Imunitné poruchy tehotenstva

15.4.2012 , Veronika Fejfarová

imunitni-poruchy-tehotenstvi.jpg - kopie
imunitni-poruchy-tehotenstvi.jpg - kopie
Imunitné poruchy tehotenstva tvoria osobitnú skupinu porúch, vďaka ktorým môže v krajnom prípade dôjsť až k potratu plodu. Medzi najčastejšie príčiny patrí tvorba protilátok proti spermiám v krčku maternice alebo protilátok proti trofoblastu a tým neschopnosť uhniezdenia zárodku v maternici. Ďalšími príčinami môže potom byť autoimunitné ochorenie matky alebo nekompatibilita v Rh faktore.

Imunitné poruchy tehotenstva

Imunitný systém človeka sa vyvíjal dlhé roky, aby bol schopný rýchlo rozpoznať látky telu cudzie a ochrániť nás pred nimi. Denne musí bojovať s rôznymi vírusmi a baktériami, ktoré na nás neustále útočia. Vďaka nemu neumierame na nádchu, ľahkú chrípku, či poranenia. Aby správne fungoval, musí sa však naučiť rozoznávať tkaniva vlastného tela a tolerovať ich a neútočiť na ne. Bohužiaľ doteraz z neznámej príčiny sa u niektorých jedincov stane, že imunitný systém chybne rozozná vlastné bunky tela a zaútočí na ne. To je podstatou autoimunitných chorôb. Imunita v tehotenstve je zaujímavá kapitola. Pretože spermie sú pre organizmus matky cudzie a taktiež nový plod. Organizmus tento problém vyriešil na niekoľkých úrovniach. V spermiách mužov sú látky, čo imunitný systém ženy lokálne tlmia. Tiež krvný obeh matky a plodu sú prísne oddelené od seba, pretože imunitné bunky a protilátky sa nachádzajú v krvi. Navyše v tehotenstve produkované hormóny prirodzene tlmia imunitu. Tento systém väčšinou veľmi dobre funguje. Bohužiaľ sa niekedy stane, že vznikne problém a vďaka nemu sa nedarí dieťa donosiť.

Imunitné poruchy tehotenstva a ich príčiny

Prvou príčinou neschopnosti donosiť dieťa sú protilátky matky, ktoré sa tvoria proti bunkám zárodku, ktoré sú zodpovedné za uhniezdenie v maternici. Sú to takzvané protilátky proti trofoblastu. Ak ich žena tvorí, tak buď nedôjde k uchyteniu embrya, alebo postupom času dôjde k potratu zárodku. Pri tvorbe protilátok proti spermiám, ktoré môžu byť v hliene krčka maternice, je jednoduchým riešením asistovaná reprodukcia. Tak sa imunitný systém matky obíde. Avšak v prípade, že sa protilátky tvoria priamo proti zárodku, tak jedinou možnosťou je utlmenie imunitného systému matky liekmi. Ďalšou príčinou neplodnosti je, že matka tvorí protilátky proti antifosfolipidom, ktoré sú napríklad v cievach placenty. Protilátky sa na cievy naviažu a upchajú ich. Takže krv v placente, ktorá vyživuje dieťa, nemôže dostatočne cirkulovať a môže dôjsť až k potratu.

Imunitné poruchy tehotenstva a autoimunitné ochorenie

Počas tehotenstva sa medzi obehom matky a dieťaťa vymieňajú dôležité látky pre prežitie dieťaťa. Napríklad kyslík, živiny, hormóny. V niektorých prípadoch bohužiaľ aj nežiaduce protilátky. Ak matka trpí autoimunitným ochorením, akým je systémový lupus erythematosus alebo Sjögrenov syndróm, tak dochádza k tomu, že protilátky, ktoré tvorí, prechádzajú cez placentu do obehu dieťaťa. Tým sú roznášané po jeho tele a reagujú s jeho tkanivami. Tieto protilátky môžu reagovať so srdcovým tkanivom. Takže môže dôjsť k poškodeniu prevodného systému srdca. Riešením vzniknutej situácie je implantácia kardiostimulátora dieťaťu hneď po narodení. Z tohto dôvodu je potrebné tieto matky celé tehotenstvo monitorovať.

Imunitné poruchy tehotenstva a Rh nekompatibilita

Ďalším imunologickým problémom v tehotenstve môže byť rozdielnosť Rh faktorov matky a dieťaťa. Ak je matka negatívna a otec pozitívny, je riziko, že aj dieťa bude pozitívne a matka na neho bude reagovať ako na cudzie. Bude tvoriť protilátky proti Rh faktoru, ktorý je naviazaný na červených krvinkách. Pri prvom tehotenstve veľké riziko nie je, ale pri ďalších sa výrazne zvyšuje. Vzniknuté protilátky sa naviažu na krvinky dieťaťa a ničia ich. Plod preto bude trpieť anémiou a nebude dostatočne vyživovaný kyslíkom. V krajnom prípade môže dôjsť až k potratu. Imunologické príčiny neplodnosti sú zložitá kapitola. Týmito poruchami sa zaoberajú špecializované centrá, ktoré dokážu navrhnúť optimálne riešenie a uľahčiť tak cestu za vytúženým bábätkom.

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