Pituitary necrosis in Sheehan .'s syndrome

The article was consulted with Specialist Doctor I Le Thi Phuong - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology, Vinmec Ha Long International General Hospital.

Pituitary necrosis in Sheehan's syndrome is a rare but life-threatening endocrine disorder. Early recognition of signs of the disease will contribute to detecting and avoiding life-threatening complications.

Sheehan's syndrome is also known as postpartum hypopituitarism, because these are symptoms that appear after giving birth in women. There are many causes of this syndrome, but mainly due to acute blood loss in women during childbirth with a large amount leading to reduced blood supply to the brain, damage to the pituitary gland, causing the pituitary gland to decrease or necrosis of the pituitary gland, resulting in a series of other endocrine glands such as thyroid gland, adrenal gland, and endocrine-gonadal glands become dysfunctional and symptoms occur.
Causes of maternal blood loss are usually uterine atony, genital tract trauma, blood clotting disorders, uterine rupture, multiple pregnancies, multiple pregnancy and polyhydramnios, breech position, prolonged labor, placenta. striker, placenta comb,...

The signs and symptoms of damage and necrosis of the pituitary gland in Sheehan's syndrome appear slowly, so it will combine a series of symptoms of hypothyroidism, adrenal and gonads. Specifically as follows:
Symptoms of hypothyroidism: The patient is sluggish, gaining weight, afraid of cold... Symptoms of adrenal insufficiency: There are symptoms of fatigue, low blood pressure, weight loss. Symptoms of hypogonadism: The patient loses armpit hair, pubic hair, does not see menstruation reappear after giving birth or has irregular periods... Other symptoms such as depression, mental disorders, severe anemia Most of the above signs are non-specific, easily confused with other diseases, so patients are often diagnosed late and misdiagnosed. Therefore, many people are admitted to the hospital in an emergency, heart failure, shock, encephalitis, liver and bone marrow failure...

Diagnosis of Sheehan's syndrome can be difficult, especially in cases of late arrival with nonspecific symptoms. Therefore, the methods used to diagnose Sheehan's syndrome are:
Ask about history of childbirth, child rearing and postpartum menstrual status. Examine and notice the symptoms of hypothyroidism, adrenal insufficiency and hypogonadism such as pale nipples, underarm hair and pubic hair loss... Blood tests to measure pituitary hormones, adrenal hormones as well as thyroid hormones genitals because these hormones are often decreased. In addition, this test to see if the patient has anemia, water and electrolyte disorders. Pituitary Magnetic Resonance Imaging: To check the size of the pituitary gland and rule out other causes of hypopituitarism and pituitary necrosis.

The treatment methods for Sheehan's syndrome are to compensate for the hormones of the pituitary gland, thyroid gland, and adrenal gland... for the patient. Drugs used for treatment are corticosteroids, levothyroxine, estrogen, growth hormone... to help patients improve symptoms.
The damage to the pituitary gland in Sheehan's syndrome is usually irreversible. Therefore, pregnant women need to have regular health check-ups and antenatal check-ups, a reasonable diet and rest to avoid complications of acute blood loss and severe hypotension. In particular, after 9 months and 10 days of heavy carrying, pregnant women entered the labor and had to face the level of labor pain compared to 20 broken ribs at the same time. In order for the birth to go smoothly and safely, pregnant women need to understand:
How the labor process takes place, how long does it usually take to have a normal delivery or caesarean section, to protect the best health for the unborn baby. Methods to relieve pain during childbirth, limit pain and relieve psychological pressure during labor. The way to push and breathe during childbirth is usually the right way so that the labor takes place quickly, the pregnant woman does not lose strength during childbirth. How to control postpartum uterine contractions in the shortest time. How to take care of the perineal suture does not cause infection and dangerous complications. Early postpartum re-examination to detect dangerous abnormalities such as residual placenta, missing gauze. Take care of newborn until full month healthy. => Advice from Specialist Doctor I Le Thi Phuong - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology, Vinmec Ha Long International Hospital: Diagnosis of Sheehan's syndrome is difficult, especially late patients, so You should see a doctor early for timely diagnosis and treatment.

To ease the pain of childbirth, Vinmec offers a full Maternity program with a complete "painless delivery" service during and after birth using non-morphine epidural and sedation techniques. ashamed. During the birth process, the mother will be guided by doctors and midwives on how to push and breathe properly, the baby will be born in just 10-15 minutes. After birth, the baby will be cared for in a sterile room before being returned to the mother.
Pregnant women will rest in a high-class hospital room, designed according to international hotel standards, 1 mother 1 room with full facilities and modern equipment. Mothers will be consulted by nutritionists on how to feed the baby before being discharged from the hospital. Postpartum follow-up with both mother and baby with leading Obstetricians and Paediatricians.