From the Guidelines
Sheehan syndrome is also known as postpartum pituitary necrosis. This condition is characterized by damage to the pituitary gland due to severe blood loss and hypovolemic shock during or after childbirth, as mentioned in the context of placenta accreta spectrum patients 1. The reduced blood flow to the pituitary gland causes ischemia and necrosis of the anterior pituitary tissue, leading to varying degrees of pituitary hormone deficiencies. Some key points to consider about Sheehan syndrome include:
- It occurs due to severe blood loss and hypovolemic shock during or after childbirth
- The condition leads to damage to the pituitary gland, resulting in hormone deficiencies
- Symptoms may include an inability to breastfeed, fatigue, weakness, amenorrhea, loss of pubic and axillary hair, and hypothyroidism
- Treatment involves hormone replacement therapy tailored to the specific hormonal deficiencies, which may include levothyroxine for hypothyroidism, cortisol replacement with hydrocortisone, estrogen and progesterone for gonadal dysfunction, and growth hormone if indicated, as part of the management of postpartum complications 1.
From the Research
Definition and Terminology
- Sheehan syndrome is also known as Postpartum Pituitary Necrosis or postpartum hypopituitarism 2, 3, 4.
- It is a rare condition characterized by hypopituitarism due to necrosis of the pituitary gland, typically occurring after postpartum hemorrhage 2, 5, 3, 6, 4.
Clinical Presentation and Diagnosis
- The syndrome is characterized by varying degrees of anterior pituitary dysfunction resulting from the deficiency of multiple pituitary hormones 3, 4.
- Symptoms may include failure to lactate, nonspecific symptoms such as fatigue, and severe adrenal crisis 2, 5, 3, 6.
- Diagnosis is based on clinical manifestations combined with a history of severe postpartum hemorrhage, hormone levels, and/or stimulation tests 2, 5, 3, 6, 4.