Shortly after her 31st birthday, Maira found out she was pregnant. It was a fairly typical pregnancy until an unusual set of symptoms turned out to be something serious.
Maira Avalos-Gonzalez and her 11-year-old daughter, Amaris, moved from their native Guatemala in 2019. They settled in Cleveland with help from family connections in the area. Soon afterward, Maira met Willie Rojas – and they fell in love.
In the spring of 2021, shortly after her 31st birthday, Maira found out she was pregnant.
Maira was determined to have a healthy pregnancy. Her pregnancy with Amaris had been uneventful, and she hoped this one would be, too. However, the health center she had been going to for care didn’t offer ultrasounds or more thorough exams. People recommended MetroHealth, telling her she would get the care she needed.
Maira was assigned Sybil Sailofsky, MD, an obstetrician/gynecologist who joined MetroHealth in September 2021 as an attending physician after completing her OB-GYN residency there. Growing up in Montreal, Quebec, in Canada, she spoke English, French and Hebrew. She took a few classes in Spanish in college, but when she found out she would be working at the MetroHealth Ohio City Health Center, she quickly took up Spanish again. Today, she’s mostly fluent in Spanish and uses an interpreter only as needed.
In the fall of 2021, Maira—by then 24 weeks pregnant—had her first appointment with Dr. Sybil Sailofsky. Maira liked her from the moment they met.
“Dr. Sailofsky is wonderful, very caring, and she takes time with her patients. She doesn’t rush the appointment,” says Maira, whose English is limited. “I felt comfortable with her right away. I could tell that she’s very passionate about her job.”
Roughly 60% of the patients Dr. Sailofsky sees at the MetroHealth Ohio City Health Center are Spanish speaking only.
“I’ve been working really hard on my Spanish, and really see patients light up when they hear me talking to them in their language and listening to them,” she says.
Maira was a little over a month away from her February 9 due date when she mentioned to Dr. Sailofsky that she recently started experiencing itchy, irritated hands and feet.
“It only happened during nighttime,” Maira says, “At first, I thought it was maybe irritated because of the heat being on in the house. I was putting on moisturizing cream, but it wasn’t helping.”
Dr. Sailofsky immediately ordered blood and liver function tests. The following day, the test results came back abnormal.
The cause of her itching was most likely cholestasis of pregnancy, a liver disease that slows or stops the normal flow of bile from the gallbladder. If left untreated, it carries a high risk of preterm delivery and fetal death.
“It’s not something that doctors screen for, but patients will usually tell us if they’re having discomfort,” says Dr. Sailofsky. “They’ll say, ‘I’m itching on my hands, or my palms and soles won’t stop itching.’”
Cholestasis of pregnancy typically develops during a woman’s third trimester. It’s believed to be caused by a combination of genetic, hormonal and environmental issues but the exact cause is unknown.
Dr. Sailofsky prescribed the oral drug ursodiol to help lower the level of bile in Maira’s blood and relieve her itching symptoms. She also kept a close eye on the baby’s development with additional ultrasounds.
On January 19, when Maira was 37 weeks pregnant, Dr. Sailofsky decided to induce her to reduce the risk of complications. And after 19 hours of labor, Sophia Camilla Rojas Avalos entered the world at MetroHealth Medical Center, weighing 5 lbs., 8 oz and 18.1 inches long.
A month later, Maira returned to Dr. Sailofsky at MetroHealth Ohio City Health Center and brought Sophia with her. It wasn’t Dr. Sailofsky’s first time seeing the baby since the delivery as patients walk by the OB-GYN area on the way to the pediatrics clinic.
“I always love when patients bring their babies to their postpartum visits,” she says. “She is such a cute baby, and Maira is so good with her.”