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Endocrine glands
Endocrine glands

Sheehan’s syndrome
Definition:
Sheehan's syndrome is a condition that may occur in a woman who has a severe uterine hemorrhage during childbirth. The resulting severe blood loss causes tissue death in her pituitary gland and leads to hypopituitarism following the birth.

Alternative Names:
Postpartum hypopituitarism; Postpartum pituitary insufficiency

Causes, incidence, and risk factors:

If a woman's pituitary gland doesn't receive enough blood because she had a severe hemorrhage during childbirth, the gland will lose its ability to function properly. The pituitary gland, which is located at the base of the brain, is responsible for producing a variety of hormones that help regulate growth, reproduction, and metabolism.

Sheehan's syndrome is very rare now because of good obstetrical care.

Conditions that increase the risk of an obstetric hemorrhage include multiple pregnancies (twins or triplets) and abnormalities of the placenta.
Symptoms:

The pituitary gland normally produces hormones that stimulate breast milk production, growth, reproductive functions, the thyroid, and the adrenal glands. A lack of these hormones results in a variety of symptoms related to all of these areas.

These symptoms may include:

  • Inability to breast-feed (breast milk never "comes in")
  • Fatigue
  • Loss of pubic and axillary hair
  • Amenorrhea, or lack of menstrual bleeding
  • Low blood pressure
Signs and tests:
  • Blood tests are performed to measure hormone levels.
  • A CT scan of the head may be recommended to rule out other abnormalities of the pituitary such as a tumor.
Treatment:

The treatment for pituitary insufficiency is life-long hormone supplements, including estrogen and progesterone hormone replacement. Thyroid and adrenal hormones also must be taken.
Expectations (prognosis):

The outlook with early diagnosis and treatment is excellent.
Complications:

This condition can be life-threatening if not treated because of the lack of thyroid and adrenal hormones, which allow the body to react to stress or infections.
Prevention:

Obstetric hemorrhage may be preventable through careful obstetrical practices. Otherwise, Sheehan's syndrome is not predictable or preventable.
Review Date: 6/18/2001
Reviewed By: Catherine S. Bradley, M.D., Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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