Post partum mortality; WHY? Sheehan’s Syndrome

Abstract

Necrosis in the pituitary gland due to postpartum hemorrhage or hypovolemia is called Sheehan’s syndrome (SS). The clinical condition may result in hypothyroidism, adrenal insufficiency, coma and death, as well as asymptomatic. A 30-year-old woman was admitted to our clinic because of complaints of fatigue, swelling and bruising on her postpartum 10th day. The patient with general condition was in hypotensive shock. The patient, who had a short time of arrest, did not respond to the resuscitation and died. While SS is usually present in years, it may rarely cause cardiac dysrhythmias, adreanal crises, coma and death in some patients. In this case, we wanted to discuss the case of acute SS who died at the age of 30 years.

Keywords

• Adrenal insufficiency,,HELLP syndrome,postpartum hemorrhage,,difficult birth

References

1. Referans1 Giri S, Bansal P, Malik S, Bansal R. Hypopituitarism presenting as congestive heart failure. J Postgrad Med. 2017;63(4):268-270. Referans2) Dharmshaktu P, Bhowmick J, Manglani D, Dhanwal DK. Recurrent symptomatic hypoglycaemia with pancytopenia as a delayed presentation of Sheehan’s syndrome with complete recovery after hormone replacement. BMJ Case Rep. 2013;1-4. Referans3 Gökalp D, Bahçeci M, Tuzcu AK, Arıkan Ş, Bahçeci S, Çil T. A case of Sheehan’s syndrome with pancytopenia. Turkey Clinics J. Neur 2008;3(3). Referans4 Dökmetaş HS¸ Kılıçlı F, Korkmaz S, Yönem Ö. Characteristic features of 20 patients with Sheehan’s syndrome. Gynecological Endocrinology. 2006;22(5):279–283. Referans5 Israel SL, Conston AS. Unrecognized pituitary necrosis (Sheehan's Syndrome)A cause of sudden death. JAMA. 1952;148(3):189-193. Referans6 Laway BA, Mir AS, Jan VM, Bhat MA, Farooqui KJ. Recurrent Ventricular Tachycardia in Sheehan’s Syndrome. Turk Jem 2015;19: 28-30. Referans7 García-Castro JM, García-Martín A, Guirao-Arrabal E, Carrillo-Alascio PL Long QT syndrome and polymorphic ventricular tachycardia due to hypopituitarism. Report of one case. Rev Med Chil. 2017;145(7):941-944. Referans8 Jain N, Dutta P, Dutta A, Sharma R, Bhansali A. Panhypopituitarism: a rare cause of cardiac tamponade. An International Journal of Medicine. 2018;731–732. Referans9 Matsuzaki S, Endo M, Ueda Y, Mimura K, Kakigano A, Takata TE, Kumasawa K, Yoshino K, Kimura T. A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage. BMC Pregnancy and Childbirth. 2017;17(188):1-10. Referans10 Vatansever Ş, Kutluyurdu B, Tuluk G, Arıkan S, Özyuvacı E. A delayed diagnosis: Sheehan’s Syndrome. Journal of Anesthesia 2009;17(2):115. Referans11 Baştürk M, Tokgöz O, Evsen MS, Tekbaş G, Kapan M, Suyuçok E, Al B. Emergency Approach in HELLP Syndrome. JAEM. 2009;8(1):9-12. Referans12 Kumar N, Singh P, Kumar J, Dhanwal DK. Recurrent hypoglycaemia: a delayed presentation of Sheehan syndrome. BMJ Case Rep. 2014;1-3. Referans13 Lee MH, Calder GL, MacIsaac RJ, Sachithanandan N. Hyponatraemia and hypopituitarism: an easily missed entity. MJA. 2017;207(7):282-283. Referans14 Varan Ö, Gürlek A. Adrenal Insufficiency: Diagnosis and Treatment Algorithm. Journal of Intensive Care 2010;9(4):200-207.