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Bastu Odoka: Closing the Gap on Anti-D Prophylaxis in Maternal Care
Feb 25, 2026, 09:08

Bastu Odoka: Closing the Gap on Anti-D Prophylaxis in Maternal Care

Bastu Odoka, Transfusion Scientist at Effia-Nkwanta Regional Hospital, shared a post on LinkedIn:

“Anti-D Prophylaxis: A Preventable Gap in Maternal Care

In a recent pre-print review:

  • 39 RhD-negative mothers with previous pregnancies
  • Only 13 received Anti-D prophylaxis
  • 3 of the 13 later developed anti-D antibodies

This is not about blame. It is about systems.

Why Anti-D matters

Anti-D immunoglobulin prevents RhD alloimmunisation when:

  • The mother is not already sensitised
  • It is administered at routine antenatal timing (around 28 weeks per protocol)
  • It is given within 72 hours postpartum when indicated
  • All sensitising events are recognised and treated
  • Appropriate dosing is used (including for significant fetomaternal haemorrhage)
  • Antibody screening (Indirect Antiglobulin Test) is properly documented

If Anti-D is given late, after sensitisation has already occurred, or in inadequate dose, it will not prevent alloimmunisation.

Why this matters clinically

Missed or delayed prophylaxis can lead to:

  • Preventable maternal sensitisation
  • Haemolytic disease of the fetus and newborn (HDFN)
  • High-risk future pregnancies
  • Increased neonatal morbidity and healthcare costs

Prevention is safer and far more cost-effective than managing severe neonatal complications.

A systems opportunity in Ghana and similar settings

Strengthening Anti-D access and standardisation could significantly reduce preventable alloimmunisation.

Potential areas for improvement:

  • National bulk procurement to ensure consistent availability and reduce unit cost
  • Inclusion of Anti-D under NHIS to remove financial barriers
  • Development or update of a clear national guideline to standardise timing, dosing, documentation and follow-up
  • Strengthening routine antibody screening and documentation practices

This is not only a laboratory issue. It is a maternal and neonatal safety priority.

Preventable alloimmunisation should not become a lifelong risk for mothers when effective prophylaxis exists.

Strong systems protect mothers.

Strong policies protect future generations.”

Bastu Odoka: Closing the Gap on Anti-D Prophylaxis in Maternal Care

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