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.

"Because the patient had no urine output while on dialysis, it was difficult to monitor for possible toxemia of pregnancy and we relied heavily on the radiologist to monitor uterine and placental blood circulation indicators. We also had to ensure that there was no risk of fetal distress from fluctuating blood pressure changes during dialysis therapy.”

The team of doctors also included Dr Maliha Hameed, specialist endocrinologist, Dr Suvarna Dhake, specialist radiologist, Dr Zuhair Shihab, head of neonatology and consultant paediatric neonatology, Dr Harish Prabhu, specialist nephrologist, and Dr Khaled Mohsen, specialist anesthesia.

Dramatic climax

However, in May, four days before the planned cesarean, the baby started showing abnormal blood flow and abnormal heart rate, and an emergency c-section was carried out.

A baby boy weighing 2.1kg was born and named Suhail Al Kaabi. Baby Suhail was immediately taken to the NICU for care. The first few days were tough, but the little one like his mother, was a fighter and did well.

Hanan, becoming a mother after five years, was relieved, but the recovery was still a battle.

“Thanks to the Almighty for blessing me with my second child. It was a tough time for us. Despite the obstacles, I never lost faith and continued to fight for the ones I loved. The support of my husband and family, and the medical team helped me overcome the difficulties,” said Hanan.

Dr Jain lauded Hanan’s positive attitude throughout a long, arduous, and emotionally challenging journey.

“Her story truly reminds us that even in the face of adversity, one must never lose faith and believe in the power of love and courage. Also, the baby was a symbol of hope, a reminder that even in the darkest times, light always shines brightly,” she said, adding that the baby needs regular follow-ups with the pediatrician.

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