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<article  article-type="research-article"        dtd-version="1.4">
            <front>

                <journal-meta>
                                    <journal-id></journal-id>
            <journal-title-group>
                                                                                    <journal-title>Ankara Üniversitesi Tıp Fakültesi Mecmuası</journal-title>
            </journal-title-group>
                            <issn pub-type="ppub">0365-8104</issn>
                                        <issn pub-type="epub">1307-5608</issn>
                                                                                            <publisher>
                    <publisher-name>Ankara University</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id/>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Endocrinology</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Endokrinoloji</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <trans-title-group xml:lang="tr">
                                    <trans-title>Postpartum Hemorrhagic Shock-Induced Hypopituitarism Syndrome: Pathogenetic Insights</trans-title>
                                </trans-title-group>
                                                                                                                                                                                                <article-title>Postpartum Hemorajik Şok Hipopituitarizm Sendromu (Patojenetik Görüşler)</article-title>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                <name>
                                    <surname>Bayçın</surname>
                                    <given-names>Tokay</given-names>
                                </name>
                                                                    <aff>ANKARA UNIVERSITY, ANKARA FACULTY OF MEDICINE</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="19750930">
                    <day>09</day>
                    <month>30</month>
                    <year>1975</year>
                </pub-date>
                                        <volume>28</volume>
                                        <issue>3-4</issue>
                                        <fpage>709</fpage>
                                        <lpage>722</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="19750701">
                        <day>07</day>
                        <month>01</month>
                        <year>1975</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="19750930">
                        <day>09</day>
                        <month>30</month>
                        <year>1975</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 1947, Ankara Üniversitesi Tıp Fakültesi Mecmuası</copyright-statement>
                    <copyright-year>1947</copyright-year>
                    <copyright-holder>Ankara Üniversitesi Tıp Fakültesi Mecmuası</copyright-holder>
                </permissions>
            
                                                                                                                        <abstract><p>This article presents three clinical cases of Sheehan&#039;s syndrome, a form of postpartum hypopituitarism caused by ischemic necrosis of the anterior pituitary due to severe hemorrhagic shock following childbirth. The authors analyze patient histories, physical findings, and detailed laboratory evaluations to diagnose panhypopituitarism in the absence of tumors, infections, trauma, or vascular disease.Clinically, all three patients showed gonadal failure and hypothyroidism, with latent adrenocortical insufficiency. Symptoms included amenorrhea, loss of libido, lactation failure, hair thinning, facial edema, and general fatigue. One patient exhibited mild clinical signs of adrenal deficiency. Substitution therapy led to recovery in all three cases.The authors argue that the syndrome is not as rare as previously thought—especially in developing regions—and may be underdiagnosed due to delayed symptom onset. They propose that pregnancy-induced pituitary hypertrophy increases susceptibility to ischemia in the context of hemorrhagic shock, setting Sheehan&#039;s syndrome apart from other causes of hypopituitarism. The article emphasizes the gradual progression of pituitary fibrosis and urges clinicians to consider this diagnosis even in cases of moderate postpartum hemorrhage.</p></abstract>
                                                            
            
                                                                                        <kwd-group>
                                                    <kwd>Sheehan</kwd>
                                                    <kwd>  Postpartum hemorrhagic shock</kwd>
                                                    <kwd>  Hypopituitarism</kwd>
                                                    <kwd>  Adenohypophysis necrosis</kwd>
                                                    <kwd>  Pituitary insufficiency</kwd>
                                                    <kwd>  Gonadal failure</kwd>
                                                    <kwd>  Hypothyroidism</kwd>
                                                    <kwd>  Adrenocortical insufficiency</kwd>
                                                    <kwd>  Pluriglandular deficiency</kwd>
                                                    <kwd>  Endocrine pathology</kwd>
                                            </kwd-group>
                            
                                                                                                                                                    </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
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                    </ref>
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                    </ref>
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                    </ref>
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                        <mixed-citation publication-type="journal">13. Schneeberg NG, Perloff WH, Israel SL. Incidence of Unsuspected Sheehan&#039;s Syndrome. JAMA. 1960;172:70–78.</mixed-citation>
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                        <label>16</label>
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                    </ref>
                            </ref-list>
                    </back>
    </article>
