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Updated: Aug 6 2019

Sheehan Syndrome

  • Snapshot
    • A 26-year-old woman, 5 days post vaginal delivery, presents to her child's pediatrician with a complaint that she is unable to breast feed her child. History reveals a vaginal delivery complicated by postpartum hemorrhage.
  • Introduction
    • Failure to lactate following postpartum hemorrhage
      • result of pituitary infarction that occured as a result of hypovolemic shock
        • pituitary normally very enlarged during pregancy due ↑ lactotrophs
        • no corresponding ↑ blood supply
      • hypopituitarism results in ↓ prolactin secretion
  • Presentation
    • Symptoms
      • sudden cessation of lactation
        • loss of prolactin
      • fatigue
        • loss of TSH
      • loss of pubic and axillary hair
        • loss of LH/FSH
      • anorexia
  • Evaluation
    • Only clinically significant cause of lower than normal serum prolactin levels
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