RESUMO
Lassa fever is endemic in West Africa, with an estimated 300,000 to 500,000 infections occurring annually and approximately 5,000 deaths. Two Lassa fever cases in pregnancy with maternal and fetal complications were presented. The age range was 20 to 30 years and the range of parity was 1 to 3. The duration of symptoms was 13 to 14 days. Clinical presentation and complications common to the two cases were fever, abnormal bleeding, cough/sore throat, anaemia, IUFD/Stillbirth, and maternal deaths. Others are vomiting, restlessness/confusion, hypotension and thrombocytopaenia. Major challenges encountered are late presentation, delay in confirming diagnosis and instituting definitive treatment, limited facility, and the impact of traditional and religious factors in safe burial for Lassa fever cases. In resource-constrained settings; diagnosis, treatment and surveillance for Lassa fever may be challenging. Early clinical suspicion and appropriate case management are critical for good reproductive outcome.
RESUMO
Primary umbilical endometriosis (PUE) is a rare condition affecting 0.5 - 1% of all extragenital endometriosis cases. We reviewed the data of five women with umbilical endometriosis retrospectively. The age range was 29 - 46 years, and they were all nulligravid at presentation. Common clinical presentation was umbilical pain and masses, dysmenorrhea, and primary infertility. Radical umbilical excision was performed to remove the nodule as a definitive treatment. Diagnostic laparoscopy was performed, followed by varying degrees of operative laparoscopic procedures. They all had endometriosis in the pelvis. Three out of five women operated became pregnant and had live births. Complete resolution of clinical symptoms with a reduction in umbilical and menstrual pain scores occurred. In resource-constrained settings, diagnosis, and treatment of PUE may be challenging. Clinical suspicion and appropriate case management are critical for good reproductive outcomes and quality of life.