Pregnant dialytic patients are among the greatest concerns throughout the States considering they fall under high-risk patients. Therefore, since dialytic patients are often not considered fit to carry a pregnancy to full term there are things they should know if they consider having a child. So far, only 1-7% of dialytic patients are able to carry their pregnancy to at least 32 weeks otherwise, majority of the patients have been advised from having children. On the other hand, there have been situations where it was possible to have children despite the low statistics. So some of the truths that could help in making a well-informed decision include:
One of the reasons obstetricians and doctors discouraged patients with kidney diseases from having children included the hormonal imbalances. Most of them have irregular periods making fertilization slightly difficult. Therefore, for a patient under dialysis to conceive is difficult and in most cases, doctors encouraged family planning methods even in cases where the periods were regular. For these reasons, it was important to have urine tests and other blood tests before proceeding with the conception plans. Otherwise, depending on the severity of the kidney disease the doctors have offered assistance in making the right plans on how to go about it.
Positive: As far as NCBI medical report was of concern, women who had a residual kidney function and had just started dialysis qualified for successful pregnancies than the ones who had been undergoing such treatment for a longer period. On the other hand, they still had to be monitored and advised to have more dialysis sessions than they used to before.
Health Care Teams
When a dialytic patient discovered she had conceived she had to work with a medical team of six specialists. These included the doctor, obstetrician who’s specialized in such pregnancies, a renal dietitian, a nephrologist, a dialysis nurse and a pediatrician who specialized in premature births. Therefore, the team monitors the blood pressure, protein levels from the urine tests, baby’s growth, weight gain on the mother and the diet. In other words, until the baby is born the mother would have to work closely with this team for healthier and safer pregnancy on delivery.
Positive: As long as the mother had frequent dialysis, the renal dietitian should be able to recommend healthier meals that assured positive baby’s development throughout the period. In fact, the more number of dialysis the easier it would be for the baby to get all the crucial nutrient requirements needed for its growth.
Most nephrologists recommend a transplant to improve chances of a successful gestation period. At least, 20% of transplant females have had a better chance of conceiving compared to those on dialysis. So a transplant has been highly recommended for those longing to have a baby. On the other hand, to avoid the loss of a transplant or the child it has been advised to wait for at least one year before considering pregnancy. In other words, doctors could walk with you throughout the transplant as well as give a green light on when to have a child.
Positive: Transplant patients have had a better kidney function than those under dialysis increasing the chances of 100% clean and healthy diet delivered to the fetus. In addition, after the transplant, there have been better chances of getting back to a regular menstrual cycle and increasing chances of normal blood pressure making a person an ideal candidate for pregnancy.
One of the main reasons for discouraging women under dialysis from getting pregnant included the protein levels in their blood. Most of the time, suffering from kidney diseases meant proteins leaking to the waste, leading to little protein flowing in the bloodstream. Therefore, proteins should be in the bloodstream and not in the urine. So depending on the stage of the sickness and proteinuria levels, a patient could be advised against or advised to have a baby.
Positive: Tests indicated patients undergoing erythropoietin (EPO) stood a better chance of having successful pregnancies and being qualified for them. The EPO also helped in retaining better levels of blood count.
All pregnant women or women planning to conceive but under dialysis have to undergo counseling. The psychological preparation to either be able to conceive or to face the risks of carrying the pregnancy should never be underestimated or brushed off because the risks have been as real as being considered as unable to conceive. So regardless of the doctor’s results it’s important to seek counseling to help cope with the emotional impact over the whole issue.
Positive: Counseling has not only helped to unwind the impact of the result to a patient but it’s also buffered the emotional turmoil. So far, counseling should also reduce the chances of suffering from hypertension or blood pressure related issues. In fact, undergoing counseling assists in being a little bit positive on the outcome of the doctor’s recommendations.
In other words, with a good medical team and residual kidney functions it should be possible to carry a pregnancy to full term. Even though with the chances of premature births there should be better chances of having a healthy child and successful development long after the incubation. Most babies that have been delivered prematurely have survived and thrived like every other child. There could be concerns of malformations during pregnancy or ending up with a special-need child but most of the time, the child ended up a normal.
The hope of many parents is a child who will grow, play with the others and with the current medical interventions it is very possible. In most cases, mothers on antenatal care are continually advised and guided on nutrition to ensure the baby continued to get its nutrients especially for nursing mother. On the other hand, most doctors have advised bottle feeding as a result of medication leaking to the breast milk.
Doctors will assess the safety of nursing the baby. The most crucial factor in consideration has been the risk exposed to the baby. Some doctors have altered medication to ensure the mother continued to nurse her baby and there were also times when altering did not work. In the long run, it was important to keep the baby healthy but with the formula milk any child should thrive regardless the circumstances of the child’s birth. In some cases, such babies did even better than the children born under normal conditions including the developmental milestones which have often been the same as other children.
So a woman who hopes to have a child even under dialysis, she should know it is possible.