fetomaternel

Fetomaternel refers to the relationship and interactions between the fetus and the mother during pregnancy, particularly through the placental interface. The term encompasses the exchange of gases, nutrients, and waste, as well as immune interactions across the placenta.

The placenta consists of fetal tissue connected to the mother via the maternal blood in the intervillous spaces. Although maternal and fetal blood circulate in close proximity, their circulations are separated by the placental barrier, allowing selective transfer of substances while limiting direct mixing.

Fetomaternal hemorrhage describes the transfer of fetal red blood cells into the maternal circulation, which can occur during delivery, miscarriage, trauma, or invasive prenatal procedures. Although often small, this event can trigger maternal immune sensitization to fetal antigens and influence future pregnancies.

Alloimmunization and Rh disease are key concerns when fetomaternal hemorrhage exposes the mother to fetal red cell antigens. In Rh incompatibility, maternal anti-D antibodies can develop after sensitization and cross the placenta, potentially causing hemolytic disease in the fetus or in subsequent pregnancies. Prevention with Rh immunoglobulin reduces the risk of sensitization after events that may cause bleeding.

Diagnosis and management involve screening for maternal alloantibodies and assessing fetomaternal hemorrhage when indicated. The Kleihauer-Betke test or flow cytometry can quantify fetal cells in maternal blood. Management depends on gestational age, antibody status, and the severity of exposure, and may include monitoring or targeted interventions.

Clinically, fetomaternel interactions influence obstetric outcomes, including risks of fetal anemia, alloimmunization, and transfusion needs. Ongoing research aims to improve detection, prevention, and understanding of placental immune tolerance in pregnancy.