Postpartum Hemorrhage Complicated by Pan-hypopituitarism: Sheehan’s Syndrome; Case Report, 2022

Abstract

Background: Sheehan’s syndrome is hypopituitarism due to postpartum ischemic necrosis of the pituitary gland. Due to its potentially life-threatening and very rare complications; it still remains important to pregnant women, clinicians, and public health services around the world. Case Report: 38 years parity three Eritrean mother from Ghone subzone of Gash Barka, Eritrea; had history of postpartum hemorrhage and blood transfusion before 10 years (2011) on her last delivery. She presented with history of failed lactation, amenorrhea and infertility of 10 years. She had also constipation, lethargy and generalized body weakness with her current complaint. Hormone analysis revealed pan-hypopituitarism of most anterior pituitary hormones and Magnetic Resonance Imaging of the brain revealed empty sella. She was started on Levothyroxine and fertility supplements based on her fertility desire, and on subsequent follow-ups, her menses was resumed and constipation had subsided and she was attached to endocrinology department for further followup and management. Conclusion: The history of failed lactation, amenorrhea and infertility following postpartum hemorrhage, hormone analysis and imaging findings were consistent with a rare complication of Sheehan’s syndrome. This case was reported for its rarity. Physicians should aware about this complication and should have high index of suspicion for cases with common manifestation of uncommon syndromes.