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.
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