The Frequency of Post‐partum Hypopituitarism

Hl, Sheehan

doi:10.1111/j.1471-0528.1965.tb01380.x

Cited by 45 publications

(2 citation statements)

References 9 publications

(2 reference statements)

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“…Among the scarce publications found on SS, many have been reported in developing countries, where SS represents one of the most common causes of hypopituitarism and thus a big health issue (6,7).…”

Section: Introductionmentioning

confidence: 99%

Delayed diagnosis of Sheehan's syndrome in a developed country: a retrospective cohort study

Ramiandrasoa

Castinetti

Raingeard

et al. 2013

European Journal of Endocrinology

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Background: Little is known about Sheehan's syndrome (SS), even though it is believed that its incidence is low. The aims of this study were to determine the clinical features and diagnostic delay of SS and to ascertain whether early signs could have allowed earlier diagnosis. Subjects and methods: All patients with SS diagnosed in reference units in the southeast of France between 1980 and 2011 were recruited for this study. Data on obstetrical history, clinical symptoms suggestive of hypopituitarism, early signs, hormone analysis, and magnetic resonance imaging were collected. Results: Of the 40 women found to have SS, 39 were studied. Mean delay in the diagnosis of SS was 9G9.7 years. We found that four of the 35 assessable patients were diagnosed with agalactia, 16 of the 29 assessable ones with amenorrhea, 19 of the 39 with hypothyroidism, eight with acute adrenal insufficiency, and 15 with asthenia. Among the patients for whom there was a diagnostic delay of more than 1 year (nZ28), seven had headaches during the postpartum period, all assessable patients had agalactia, six of the 22 assessable ones had amenorrhea, seven of 28 had hypothyroidism, and 12 of 28 had asthenia. Conclusion: Most signs of SS are aspecific and classical signs such as agalactia and amenorrhea are often difficult to detect, which can explain the long diagnostic delay. We suggest that all women failing to lactate after postpartum hemorrhage (PPH) should be evaluated by measuring prolactin levels and women with signs such as amenorrhea and asthenia, even several years after PPH, should undergo a blood test including assessment of thyroxine, TSH, 0800 h ACTH-cortisol, and IGF1 levels.

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Section: Introductionmentioning

confidence: 99%

Delayed diagnosis of Sheehan's syndrome in a developed country: a retrospective cohort study

Ramiandrasoa

Castinetti

Raingeard

et al. 2013

European Journal of Endocrinology

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“…Ya desde 1937 (59) se había descrito el hecho de que la hipófisis hipertrofiada al final del embarazo es muy sensible a los cambios hemodinámicos y puede sufrir necrosis y colapso secundarios a estados de shock de la enferma durante y después del parto. También es conocido que la ex tensión de la necrosis es proporcional a la cantidad de sangre pe rdida y a la seve ridad del shock (60,61,62,63). Aunque han sido descritos casos de Síndrome de Sheehan después de partos normales (23), la frecuencia de este síndrome va siendo cada ve z más rara e n la obstetricia mo derna debido a una mejor asistencia obstétri ca y a una mayor facilidad de transfusión inmediata cuando se presentan pérdidas hemorrágicas .…”

Section: Síndrome De Sheehanunclassified

Amenorrea post-gestación

Cajiao¹,

Part²,

Barriendos³

et al. 1984

Rev. Colomb. Obstet. Ginecol.

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Un porcentaje relativamente alto de amenorreas secundarias (11%) puede ser posterior a una gestación.Toda amenorrea consecutiva a una gestación, de más de 6 meses de duración, es patológica y requiere una valoración exhaustiva y un tratamiento etiológico adecuado. La anamnesis es fundamental en este estudio, pero no debe basarse solamente en ella el diagnóstico, pues solamente en un porcentaje pequeño de pacientes (27.2%) que presentaron hemorragia o shock durante el parto y cambios ponderales puerperales, la causa de la amenorrea fue el Síndrome de Sheehan. No debe olvidarse tampoco la importancia que la amenorrea hipotalámica, la hiperprolactinemia y la menopausia precoz tienen como etiologías de esta amenorrea; y el papel preponderante que las determinaciones hormona les juegan en su diagnóstico. Por lo tanto, el estudio racional de las amenorreas post-gestación será hecho con la combinación juiciosa de la Historia Clínica, el examen físico y el estudio endocrinológico.

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Postpartum Thyroid Disease

Amino

1991

Advances in Experimental Medicine and Biology

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The Frequency of Post‐partum Hypopituitarism

Cited by 45 publications

References 9 publications

Delayed diagnosis of Sheehan's syndrome in a developed country: a retrospective cohort study

Delayed diagnosis of Sheehan's syndrome in a developed country: a retrospective cohort study

Amenorrea post-gestación

Postpartum Thyroid Disease

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