A case of Sheehan syndrome in early pregnancy
DOI:
https://doi.org/10.18203/2320-6012.ijrms20250276Keywords:
Sheehan syndrome, Hypopituitarism, Physiological hyperplasia, NecrosisAbstract
Sheehan syndrome is also known as hypopituitarism due to necrosis of the anterior pituitary gland due to hypotension or shock, secondary to postpartum bleeding. It generally occurs in postpartum bleeding after a full-term delivery as there is physiological hyperplasia of the pituitary gland which demands more blood supply. After severe postpartum haemorrhage, there is inadequate blood supply to the pituitary gland which results in necrosis of the gland. The first and most common symptom of Sheehan syndrome is absence of lactation. Other symptoms may include amenorrhoea, hot flashes. Sheehan syndrome is still a significant cause of morbidity and mortality in less developed countries. The diagnosis of Sheehan syndrome may not present immediately after birth. But rarely, it can be seen in the first trimester due to incomplete abortion. In our case a 35-year female G5P4L4 with one month and fifteen days of amenorrhoea came with complain of bleeding per vaginal and severe generalised weakness. After stabilisation patient was evaluated and it came to know that patient has hypopituitarism.
Metrics
References
Laway BA, Baba MS. Sheehan syndrome. JPMA. The Journal of the Pakistan Medical Association. 2021;71(4):1282-568.
Ratarasarn C, Rajatanavin R, Himathongkam T. Salient clinical features of Sheehan's syndrome. J Med Assoc of Thailand Chotmaihet thangphaet. 1989;72(1):41-7.
Matsuzaki S, Endo M, Ueda Y, Mimura K, Kakigano A, Egawa-Takata T, et al. A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage. BMC Pregnancy and Childbirth. 2017;17:1-10. DOI: https://doi.org/10.1186/s12884-017-1380-y
Lundholm MD, Yogi-Morren D. A Comprehensive Review of Empty Sella and Empty Sella Syndrome. Endocr Pract. 2024;30:497–502. DOI: https://doi.org/10.1016/j.eprac.2024.03.004
Chiloiro S, Giampietro A, Bianchi A, De Marinis L. Empty sella syndrome: multiple endocrine disorders. Handbook of Clinical Neurology. 2021;181:29-40. DOI: https://doi.org/10.1016/B978-0-12-820683-6.00003-8
Karaca Z, Tanriverdi F, Unluhizarci K, Kelestimur F. Pregnancy and pituitary disorders. European J Endocrinol. 2010;162(3):453-75. DOI: https://doi.org/10.1530/EJE-09-0923
Snyder PJ, Utiger RD. Inhibition of thyrotropin response to thyrotropin-releasing hormone by small quantities of thyroid hormones. The J Clin Invest. 1972;51(8):2077-84. DOI: https://doi.org/10.1172/JCI107014
Poon P, Smith JF. The short Synacthen and insulin stress tests in the assessment of the hypothalamic-pituitary-adrenal axis. Clin Endocrinol. 1996;45(2):245-9. DOI: https://doi.org/10.1046/j.1365-2265.1996.d01-1553-7742.x