38-year-old Emirati woman undergoing dialysis blessed with baby boy
- 26 Jul 2023
Mariecar Jara-Puyod, Senior Reporter
A 38-year-old Emirati undergoing dialysis since four years back because her kidneys could no longer function well has been blessed with a boy, now two months old.
Hanan also has been living with diabetes since she was 12 and so the necessary dialysis, beginning 22 years later, and son Suhail had been discharged and are doing well.
Gulf Today was informed that Hanan’s dialysis was only discontinued on May 25 (Thursday), the scheduled Caesarean section delivery of Suhail when he was already 36 weeks and which was in accordance with Hanan’s state.
Moreover, the Burjeel Royal Hospital in Al Ain multi-disciplinary team of specialists who have been closely monitoring and taking care of her since 2019, had resumed the procedure thrice a week “after Suhail was born.”
Nephrology consultant Dr Venkat Sainaresh Vellanki said: “Conceiving while on dialysis is extremely unusual. In the rare occasions where dialysis patients do conceive, the pregnancies are complex and the vast majority end in miscarriage or pre-term. The key challenges during therapy were to provide safe dialysis without consequences during the long and frequent dialysis sessions; to avoid blood clots; to maintain proper weight gain; control anaemia, hypertension, diabetes, retinopathy (disease of the retina); and to maintain cardiac stability.
Because the patient had no urine output while on dialysis, it was difficult to monitor for possible toxemia of pregnancy (existence of hypertension and signs of damaged organs).
We relied heavily on the radiologist to monitor the uterine and placental blood circulation indicators. We also had to ensure that there was no risk of foetal distress from fluctuating blood pressure changes during the dialysis therapy.”
Hanan’s husband Saeed Al Kaabi admitted to being anxious: “We were passing through a difficult time. I was worried about my wife’s and baby’s condition. Luckily, by the grace of the Almighty and the support of the doctors, we were able to overcome. Through the struggles of dialysis, the strength of a mother prevailed, as she brought forth the greatest gift of all new, a new life.”
Hanan’s Obstetrics & Gynaecology specialist Dr Sulsa M. Jain was interviewed as well for a closer understanding on the risks and consequences of pregnancy while on dialysis.
Jain primarily reiterated what Vellanki had claimed about the rarity of getting pregnant while on dialysis because the technology-assisted removal of substances such as water and toxins from the body, leads to “decreased egg production” with over 90 per cent of childbearing age women affected and only one to seven per cent of women in this situation, impregnated.
According to the UK-based National Kidney Federation, the high improbability of pregnancy while on dialysis is so because despite the procedure, not all the wastes are extricated from the body. Therefore, ovulation and menstrual cycle become irregular.
Jain said the pregnant woman on dialysis has to extremely coordinate with and obey the order of the team of “nephrologists, obstetricians, paediatricians, dialysis nurses, and dietitians for the increased chances of maintaining her health and carrying the baby to full term.” Miscarriages, emergency childbirth and stillbirth must at all cost be prevented.
“Renal transplant is often recommended to improve and stabilise the patient’s kidney status. However, pregnancy is generally considered a high-risk situation for dialysis patients,” she added, also pointing out that it is important for the pregnant woman on dialysis to attend more frequently dialysis sessions from three to six times a week as per her doctor’s recommendation.
Doing so “can help in better blood pressure control,” Jain continued.
She also said: “During pregnancy, maintaining a healthy and nutrient-dense diet is of utmost importance. Many kidney disease patients experience high blood pressure which tends to worsen during pregnancy and can lead to miscarriage or preterm delivery.
Close monitoring of the mother’s blood pressure is crucial as it may rise during pregnancy, posing risks to both mother and baby. It is recommended for the expectant mother to take additional vitamins and consume a diet with higher protein content. Regular ultrasounds should be performed to monitor the baby’s progress to promptly identify and address any potential issues.”