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Molecular techniques like polymerase chain reaction and DNA sequencing have significantly improved the identification of weak D variants, offering more reliable transfusion strategies and reducing the risk of alloimmunization. However, challenges such as lack of standardized protocols, cost constraints, and population-specific variations remain. In obstetrics, proper management of pregnant women with weak D is essential to prevent hemolytic disease of the fetus and newborn. Non-invasive prenatal testing using cell-free fetal DNA shows promise in predicting RhD incompatibility and minimizing unnecessary Rh immune globulin administration. Future advancements in high-throughput genotyping and discovery of novel RHD  alleles could enhance RhD testing accuracy and efficiency. Standardizing RHD  genotyping and adopting genotype-based management strategies for Rh immune globulin therapy and red blood cell transfusions will improve patient safety and clinical outcomes. This review examines the molecular basis, challenges, and future prospects in weak D phenotype management.<\/jats:p>","DOI":"10.5493\/wjem.v15.i2.102345","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T07:35:38Z","timestamp":1744356938000},"source":"Crossref","is-referenced-by-count":5,"title":["Weak D phenotype in transfusion medicine and obstetrics: Challenges and opportunities"],"prefix":"10.5493","volume":"15","author":[{"given":"Prasanna Bharathi","family":"Sainath","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Velmurugan","family":"Ramaiyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024025099"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/voxs.12280"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.43386"},{"key":"B4","unstructured":"Dean L.   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