is performed to confirm the diagnoses.application/pdfpor204100550Doença hemolítica do feto e do recém-nascidoAloimunização maternaHemólise fetalIncompatibilidade de Rh e AB0Imunoglobulina anti-DTeses de mestrado -2025master thesis