Incidence of Unsuspected "Sheehan's Syndrome"

Pituitary Function Tests in Sheehan's Syndrome

“…The patients presented in the present paper all had clinical history and physical findings typical of Sheehan's syndrome (Sheehan, 1939, 1954Schneeberg et al, 1960Sheehan, 1961) and in all symptoms of pituitary failure followed a severe post-partum bleed. The reason for referral in all the patients were symptoms attributable to hypothyroidism.…”

“…Diagnosis of the disorder is made more difficult owing to the chronicity of the disease (Sheehan, 1961), and the long latent period between the obstetric shock and the referral of the patient to the physician (Querido et al, 1954;Sheehan, 1961;Murdoch, 1962a;Drury & Keelan 1966). Absence of a clear relationship between the severity of the haemorrhage and the appearance of hypopituitarism (Schneeberg et al, 1960;Murdoch, 1962b), and the appearance of atypical forms (Querido et al, 1954;Sheehan, 196 1;Murdoch, 1962a), further complicate the diagnosis. Little data are available regarding tests of pituitary function in this disease.…”

Anterior Pituitary Function in Women with Postpartum Hemorrhage

“…The patient did not elect to breastfeed either child. Normal menses resumed after the second pregnancy, and the patient took oral contraceptives [2], and there is no definite sequence of loss of hormone function [13]. There have been numerous reports of patients with Sheehan's Syndrome having normal pregnancies and deliveries [2].…”

“…However, there appears to be no correlation between the amount of blood loss and the subsequent development of anterior pituitary insufficiency [2,21]. Effkemann and Muller-Jager found that in a group of 84 patients who lost between 800 and 1600 cc of blood at the time of delivery, 12 of the 20 patients who lost between 1200 and 1600 cc of blood suffered decreased menstrual function and 10 of these 20 patients became permanently sterile [22].…”

“…Sheehan's Syndrome becomes clinically apparent in the puerperium with failure of lactation followed by absent or scanty menses, loss of pubic and axillary hair, atrophy of breasts and-genitals, pallor, infertility, and signs of adrenal and thyroid insufficiency. However, Sheehan's Syndrome often emerges insidiously and may not fully develop for several years [2]. Patients with long-standing Sheehan's Syndrome are exposed to considerable risk especially during times of stress [3].…”