Emirati woman beats odds, delivers baby while undergoing dialysis for end-stage kidney disease in Al Ain hospital

In a heartwarming development, a 38-year-old Emirati woman with diabetes and end-stage kidney disease for the past four years, who was undergoing dialysis, has fought all odds to deliver a healthy baby boy in Abu Dhabi’s ‘Garden City’ of Al Ain.

Medical experts and studies noted that a pregnant woman with such serious health issues and on dialysis is at a high risk of maternal and foetal complications like miscarriage, stillbirth, and preterm among others. Pregnancy, a beautiful journey for any woman, was filled with fears of such uncertainties for Hanan.

Four years back, after delivering her first baby girl, Hanan was diagnosed with end-stage renal disease and diabetes. Even as her dialysis started at a private hospital in Al Ain, she strived to manage her health issues and lead a normal life. However, she longed to have another child to complete her family.

Though the risks associated with pregnancy and dialysis were understandably significant, Hanan was determined to become a mother again. While on a personalised dialysis regimen with good control of her diabetes and hypertension, she became pregnant.

It was exciting yet daunting news for the couple. At that time, Hanan was under the treatment of Dr Venkat Sainaresh Vellanki, consultant nephrologist at Burjeel Royal Hospital in Al Ain.

“Initially, being on dialysis, I was both anxious and overwhelmed about the pregnancy. There were many concerns, especially from my family and my husband, but I had confidence that I was being treated by safe hands and wanted to keep the baby,” Hanan recollected.

Dr Vellanki underlined that 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 preterm,” said Dr Vellanki, who along with Dr Sulsa M. Jain, specialist obstetrics and gynecology, had counselled Hanan on the potential complications.

Hanan took extreme care in monitoring her condition and following the instructions given to her.

Emotional rollercoaster

Pregnancy in dialysis patients is considered high-risk and requires management by a multidisciplinary team of medical experts. According to doctors, Hanan’s case was quite challenging because of her age and other risk factors including obesity, type 2 diabetes mellitus, hypertension, anemia, anuria, bleeding tendency, etc. There was also a need for constant monitoring for congenital anomalies in the child, intrauterine growth retardation (smaller growth than expected), and fetal distress from the cord around the neck.

Despite all these precautions and care, the fear of losing her baby constantly weighed on Hanan’s mind as she carried on bravely without missing any checkups, blood tests and ultrasounds. Hanan’s husband Saeed Al Kaabi, said those months were a challenging period.

“I was worried about my wife and baby’s condition. Luckily, by the grace of the Almighty and the support of the doctors at Burjeel Hospital, we were able to overcome the situation. Through the struggles of dialysis, the strength of a mother prevailed, as she brought forth the greatest gift of all – a new life.”

Dynamic treatment plan

The dialysis schedule was constantly tweaked to meet the prescribed goals for safe pregnancy outcomes. Hanan was also able to spend time outside Al Ain during Ramadan holidays.

“The key challenges during therapy were to provide safe dialysis without consequences during frequent and long dialysis sessions, to avoid blood clots, to maintain proper weight gain, control anemia, hypertension, diabetes, retinopathy, and to maintain cardiac stability," Dr Vellanki said and added that her cesarean delivery was planned at 36 weeks.

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