A Case Report on Sheehan’s Syndrome

Abstract

Sheehan's Syndrome refers to hypopituitarism that develops after a severe postpartum haemorrhage (PPH).Sheehan's Syndrome has become a rare entity in developed countries due to good obstetric care. In the Indian context, it is still a rare and serious problem. The severity of the pituitary necrosis determines the timing of presentation, with severe cases presenting immediately and less severe cases presenting years or decades later. At the time of her premature twin pregnancy delivery, a young woman had preeclampsia, antepartum haemorrhage, and postpartum haemorrhage. She presented with secondary amenorrhoea three years later. The diagnosis was confirmed by symptoms such as weakness, hypotension, cold intolerance, loss of sexual hair, breast and vulval atrophy, and loss of libido. ACTH, TSH, FSH, LH, Prolactin, as well as Estradiol, Cortisol, and Sodium levels were all low, confirming the diagnosis. Hormone replacement therapy with Cortisone, Thyroxine, Estrogen and Progesterone improved her general condition. Her menstrual cycles have been restored, her genital organs have been rejuvenated, and her libido has been regained. Less severe forms of Sheehan’s syndrome are insidious in onset, vague in presentation and so are under diagnosed.