Multidisciplinary Team Protects Kidney Transplant Patient First-time Mom and Son

By: Miranda Torres

After being exposed to E.coli as a child, Hayley Dodge, 35, developed hemolytic syndrome and hypertension, which was just the beginning of a long, complex health journey involving renal complications and an eventual kidney transplant. Once she became pregnant with her first child, Dodge knew her pregnancy would be affected by her medical history.

Because her nephrology and hematology care teams were at UHealth – University of Miami Health System, Dodge decided to seek out an OB-GYN at The Women’s Hospital at Jackson Memorial. This led her to Anna Sfakianaki, MD, a maternal-fetal medicine specialist at The Women’s Hospital.

Dr. Sfakianaki explained to Dodge that her pregnancy was considered high risk due to her history of renal failure. One major factor that contributed to Dodge’s high-risk status was a previous diagnosis of atypical hemolytic uremic syndrome (HUS), a rare disease that causes blood clots to form, and blocks blood flow to vital organs like the kidneys. The medications Dodge was taking in order to treat the condition posed potential threats to her and her baby since they can cause her body to go into shock.

In order to combat this risk, she began treatments with Erika Correa, MD, a UHealth hematology specialist. Dr. Correa started Dodge on a new medication that provided a hormone the kidney produces, which stimulated her bone marrow to create more red blood cells. She also closely monitored Dodge for a potential HUS relapse.

This treatment plan was key to protecting Dodge and her baby since hemoglobin carries oxygen, which is vital to the healthy development of the baby and can help mom feel strong.

Another risk Dodge faced was preeclampsia – an abnormally high blood pressure condition unique to pregnancy. Dr. Sfakianaki was seeing Dodge once to twice a week to monitor the baby’s growth via scans and ensure the risks were mitigated.

Dr. Correa and Dr. Sfakianaki worked together to create an ideal birth plan for Dodge, which included reaching certain health markers. Dr. Correa’s goal was for Dodge’s hemoglobin levels to reach 10 before delivery, and Dr. Sfakianaki wanted Dodge to safely reach 37 weeks gestation before inducing labor to ensure the baby had enough time to grow.

“Some of these cases are clear cut, she was teetering between healthy kidney function and keeping the baby safe,” Dr. Sfakianaki said. “This birth plan wasn’t a decision made by one medical team, it required input from maternal-fetal medicine, nephrology and anesthesiology teams, and that’s not something you get at every hospital.”

At 36 weeks, Dodge’s blood pressure began to increase and her creatinine levels were fluctuating to the point where her care team worried about permanently compromising her kidney function. Dr. Sfakianaki encouraged her to deliver, despite not reaching 37 weeks.
“This was not a time to be strong-willed, this was a time to listen to my doctors and follow their suggestion,” Dodge said. “It didn’t matter that I didn’t meet the benchmarks I ideally wanted; my baby was delivered healthy because of that.”

On October 2, 2023, August Dodge entered the world, requiring no NICU stay or follow-up care. Both mom and baby are doing well and staying healthy.

“It was very cool to see that Jackson has attracted all of the brightest minds and these incredible doctors,” said Dodge. “I can’t imagine having given birth anywhere else because the most equipped and expert team is at Jackson Memorial.”

Anna Sfakianaki, MD

Maternal-Fetal Medicine, Obstetrics & Gynecology