Abstract

Sheehan’s syndrome (SS), also known as postpartum pituitary gland necrosis, is a rare but potentially life-threatening complication of postpartum haemorrhage. The diagnosis of Sheehan’s syndrome is based on the features of hormone deficiency, a suggestive obstetric history and decreased levels of basal hormones. Diagnosis of pan-hypopituitarism is straightforward, but partial deficiencies are often difficult to elicit. SS is a frequent cause of hypopituitarism in underdeveloped countries. The clinical features of hypopituitarism are often subtle, and years may pass before the diagnosis is made following the inciting delivery. History of postpartum haemorrhage, failure to lactate and cessation of menses are important clues to the diagnosis.

Highlights

  • Sheehan’s syndrome (SS), known as postpartum pituitary gland necrosis, is a rare but potentially life-threatening complication of postpartum haemorrhage

  • The most common hormone to get affected is growth hormone (GH) because somatotrophs are located in the lower and lateral regions of the pituitary gland and are most likely to be damaged by ischemic necrosis of the pituitary [2]

  • It must be remembered that patients of SS can have varied presentations and the clinical manifestation may change from one patient to another [1,3]

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Summary

Introduction

Sheehan’s syndrome (SS), known as postpartum pituitary gland necrosis, is a rare but potentially life-threatening complication of postpartum haemorrhage. It still remains a common cause of hypopituitarism in less developed countries. The underlying process leading to Sheehan’s syndrome is the infarction of the pituitary gland, the anterior lobe, secondary to the grossly decreased blood supply as a result of severe haemorrhage during and/or before parturition. The damage to pituitary can be mild or severe, and can affect the secretion of one, several or all of its hormones [1].

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