J Korean Endocr Soc.  2009 Jun;24(2):121-125. 10.3803/jkes.2009.24.2.121.

Spontaneous Pregnancy and Delivery in a Patient with Sheehan's Syndrome

• Choo YK
• Yoo WS
• Kim DH
• Chung HK
• Kim HJ

• KMID: 1468507
• DOI: http://doi.org/10.3803/jkes.2009.24.2.121

Abstract

Sheehan's syndrome is postpartum hypopituitarism due to the necrosis of the pituitary gland. It is usually the result of severe hypotension or shock caused by massive hemorrhage during or after delivery. Patients with Sheehan's syndrome have varying degrees of anterior pituitary hormone deficiency. They are accompanied with amenorrhea and ovulation dysfunction, and so they rarely get pregnant naturally. Ovulation induction is necessary if these patients desire to become pregnant. However, spontaneous pregnancy may be possible in some patients who have a preserved gonadotrophin reserve. We experienced a case of 29-year-old woman who was diagnosed Sheehan's syndrome 20 months after delivery and we medicated her with prednisolone and thyroxine. She got pregnant spontaneously after 18 months of hormone replacement therapy although she had amenorrhea and irregular menstrual cycles. She successfully delivered a baby by cesarean section. Here we report on this case with a review of the relevant literature concerned with pregnancy and Sheehan's syndrome.

Keyword

postpartum hypopituitarism; pregnancy; Sheehan's syndrome

MeSH Terms

Adult
Amenorrhea
Cesarean Section
Female
Hemorrhage
Hormone Replacement Therapy
Humans
Hypopituitarism
Hypotension
Menstrual Cycle
Necrosis
Ovulation
Ovulation Induction
Pituitary Gland
Prednisolone
Pregnancy
Shock
Thyroxine
Prednisolone
Thyroxine

Figure

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  Fig. 1 Magnetic resonance imaging (MRI) of the hypothalamopituitary region reveals the normal size of the sella turcica and the almost absence of the pituitary gland. Coronal (A) and sagittal (B) images show CSF filling the sella turcica and pituitary stalk extending up to the floor of the sella turcica.

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