Pregnancy, COVID and CKD

by Elinor Lyon Murphy

Following a family holiday in Wales, three year old Elinor Lyon Murphy became desperately ill and was left with chronic kidney disease. Now, with a young child of her own, Elinor shares with us her decision to become pregnant.

In 1988, aged just three years old, I was diagnosed with hemolytic uremic syndrome (HUS) after contracting E. coli whilst on holiday in Wales. I spent six weeks on life support and I was very lucky to recover. I was left with chronic kidney disease (CKD), which means my kidney function has been deteriorating incrementally ever since. I was prescribed ramipril, an angiotensinconverting enzyme (ACE) inhibitor that also regulates blood pressure.

30 years on...

In 2018, my husband Luke and I were keen to start a family. My kidney function had been stable at around 25 eGFR for about 10 years, and after conversations with two renal consultants, we decided to try for a baby. We were advised that I couldn’t take ramipril whilst trying to conceive, or during pregnancy and breastfeeding. I was also told that I was at higher risk of developing pre-eclampsia which could mean delivering prematurely. It took around 12 months for us to conceive and in November 2019 I fell pregnant - the same week I began fertility acupuncture. I still don’t know whether it was a coincidence or not. Throughout my pregnancy, I was monitored weekly due to me being considered high risk. I was fortunate to have a relatively straightforward first and second trimester – I even managed to avoid morning sickness! At 36 weeks, my blood pressure and proteinuria began to creep up – both early indicators of pre-eclampsia. The baby was also breech, so my obstetrician decided to deliver by planned caesarean section at 36 weeks. I was a little bit disappointed as I had been hoping for a natural birth, but we were overjoyed to welcome our daughter Eva in July 2020 who was a healthy 6lbs in weight with a full head of hair.

Happy family - Elinor, Luke and baby Eva

Pregnancy, COVID and CKD

The experience of being pregnant during the coronavirus pandemic with CKD was undoubtedly challenging. Luke wasn’t able to join me for any of the scans or appointments and for the C-section itself, he was only allowed to join once the surgery was underway. I had to walk into the operating theatre and begin the procedure alone. The risk of catching Covid-19 was a huge concern. After the birth, I spent five days in hospital and visiting hours were heavily restricted. Eva also spent two days in the neonatal intensive care unit (NICU) to monitor her oxygen levels and we were only allowed to visit her for an hour each day. We live a long way from my parents, so they were unable to travel to meet Eva until she was four weeks old. Another caveat of my kidney condition was that they weren’t able to administer the usual pain relief for a C-section – they waited until I was on the operating table to tell me they could only give me paracetamol for pain relief afterwards! It was a rough week of recovery. Two days after going home I also had a scare when my blood pressure increased dramatically and I spent another two nights in hospital with Eva alongside me.

Facing the future

Eva is now eight months old and getting more cute and cheeky every day. Luke and I are besotted. I feel lucky to have lived a relatively normal life pre-motherhood and do all the things I wanted to do – study, travel and work - and we’re extra blessed to have conceived and given birth to a healthy, happy daughter. In April I discovered that my eGFR had fallen to 16 and that I now require a kidney transplant. I have begun the necessary tests to go on the transplant list, and my husband Luke will explore becoming my donor. Our plans for another baby are on hold until after the transplant. I feel weirdly calm and level-headed about it. I’ve lived my whole life knowing that this will one day become a reality and I’ve made my peace with it. That’s not to say it isn’t a big deal, but I have good support, feel well informed and for now, I just want to spend as much time as possible enjoying life with Luke and Eva.

The experience of being pregnant during the pandemic with CKD was challenging.