Hematoma vulvo-vaginal: exceptional etiology of obstetrical near miss

Postpartum hematoma, rare among several causes of postpartum hemorrhage, is exceptionally reported in the etiologies of obstetrical near miss. The authors reported a case of large vulvo-vaginal hematoma after home delivery in a 26 year old patient of Franco-Indian descent. The patient was admitted in a state of hemorrhagic shock combined with an impregnable blood pressure, a significant skin-muquauses pallor and conscience disorder. Its management required a good coordination between the anesthesia team and the obstetrical team as it was based on the hemostasis results after surgical evacuation of the hematoma for more than 1000 ml blood and corrections of blood crass disorders

Prevalence and factors associated with overweight and obesity among children from primary schools in urban areas of Lomé, Togo

OBJECTIVE: Overweight and obesity in childhood are serious public health issues, both in developing and developed countries. The present study aimed to ascertain overweight and obesity prevalence rates among Togolese schoolchildren in Lomé, Togo, and their correlation with physical activity, socio-economic conditions and eating habits. DESIGN: Cross-sectional survey conducted in December 2015. Overweight and obesity were defined using age- and sex-specific BMI cut-off points of the International Obesity Task Force. Physical activity, socio-economic conditions and eating habits were assessed with a standardized questionnaire. Specially trained medical students interviewed children and collected the data. After bivariate regression analyses, factors associated with overweight/obesity were identified by multivariate logistic regression. Statistical significance was two-sided P\textless0\textperiodcentered05. SETTING: Lomé, Togo. SUBJECTS: Representative sample of 634 children (288 boys, 346 girls), aged 8-17 years, who were studying in primary schools. RESULTS: Overweight and obesity respectively affected 5\textperiodcentered2 and 1\textperiodcentered9 % of children surveyed. Watching television (\textgreater4 h) on weekends (OR; 95 % CI: 3\textperiodcentered8; 1\textperiodcentered2, 12\textperiodcentered0, P=0\textperiodcentered02) and medium dietary diversity score (3\textperiodcentered0; 1\textperiodcentered1, 8\textperiodcentered1, P=0\textperiodcentered03) were independently associated with overweight/obesity in a multivariate regression model. Eating breakfast in the school cafeteria (0\textperiodcentered2; 0\textperiodcentered1, 0\textperiodcentered8, P=0\textperiodcentered03) and eating fruits (0\textperiodcentered4; 0\textperiodcentered1, 0\textperiodcentered9, P=0\textperiodcentered03) significantly reduced the risk of overweight/obesity. CONCLUSIONS: Overweight and obesity prevalence were linked with sedentary behaviour and non-optimal food diversity. Promoting physical activity and fruit consumption should be explored as interventions to reduce and prevent overweight and obesity in Lomé schoolchildren. In addition, preventive approaches in the social environment of children should be considered