[Premature deliveries at the maternity hospital of Befelatanana, Antananarivo in 1997].

Preterm deliveries (PT) produce new-borns whose prognosis is generally very dark. Prematurity is the first cause of neonatal death. A retrospective study was carried out at the Maternity Hospital of Befelatanana, Antananarivo in order to specify causes and difficulties of PT and to draw up strategy for their better management so that premature infants have chance to survive. The survey concerned 1394 patients: all pregnancies whose gestational age are between 22 and 36 weeks and those who delivery viable infants discharged home whose weights are between 500 and 2,500 grams. PT occur frequently among teenagers and more than 35-year old women. Risk factors and determinative causes of PT are mothers' toxic habits, gyneco-obstetrical history as PT, abortion, cicatricial uterus, urogenital infections. 12 maternal deaths were noted. Infant perinatal mortality rate was of 47.3 per cent. The authors conclude that difficulties were in labor and both antepartum and intrapartum periods. Preventive measures must surpass curative therapy. They will be based on the improvement of standard of living, the reinforcement of planning family and a strict pregnancy surveillance.