Evaluation of obstetrical factors related to Sheehan syndrome.
OBJECTIVE
To evaluate factors related to the occurrence of Sheehan syndrome.


METHODS
The obstetrical disseminated intravascular coagulation score, total volume of hemorrhage, shock index, level of consciousness at the time of shock occurrence and pituitary magnetic resonance imaging findings were evaluated in nine women who showed massive hemorrhage during delivery. These clinical outcomes were analyzed in all these patients who were prospectively followed-up to identify any possible occurrence of Sheehan syndrome.


RESULTS
Compared to six women with non-Sheehan syndrome, three women who were diagnosed with Sheehan syndrome showed significant elevation of the obstetrical disseminated intravascular coagulation score, decrease in the level of consciousness during shock and remarkable pituitary gland atrophic change with an empty sella turcica detected by pituitary magnetic resonance imaging. The volume of hemorrhage during delivery and shock index were not significantly different between these two groups of women.


CONCLUSIONS
Careful attention and follow-up should be paid to women with post-partum massive hemorrhage for early detection and management of women with Sheehan syndrome.
Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Takahiro
T
Matsuwaki
Khaleque Newaz
KN
Khan
Tsuneo
T
Inoue
Atsushi
A
Yoshida
Hideaki
H
Masuzaki
D000037:Abruptio Placentae / Q000503:physiopathology; D000328:Adult; D001284:Atrophy; D002585:Cesarean Section / Q000009:adverse effects*; D017604:Cesarean Section, Repeat / Q000009:adverse effects; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000517:prevention & control; D004652:Empty Sella Syndrome / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D007044:Hysterectomy; D008279:Magnetic Resonance Imaging; D010902:Pituitary Gland / Q000473:pathology; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy; D011247:Pregnancy; D012720:Severity of Illness Index; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D053608:Stupor / Q000209:etiology / Q000517:prevention & control
Sheehan syndrome; magnetic resonance imaging findings; obstetrical outcome