• Madeline Lewis •
• Originally published November 16, 2008 at 12:05 a.m., updated November 16, 2008 at 12:05 a.m.

Pantera Trahan eats, looks around, smiles and sleeps - a lot.

"She's basically a newborn baby," said her mother, Chandia Copeland.

However small, the 4-month-old's accomplishments are no mean feats. Indeed, some describe them as miracles.

"According to all medical statistics, there's no reason Pantera should have survived," said her doctor, Kathleen Steiner, a family physician and obstetrician at DeTar Hospital North in Victoria.

Born about 17 weeks shy of a typical 40-week gestation, Pantera wasn't expected to live. Many fetuses at this stage of development do not have lungs or hearts capable of functioning independently of their mother's oxygen supply, Steiner said.

"Nothing is quite ready to be here," she said.

Steiner had previously helped deliver babies that were the same size of Pantera at birth - 1 pound and 3 ounces - but none so early.

Copeland came to see Steiner at almost 21 weeks in her pregnancy. From an ultrasound, Steiner discovered Copeland's cervix was "funneling," or shortening and opening up on the inside, putting the Victoria woman at "high risk" of going into premature labor.

"Our biggest concern with her was that she had an incompetent cervix - one that can't carry the baby 'til term," Steiner said.

Copeland's previous pregnancy made it more likely she had an incompetent cervix. Three years ago, she went into labor at 20 weeks and delivered stillborn twin boys.

Doctors can't categorically predict whether a woman will go into premature labor, but there are indicators that make some more likely candidates for pre-term labor than others.

One is a prior history of premature labor, said Dr. Charles Jaynes, an ob-gyn at Victoria Women's Clinic. Another is an increased concentration of the chemical fetal fibronectin in vaginal secretions. And a third is a urinary tract infection, which pregnant women are more prone to develop than non-pregnant women.

Contrary to popular belief, sexual intercourse and normal work activity during pregnancy have no relationship to premature labor, Jaynes said.

To better protect her baby, a woman should start seeing a health care practitioner early in the pregnancy and return on average seven to nine times.

"The reality is good prenatal care is the only answer," Jaynes said.

Steiner gave her patient the progesterone hormone and ordered her to bed rest - a treatment that wasn't so pleasant.

"You can't do anything," Copeland said. "You can watch TV, but that's about it."

Less than two weeks later, Copeland started bleeding and went to the emergency room. She was given a continuous IV of magnesium sulfate and bed rest to try to hold off the labor. She also received an injection of steroids to strengthen the baby's lungs for the outside world, an encounter that was imminent. The baby wouldn't stay in her mother's womb for much longer.

"She decided she had to come out," Copeland said.

Steiner performed a cesarean surgery on Copeland June 27 to increase the very slim likelihood that Pantera, who still had a bigger head than body, would live. The surgery was necessary because the baby's feet would have emerged before her head during natural labor, Steiner said.

To everyone's surprise, the baby was born alive and relatively healthy for someone so small. She was soon transported to Christus Santa Rosa Hospital in San Antonio where she remained in the neonatal care unit until Oct. 11.

For many families, the cost of keeping their premature babies in intensive care for an extended period of time is very burdensome, Jaynes said. Even insurance policies don't cover the full expense, which often surpasses several thousand dollars.

Medicaid has allowed her to deal with the high costs of keeping Pantera at Christus Santa Rosa, Copeland said.

In the coming years, Pantera may face residual challenges common to premature babies, such as a learning disability. Her intellectual development will be monitored, Steiner said.

Since her birth, Pantera has battled the occasional bout of pneumonia and some minor complications with vessels in her eyes that might require laser surgery to correct, but nothing very serious.

"She looks wonderful," Steiner said. "She's very healthy."

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