Pregnancy & Dialysis
I was asked to write an article on my experience being pregnant while on dialysis. I thought it would be a great idea to give some insight on my journey. I must say that it was the hardest thing I have ever had to do, but when I look at my baby boy now, I know that would do it a million times over.
Before I was pregnant, I was on peritoneal dialysis for approximately 9 months. Prior to PD, pregnancy was not an option because I had no menstrual period, as most women don’t while on dialysis. When my menstrual cycle resumed about 5 months after starting PD, I considered it to be a miracle. My husband and I began doing research on pregnancy and dialysis and decided to give it a try. After losing a baby 4 years ago to miscarriage we knew that we wanted a baby more than ever. The doctors were not very happy about this and warned us about how difficult it would be…. 3 months later we were pregnant!
I continued PD until I was 24 weeks pregnant, I went to the hospital to start hemodialysis. This was especially hard for me because I have a 9yr old son at home, and I didn’t want to be away from him my hubby, or my dog. It was October, so the holidays were quickly approaching, and I would be away from my family for Thanksgiving and Christmas. I was told that I would stay there until the baby was born (or my due date), whichever came first. My due date was February 2018.
I couldn’t do my hemodialysis treatments as an outpatient because the baby had to be monitored during dialysis and for one hour after. PD was impossible because my belly was growing and I couldn’t handle so much fluid. At that time I was doing treatments for 17 hours a day. It was really hard to be connected to a machine for so many hours. 1100 ml of fluid and a growing baby in my belly was also difficult to manage.
I went into surgery to get my permacath placed in my neck, for which I was admitted for. I was awake for the procedure and only under local anaesthesia since I couldn’t get general anaesthesia. It was so painful that I cried the whole time on the table. The following day I started dialysis 3x a week – by the end of my pregnancy, I was doing haemodialysis 5 days a week for 4 hours. The only good thing about so much dialysis was that my diet was open and I could eat pretty much anything I wanted. The baby was doing well except that he was a little smaller for his gestational age. I was getting 2 shots of heparin daily which left my arms bruised, and a bunch of other meds that I honestly can’t remember. I also was given 2 rounds of 2 shots of steroids for the baby’s lungs.
At about 28 weeks I developed cholestasis. Cholestasis is defined as a decrease in bile flow due to impaired secretion by hepatocytes or to obstruction of bile flow through intra-or extrahepatic bile ducts. It caused me to have the worst itching on every part of my body mostly the bottom of my feet and my hands. The itching would get a lot worse at night. Sometimes I would only get 30 mins of sleep. They started me on a liquid medicine called atarax, that was supposed to help with the itching, but it didn’t help at all. I was worried because the medicine would make me sleepy. It would also make the baby sleepy. I fought with the doctors to give me relief or plan for delivery a little bit sooner. The itching was ridiculous. The best way to describe the itching was that it was from within. No matter how much I scratched the itching would not go away.
At 32 weeks and 4 days, I had just completed dialysis and I was on the baby monitor waiting for my hour to finish so that I could eat lunch when the nurse entered the room in a panic and asked me to turn on my side. I was a little concerned. The nurse couldn’t find his heartbeat. A minute or so later a few more nurses rushed into the room and starting getting oxygen machines ready. At this point, I started to panic. My husband was an hour away with our older son and I knew that if the baby was coming he would miss his birth. When the baby’s heartbeat wasn’t found after a few minutes, they rushed me to the operating room. Thankfully when we reached the OR they did an ultrasound and his heartbeat was found. They never told me what caused his heart rate to drop although I believe it was due to the atarax. The rest of the day I was on the baby monitor and I couldn’t eat just in case the baby wanted to start his shenanigans again. Finally, they let me go back to my room and have something to eat, but I had to stay on the monitor. I am grateful that I was because that night at 4 am I was awakened by the nurse. Once again the baby’s heartbeat couldn’t be found. I was rushed into the OR again and 20 mins later Baby Enzo was born, weighing in at 3lbs. I was told that I had to have an emergency c-section because he was being deprived of oxygen. I woke up from surgery and called my husband and told him he was a daddy.
2 months later we brought our little boy home after spending much needed time in the NICU so he could grow. He came home weighing 6lbs 5oz. I was also able to breastfeed which I thought was impossible. When I look back at what I went through, at the time I wanted to give up. It was so hard! Not only being away from my family, but I was always in pain from the shots. I was over getting dialysis almost every day. It felt like I was going to be there forever. I knew that it was going to be hard but this was by far the hardest thing. I don’t think that there is a way to mentally prepare yourself for an experience like this. I knew that I wanted to be a mom again, and I knew that this would be the only way that it would happen. I’m grateful for my family and friends that kept me positive. The doctors and nurses were also wonderful and did the best that they could to make sure that I was comfortable. You definitely need to have tough skin to be able to go through this process but it is well worth it when you see the life you created. I’m happy to be home with my miracle baby, and able to share my story. Thank you 🙂
Angelique Feliciano, 35 yrs old. Wife and full time mom of 2 miracle boys.
Many thanks to Angelique for this amazing post. Please remember that no recommendations are made for any drugs mentioned.