Definition of Sheehan syndrome:

Sheehan syndrome is a condition that may occur in a woman who bleeds severely during childbirth.

See also: Hypopituitarism

Causes, incidence, and risk factors:

Severe bleeding during childbirth can cause tissue death in the pituitary gland, which may cause the gland to lose its ability to function properly.

The pituitary gland is located at the base of the brain. It normally produces hormones that stimulate breast milk production, growth, reproductive functions, the thyroid, and the adrenal glands. A lack of these hormones can lead to a variety of symptoms.

Conditions that increase the risk of bleeding during childbirth and Sheehan syndrome include multiple pregnancies (twins or triplets) and problems with the placenta, the organ that develops during pregnancy to feed the fetus.

Sheehan syndrome is very rare.

Symptoms:

Symptoms of Sheehan syndrome may include:

• Inability to breast-feed (breast milk never "comes in")
• Fatigue
• Lack of menstrual bleeding
• Loss of pubic and axillary hair
• Low blood pressure

Note: Symptoms other than inability to breast feed may not develop for several years after the delivery.

Signs and tests:

• Blood tests to measure hormone levels
• MRI of the head to rule out other pituitary problems, such as a tumor

Treatment:

Treatment involves estrogen and progesterone hormone replacement therapy, which must be taken for the rest of your life. Thyroid and adrenal hormones also must be taken.

Expectations (prognosis):

The outlook with early diagnosis and treatment is excellent.

Complications:

This condition can be life threatening if not treated.

Prevention:

Extreme bleeding during childbirth can often be prevented by proper medical care. Otherwise, Sheehan syndrome is not preventable.