Written by Suma rp
Sheehan’s syndrome or postpartum hypopituitarism is a condition that can occur due to massive blood loss in women post-delivery. During pregnancy, the pituitary gland, a small pea-shaped gland located at the base of our brain, gets doubled in size and requires more oxygen to operate. Thus excessive bleeding during childbirth can deprive the pituitary gland of the vital oxygen supply it requires to work. As a result, some of the cells of the “master gland” die which leads to a shortage of hormones directly and indirectly secreted by the pituitary gland.
This condition is named Sheehan syndrome. It is also known as Pituitary Infarction or Postpartum Hypopituitarism. This condition can impact the whole afterlife of pregnancy as the pituitary gland secretes hormones that function almost all of our vital bodily activities. So let’s take a deeper understanding of what Sheehan syndrome is, how it can happen and what are its prevention and cure.
In This Article
Sheehan’s syndrome is a condition where massive blood loss during childbirth causes great damage to the pituitary gland of the mother. According to the Cleveland Clinic, It is a very rare condition with 5 out of 100,000 cases of childbirth. According to NCBI, 1-2% of women who lose 1-2 L blood during their childbirth can suffer from Sheehan’s syndrome.
After the delivery of the baby, the uterus generally expels the placenta through continuous contractions. The bleeding vessels around the area of the placenta then get compressed with the help of these contractions. If this process named uterine atony does not happen properly then those blood vessels continue to bleed freely and lead to massive blood loss and hemorrhage. According to the Children’s Hospital of Philadelphia, the risk of bleeding during childbirth gets high in the cases of
[Read : Placental Abruption]
The symptoms of Sheehan’s Syndrome depend on how much damage occurs to the pituitary gland and how much it is incapable of secreting hormones. As a result, the symptoms of Sheehan’s syndrome will vary in women. Also in most cases, the symptoms of Sheehan syndrome occur gradually with time. Sheehan syndrome has two types according to its impact on the pituitary gland – acute and chronic.
In acute Sheehan syndrome, a considerable amount of damage happens in the pituitary gland thus symptoms will show within days or weeks after delivery. But in the case of the chronic subtype of Sheehan syndrome, the damage is much less so symptoms may take months or years to emerge. The symptoms of Sheehan syndrome are
It is quite difficult to diagnose Sheehan’s syndrome as its symptoms often resemble other diseases such as anemia or diabetes. Also, the symptoms of Sheehan’s syndrome generally show up gradually and make it more complicated to diagnose the actual reason.
Thus it will be helpful for the doctor to diagnose Sheehan’s syndrome if you discuss your blood loss during childbirth or if you never lactate or menstruate after childbirth.
Here are some tests that can be conducted to diagnose
The CT scan is vital to rule out the chances of having a brain tumor or pituitary tumor causing the condition of hypopituitarism. And in the case of massive blood loss that can lead to acute Sheehan’s syndrome diagnostic tests can be conducted right after the delivery.
The pituitary gland does not only secret hormones, it also controls the secretion of hormones from other glands like the thyroid and adrenal gland. The consequences of Sheehan syndrome thus can lead to complications like
Reduction in the secretion of pituitary hormones such as Thyroid-stimulating hormone, Luteinizing hormone, Follicle-stimulating hormone, prolactin, adrenocorticotropic hormone, and growth hormone.
There is only one way for treating this or any type of hypopituitarism i.e. hormone replacement therapy. For this, the doctor will take several blood tests to measure the hormone levels that may need outward help to balance. Common treatments to increase or replace the hormone levels affected by Sheehan’s syndrome are
In one of the treatment methods, thyroxine is injected as a replacement for the thyroid hormone
In this treatment method, the patient may have to take it to increase thyroid-stimulating hormones
The patient will have to take the contraceptive pills till the age of her menopause to balance the levels of these two hormones. In the case of patients with hysterectomy or removal of the uterus, only estrogen is prescribed.
[Read : Emergency Contraceptive Pills]
The patient will have to take these two cortisones as a replacement for adrenocorticotropic hormone or ACTH
Your doctor can prescribe you to take GH to increase muscle strength, and stamina, and to decrease cholesterol levels.
Sheehan’s syndrome can be prevented only by having an expert medical care team at your service. The hospital, the doctor, and the medical staff you chose should be aware of your medical condition. You will need an experienced and well-equipped medical team to avoid it as once severe blood loss occurs, Sheehan syndrome is unpreventable.
So Sheehan’s syndrome is life-threatening but thankfully a rare condition that can occur only if you do not get proper medical care during your childbirth. But if it happens when with the help of hormone replacement therapy you will be able to live a somewhat normal life.
Sheehan syndrome can affect and reduce the secretion of prolactin hormone. This means you may fail to produce breast milk for the baby.
The chances are very rare to get a smooth and successful pregnancy while having Sheehan’s syndrome. Even with the help of assisted reproductive technology, risks of pregnancy complications cannot be avoided.
Yes, Sheehan’s syndrome is permanent as once the pituitary cells get damaged there is no way to revive or replace them. You can only get hormone replacement therapy to substitute those hormones secreted by the master gland.
Suma is a passionate content writer with a strong keenness to understand the miracle of pregnancy, birth, and parenting. Suma has successfully transitioned into a full-time content writer and a key contributor at Being The Parent. She leverages on her experimental background in chemistry and experience in writing to come up with well-researched content that helps parents struggling to deal with various medical conditions of their children.Read more.
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