Slow Developing Sheehan Syndrome with Spontaneous Pregnancies: A Case Report and Literature Review

Abstract

Sheehan's syndrome (SS) is known as pituitary insufficiency that develops after bleeding and hypovolemia at birth or after birth. The pathological and clinical findings of SS were first described by Harold L. Sheehan. Due to improvements in obstetric care, the frequency of the disease has declined worldwide. Sheehan syndrome is a rare cause of hypopituitarism in developed countries.. However, it is more common in underdeveloped and developing countries. Small sella size enlargement of the pituitary gland, autoimmunity also play a role in the pathogenesis of the disease. Depending on the pituitary damage, symptoms may appear immediately or years later. It may be presented as isolated hormone deficiency or pan hypopituitarism. For diagnosis, it is important to have a history of excessive hemorrhage at birth, amenorrhea and inability to breastfeed. Lymphocytic hypophysitis should be remembered in differential diagnosis. In this review, a patient with serious post-partum hemorrhage, followed by a history of 3 pregnancies is presented with a slow developing and pan hypopituitarism-causing SS and current physio pathological data in SS are presented.