What's already known about this topic? Placenta membranacea is a rare developmental abnormality of the human placenta associated with abnormal placental adherence. This placental abnormality is usually diagnosed after post‐delivery pathologic examination of the placenta. What does this study add? We highlight the utility of magnetic resonance imaging as an adjunct to ultrasonography in the antenatal diagnosis of placenta membranacea. Magnetic resonance imaging can optimize the diagnosis of abnormal placental adherence in the presence of placenta membranacea, thereby influencing antenatal management, as well as the timing and route of delivery.

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Background: Sheehan syndrome (SS) is a rare complication of severe postpartum hemorrhage or hypotension during the processes of labor and delivery that results in ischemic pituitary infarction and necrosis. In this case report, we describe an unusual presentation of SS without inciting factors. Case Presentation: A 30-year-old multiparous woman presented 2 hours after a normal spontaneous vaginal delivery with a profound severe headache, and subsequent agalactia, dry skin, and mood changes. She was managed conservatively until 10 months postdelivery when she complained of persistent symptoms including amenorrhea. A brain magnetic resonance (MR) with pituitary imaging revealed findings consistent with SS. The patient's symptoms improved and ultimately resolved after levothyroxine, estrogen replacement therapy, and hydrocortisone were instituted. Conclusions: SS can present without recognized inciting factors. During the initial phase, women may present with profound headache and/or visual disturbances warranting neurological evaluation. A high index of suspicion and a brain MR with pituitary imaging should prompt early consideration of SS to aid in the diagnosis.

Although most epithelial inclusion cysts are asymptomatic and can be managed expectantly, cysts that enlarge or become symptomatic should be excised surgically.