Hemolytic Disease of the Fetus and Newborn (HDFN) results from fetal-maternal blood group incompatibility, particularly involving the RhD antigen. Despite preventive strategies, HDFN remains a significant cause of perinatal morbidity, especially in low-income regions. This study evaluates the efficacy of postnatal anti-D immunoprophylaxis in RhD-negative women, considering the potential benefits of earlier administration. A longitudinal follow-up study was conducted from June 2023 to September 2024. Data were collected through structured questionnaires and laboratory analyses, including ABO and RhD blood typing using the Beth-Vincent and Simonin methods and irregular antibody screening via the indirect Coombs test. Statistical analyses were performed using Fisher’s exact test with contingency tables and Microsoft Excel. Among 174 women, 50.57% were aged 25 - 35, and 56.32% were in their third trimester at the time of enrollment. Over half (53.45%) did not know their spouse’s blood type. Of the 131 RhD-negative women with RhD-positive partners, 5.71% developed anti-D antibodies despite postnatal prophylaxis. No significant association was found between immunization and parity, previous transfusions, or miscarriage history. Postnatal anti-D immunoprophylaxis does not fully prevent alloimmunization. These findings highlight the need for earlier immunoprophylaxis, including routine fetal RHD genotyping and targeted antenatal anti-D administration, to improve maternal and neonatal outcomes.
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