How a determined 38-year-old Hanan beat the odds through a high-risk pregnancy in Al Ain
Dubai: A 38-year-old Emirati woman, who has been undergoing dialysis for the past three years, has delivered a baby boy against all odds. Al Ain-based Hanan, who goes on dialysis three times a week even now, told Gulf News, “Nothing is impossible. Never give up hope and have full faith in the Almighty.” The mum of two, who has a five-year-old daughter in addition to the newborn, said she was diagnosed with end-stage kidney disease four years earlier. “I was a diabetic and felt shattered when I heard the news, but thanks to the support of my husband and my family, I accepted my situation and tried to work around it,” she said. The positive mindset prepared her well for what lay in store. Hanan said she received the most pleasant surprise when she discovered that she was pregnant last year. “I yearned to have another child and wanted to explore the possibility of going in for IVF treatment when my prayers were answered,” she said. Although she was well aware of the challenges and risks involved in going ahead with the pregnancy, she said she was determined to see it through. She was under the treatment of Dr. Venkat Sainaresh Vellanki, Consultant Nephrologist at Burjeel Royal Hospital, Al Ain, where she was put on a tailored dialysis treatment plan while also a strict protocol to keep her sugar and hypertension under control.
Dr 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/preterm.”
Accordingly, he and a multi-disciplinary team of doctors at the hospital, including Dr. Sulsa M. Jain, Specialist Obstetrics & Gynecology, counselled Hanan on the potential complications that could arise during her pregnancy while on dialysis. Hanan said, “I knew it would not be easy and I was anxious. But at no point did I doubt my decision to ahead with the pregnancy. So I took great care to follow the instructions I received.”
According to the doctors, Hanan’s case was veritable challenge because of many factors. Apart from the kidney disease, her risk factors also included her age, diabetes, weight, hypertension, anemia, anuria and tendency to bleed. “There was also a need for constant monitoring for congenital anomalies in the child, intrauterine growth retardation, and foetal distress from the cord around the neck.”
Hanan’s husband Saeed Al Kaabi admitted that it was a tough time for the entire family. “I was worried about my wife and baby’s condition. Luckily, by the grace of the Almighty and the support of the doctors, we were able to overcome the situation. The strength of a mother prevailed despite the dialysis, as she delivered the greatest gift of all – a new life,” he said. Doctors let on that the dialysis regimen had to be tailored to accommodate Hanan’s other appointments with medical consultants, besides laboratory and ultrasound tests. She also wanted to travel out of Al Ain during the Ramadan break. Dr Vellanki said the task before the doctors was not just to ensure safe dialysis, but prevent clotting, maintain cardiac stability and keep all her other health concerns under check. “Because the patient had no urine output while on dialysis, it was difficult to monitor her for possible toxemia of pregnancy. 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 foetal distress from fluctuating blood pressure changes during dialysis.”
An elective Cesarean was planned at 36 weeks, but four days before the big day, the baby started showing abnormal blood flow and abnormal heart rate. As such, an emergency C-section was carried out and Hanan’s baby boy, weighing 2.1kg, arrived. Named Suhail Al Kaabi, he was immediately taken to the NICU where he, like his warrior mum, battled it out.
“I cannot thank the doctors at the hospital enough,” said Hanan. “I never lost faith and I received the best possible support I could for me and my child.”
For the doctors, the challenges continued even after delivery as they had to readjust pre-and post-dialysis weights to minimise excessive fluid removal, monitor for early signs of depression, infection, toxemia of pregnancy, anemia, hypertension, diabetes, electrolyte imbalance, blood clots and lactation issues. As Dr Jain said, “Hanan’s journey had been long, arduous, and emotionally challenging, but it was worth every moment. It showed that motherhood can be challenging, but with the right attitude, it is a journey filled with love and joy. 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.”