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Sheehan syndrome


Definition:

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

Alternative Names:

Postpartum hypopituitarism; Postpartum pituitary insufficiency; Hypopituitarism Syndrome

Causes:

Severe bleeding during childbirth can cause tissue in the pituitary gland to die. This gland does not work properly as a result.

The pituitary gland is at the base of the brain. It makes hormones that stimulate growth, production of breast 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 is the 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 than not being able to breast feed, symptoms may not develop for several years after the delivery.

Exams and Tests:

Tests you may have include:

  • 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 hormones must 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:

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.


Review Date: 11/16/2014
Reviewed By: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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