Sheehan’s Syndrome: A Syndrome Becoming Rare Due to Improved Obstetric Care

摘要

Sheehan’s syndrome occurs as a result of ischemic necrosis of the pituitary gland due to postpartum hemorrhage and was first described in 1937. Improvement of obstetric care including availability of blood products has led to a reduction in the prevalence of Sheehan’s syndrome by seventy-five percent (75%) in the past half century in developed nations.1 Symptoms usually develop years after delivery with one study reporting a mean duration between time of diagnosis and date of last delivery was 26.8 /- 2.52 years. 2 The delay in symptom onset can lead to delayed or misdiagnosis which occurred in this case. The patient presented in this report was diagnosed at age 41 after giving birth to two healthy boys (G2P2) 20 years earlier. This patient’s second pregnancy was complicated by gestational hypertension, pre-eclampsia, and a prolonged labor. These are documented in the literature as significant risk factors associated with postpartum hemorrhage. 3 The combination of pre-eclampsia and gestational hypertension can lead to hypoperfusion of the enlarged pituitary gland. The patient had a prominent history of tobacco use and a history of Familial Hyperlipidemia.