Sheehan Syndrome

Vaphiades, Michael S.; Simmons, Debra L.; Archer, Robert L.; Stringer, W L

doi:10.1016/s0039-6257(02)00459-9

Cited by 27 publications

(4 citation statements)

References 14 publications

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“…Although the exact incidence is unknown and it rarely occurs in modern obstetric practices, Sheehan’s syndrome still must be considered in cases of PPH. Sheehan’s syndrome is pituitary necrosis after PPH and hypovolemia and occurs in 1–2% of women who lose 1–2 L of blood with associated hypotension [5, 6]. Several studies have shown that the latent period between symptoms and postpartum hemorrhage can be several years in Sheehan’s syndrome [2, 4, 7].…”

Section: Discussionmentioning

confidence: 99%

A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage

Matsuzaki

Endo

Ueda

et al. 2017

BMC Pregnancy Childbirth

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BackgroundSheehan’s syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan’s syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan’s syndrome is rare, and clinicians have little exposure to it. It can be life-threatening. There have been no reviews of acute Sheehan’s syndrome and no reports of successful pregnancies after acute Sheehan’s syndrome. We present such a case, and to understand this rare condition, we have reviewed and discussed the literature pertaining to it. An electronic search for acute Sheehan’s syndrome in the literature from January 1990 and May 2014 was performed.Case presentationA 27-year-old woman had massive postpartum hemorrhage (approximately 5000 mL) at her first delivery due to atonic bleeding. She was transfused and treated with uterine embolization, which successfully stopped the bleeding. The postpartum period was uncomplicated through day 7 following the hemorrhage. However, on day 8, the patient had sudden onset of seizures and subsequently became comatose. Laboratory results revealed hypothyroidism, hypoglycemia, hypoprolactinemia, and adrenal insufficiency. Thus, the patient was diagnosed with acute Sheehan’s syndrome. Following treatment with thyroxine and hydrocortisone, her condition improved, and she was discharged on day 24.Her next pregnancy was established 2 years after her first delivery. She required induction of ovulation for the next conception. The pregnancy, delivery, and postpartum period were uneventful. An electronic search of the literature yielded 21 cases of acute Sheehan’s syndrome. Presenting signs varied, including adrenal insufficiency (12 cases), diabetes insipidus (4 cases), hypothyroidism (2 cases), and panhypopituitarism (3 cases), with a median time of presentation after delivery for each of those conditions being 7.9, 4, 18, and 9 days, respectively. Serial changes in magnetic resonance imaging were reported in some cases of acute Sheehan’s syndrome.ConclusionClinicians should be aware of the risk of acute Sheehan’s syndrome after a massive postpartum hemorrhage in order to diagnose it accurately and treat it promptly.

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Section: Discussionmentioning

confidence: 99%

A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage

Matsuzaki

Endo

Ueda

et al. 2017

BMC Pregnancy Childbirth

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“…Our results showed that after 6-7 months, the pituitary impairments present during the first four weeks after delivery veered to improve in the majority of patients (58.33%). In fact, there have been some case reports where patients with Sheehan's syndrome recover back to normal less than 1 year after the event [ 20 , 21 ]. Nevertheless, because pituitary function impairment in Sheehan's syndrome can manifest after several years, some of our patients may experience the appearance of symptoms in future years [ 6 , 22 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

Sheehan’s Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion?

González-González

Borjas-Almaguer

Salcido‐Montenegro

et al. 2018

International Journal of Endocrinology

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Sheehan's syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to 2017, adult pregnant women, who developed moderate to severe postpartum hemorrhage (PPH), were consecutively included in the study. Pituitary function was assessed 4 and 24 weeks after PPH. At the end of the study, anti-pituitary antibodies were assessed. Twenty women completed the study. Mean age was 26.35 (±5.83) years. The main etiology for severe PPH was uterine atony (65%) which resulted mostly in hypovolemic shock grades III-IV. Within the first four weeks after delivery, 95% of patients had at least one hormonal pituitary affected and 60% of the patients fulfilled diagnostic criteria for hypopituitarism. At the end of the study period, five patients (25%) were diagnosed with hypopituitarism (GH and cortisol axes affected). Anti-pituitary antibodies were negative in all patients. At 6 months follow-up, one in every four women with a history of moderate-to-severe PPH was found with asymptomatic nonautoimmune-mediated hypopituitarism. The role of autoimmunity in Sheehan's syndrome remains uncertain. Further studies are needed to improve the remaining knowledge gaps.

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“…Medical history that suggests perinatal haemorrhage requires proper diagnostics regarding assessment of thyroid and adrenal gland function, level of growth hormone and MRI scan results [32]. Ocular symptoms of Sheehan's syndrome may recede after using hydrocortisone [33].…”

Section: Sheehan's Syndromementioning

confidence: 99%

Ophthalmological problems in pregnancy — a review

Rzeszotarska¹,

Szczapa-Jagustyn²,

Kocięcki³

2020

Ginekol Pol

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Pregnancy is associated with numerous changes affecting all organs. Ophthalmological changes in pregnant women are most often physiological and resolve spontaneously after delivery. However, the possibility of progression of previously diagnosed ophthalmic diseases or the occurrence of ophthalmological complications in the course of diseases characteristic for pregnancy should always be considered.

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Sheehan Syndrome

Cited by 27 publications

References 14 publications

A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage

A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage

Sheehan’s Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion?

Ophthalmological problems in pregnancy — a review

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