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    Sheehan syndrome

    Postpartum hypopituitarism; Postpartum pituitary insufficiency; Hypopituitarism Syndrome

    Sheehan syndrome is a condition thatcan occur in a woman who bleeds severely during childbirth. Sheehan syndrome is a type of hypopituitarism.

    Causes

    Severe bleeding during childbirth canresult intissue death in the pituitary gland. This causes the gland to lose its ability to work properly.

    The pituitary gland isat the base of the brain. It makes hormones that stimulate growth,production ofbreast milk, reproductive functions, the thyroid, and the adrenal glands. A lack of these hormones can lead to a variety of symptoms.

    Conditions that increase the risk of bleeding during childbirth and Sheehan syndrome include multiple pregnancy (twins or triplets) and problems with the placenta. The placenta isthe organ that develops during pregnancy to feed the fetus.

    Sheehan syndrome is very rare.

    Symptoms

    Symptoms of Sheehan syndrome may include:

    • Inability to breast-feed (breast milk never "comes in")
    • Fatigue
    • Lack of menstrual bleeding
    • Loss of pubic and axillary hair
    • Low blood pressure

    Note: Other thannot being ableto breast feed, symptomsmay not develop for several years after the delivery.

    Exams and Tests

    • Blood tests to measure hormone levels
    • MRI of the head to rule out other pituitary problems, such as a tumor

    Treatment

    Treatment involves estrogen and progesterone hormone replacement therapy. These hormonesmust be taken at least until the normal age of menopause. Thyroid and adrenal hormones must also be taken. These will be needed for the rest of your life.

    Outlook (Prognosis)

    The outlook with early diagnosis and treatment is excellent.

    Possible Complications

    This condition can be life threatening if not treated.

    Prevention

    Extreme bleeding during childbirth can often be prevented by proper medical care. Otherwise, Sheehan syndrome is not preventable.

    References

    Cunningham FG, Leveno KL, Bloom SL, et al . Obstetrical hemorrhage. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY; McGraw-Hill; 2009:chap 35.

    Malee MP. Pituitary and adrenal disorders in pregnancy. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics - Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 41.

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    • Endocrine glands

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      • Endocrine glands

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      A Closer Look

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          Tests for Sheehan syndrome

            Review Date: 11/8/2012

            Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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