Little Mikko Irelynd Moxam-Watson seemed to decide she wanted to see the world earlier than her mother and her doctors expected or wanted.
When she was just 25 weeks pregnant, Melanie Montemayor’s baby resolved it was time to be born.
Ms Montemayor’s doctor Sarath de Alwis, a consultant/specialist of obstetrics and gynaecology, explained: “When the mother was about 25 weeks, she presented with a little abdominal pain. I did a scan and found she was two centimetres dilated and her cervix was fully effaced, which meant imminent delivery.”
He managed to arrest the labour and sent Ms Montemayor to Baptist Health South Florida hospital where she remained for four weeks under observation and being given drugs to stop her going into labour.
“After about four weeks, she got fed up waiting in the States and against advice, she left the hospital,” Dr. de Alwis said.
Taking a commercial flight from Miami, Ms Montemayor, who was by then almost four centimetres dilated, returned to Cayman. “I just wanted to come home and get back to normal,” she said of her decision to leave Miami.
“I warned them as I stepped on the plane,” said Ms Montemayor who admitted she did not tell the airline she was 29 weeks pregnant when she checked in.
“I was told to go straight to George Town hospital, but I felt fine so I first went home and cleaned my house,” she admitted sheepishly during an interview at Dr. de Alwis’ office in the Chrissie Tomlinson Memorial Hospital this week, with Dr. de Alwis and Dr. Gillian Evans-Belfonte by her side.
Dr. Evans-Belfonte, who works at the Cayman Islands Hospital, delivered little Mikko because Dr. de Alwis was off Island at the time.
She recalled that when Ms Montemayor first came to her, the mother-to-be was just 29 weeks’ pregnant. “She was quite well, The day after she came over, she wondered if her waters had gone… but there was no evidence of that.
She came back again the following day and stayed in… On the Thursday morning, six days after returning [from Miami], she was not feeling that great and was wondering about the baby’s movements. We did an ultrasound scan and the biophysical profile was zero – zero out of eight.” That meant that there was no signs of movement or breathing from the baby. “We rushed to do an emergency caesarean and the baby came out crying,” she said, adding that the baby also had a breach presentation.
“She just wanted to be here,” said Dr. Evans-Belfonte. “Mom did perfectly afterwards and baby had no problems.”
Ms Montemayor said: “She didn’t even go on a ventilator. I don’t think she even had to have any drugs [apart from antibiotics].”
“The important thing is the baby managed to get up to 29 weeks,” Dr. de Alwis pointed out.
“They kept telling me in Miami thank God Dr. de Alwis got you out quickly, because when I landed I was already 3cm [dilated].
They expected me to go into labour. There were all sorts of precautions being taken and they showed me babies born at 25 weeks, and it was scary,” Ms Montemayor said.
Dr. de Alwis had given the mother magnesium sulphate to try to stop her going into labour and delivering the baby prematurely and the hospital in Miami continued her on that medication. “Fortunately, the uterus responded to the magnesium. That’s why she did not go into active labour,” he said.
‘Princess’ doing well
Now six months old, Mikko, which means “princess” in Japanese, has gained weight at the same rate of a baby born at full term. She can see and hear normally and responds to stimuli, Dr. de Alwis said. “All those are very good indications of normal health,” he said.
Ms Montemayor commended the staff at the Cayman Islands Hospital maternity ward, describing them as “magnificent”. “All the staff at the George Town Hospital and also Chrissie Tomlinson were wonderful. The support I got was just tremendous. I could not have done it without them,” she said.
Dr. de Alwis said it was uncommon for a mother to be dilated to two to three centimetres and not deliver for several weeks. “It’s rare. Normally, once they are three centimetres dilated, they’ll either get into established labour in a few days or pop their waters. Once you have premature rupture of the membrane [a common occurrence with early dilation], 90 per cent of them go into active labour within 48 hours,” he said.
“It is great that the mother was strong enough to make decisions and stay [in hospital] for the crucial period of time of four weeks” Dr. de Alwis said.