Objectives:To analyze the clinical features and prognosis of fetal extractions by caesarean section before 34 weeks of amenorrhea. Materials and methods:This is a retrospective and analytical study of 196 cases of women who gave birth by caesarean section at the maternity of Sylvanus Olympio's University Hospital of Lomé, before 34 weeks of amenorrhea from 1st January 2009 to 31st December 2011.Results: Fetal extraction by caesarean section before 34 weeks of amenorrhea has represented 3.6% of caesarean sections rate. Hypertensive disease during pregnancy and its complications (gestational hypertension, preeclampsia, eclampsia, and placenta abruptio) were in 61.8% of cases, the primary indication of fetal extractions before 34 weeks. The premature mortality rate was 9.8% and neonatal infection was the most deadly disease (52.4%). The first week of life was the most fatal with 61.9% of cases of early neonatal death. The minimum gestational age of 30 weeks of amenorrhea plus 6 days and more, allowed better survival as well as birth weight above 1300g. Conclusion:Fetal extraction could be considered with confidence in the center if gestational age is about 30 weeks of amenorrhea plus 6 days or more and if the birth weight is over 1300 grams. Emphasis should be put more on the prevention of infections and on the improvement of the technical platform for management of premature newborns.

Abdominal pregnancy is a rare form of ectopic pregnancy. Advanced forms with live children at birth are exceptional. We report a case of abdominal pregnancy of 35 weeks with live child, referred and after emergency management. Maternal prognosis was good. The newborn, admitted to pediatric intensive care for breathing difficulties, died 8 days after birth.

To report the first case of Demons-Meigs’ syndrome secondary to benign Brenner tumor with high CA125 plasmatic level managed in kara teaching hospital. A 40-year-old female patient was admitted with a 6-month history of abdominal distension. Clinical examination found abdomino-pelvic mass and declive dullness. Abdominal ultrasound found heterogeneous abdomino-pelvic mass of 180 mm in length and a large free ascites. Pelvic computorized tomography scan found heterogeneous extra-uterine mass of 180 mm in length, large ascites without pelvic or lombo-aortic lymphadenopathy or tumoral extension. Front thorax X-ray found bilateral pleural effusion; CA125 plasmatic level was 1138 IU/ml. Median laparotomy allow to aspire 2 liters of ascitic fluid and to perform left adnexectomy. Histological examination of surgery sample diagnosed begnin ovary Brenner tumor. Outcome after surgery was without complications with disappearance of ascites and pleural effusion, and CA125 plasmatic level back to normal value. Demons-Meigs’ syndrome is a rare benign ovarian tumor whose symptoms looks like ovarian cancer. Its fundamental characteristic is the disappearance of symptoms after ovarian tumor removal.

This study was undertaken to contribute to the reduction of maternal mortality, 11,12 specifically, to identify the factors influencing maternal mortality in severe preeclampsia 13 at the maternity of Sylvanus Olympio's University Hospital Center of Lomé in Togo (West Africa). Materials and methodsThis was a comparative study of records of patients admitted to the maternity of Sylvanus Olympio's University Hospital Center (department of Obstetrics and Gynecology) of Lomé with severe preeclampsia from 1st January to 31st December 2013 (1 year). Sylvanus Olympio's University Hospital Center of Lomé is the largest reference center of Togo. It is a rank "A" maternity, with a capacity of 160 beds, which is about 5,000 deliveries per year, providing full emergency obstetrical and neonatal care (full EmONC), Data were collected by documentary review on standardized survey forms, from the registers of births, and medical records of patients. Files were selected in the archives service of gynecology and