Sheehan syndrome, also known as postpartum hypopituitarism or postpartum pituitary necrosis, is hypopituitarism (decreased functioning of the pituitary gland), caused by necrosis due to blood loss and hypovolemic shock during and after childbirth.

Causes

It is a rare complication of pregnancy, usually occurring after excessive blood loss; the presence of disseminated intravascular coagulation (i.e., in amniotic fluid embolism or HELLP syndrome) also appears to be a factor in its development.

Pathophysiology

Hypertrophy and hyperplasia of lactotrophs during pregnancy results in the enlargement of the anterior pituitary, without a corresponding increase in blood supply.

Secondly, the anterior pituitary is supplied by a low pressure portal venous system.^[1]

These vulnerabilities, when affected by major hemorrhage or hypotension during the peripartum period, can result in ischaemia of the affected pituitary regions leading to necrosis.

The posterior pituitary is usually not affected due to its direct arterial supply.

Eponym

It is named for Harold Sheehan.^[2][3]

References

1. ↑ http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=endocrin&part=A1257 under heading Sheehan's syndrome
2. ↑
3. ↑ H. L. Sheehan. Post-partum necrosis of anterior pituitary. The Journal of Pathology and Bacteriology, Chichester, 1937, 45: 189-214.

External links

• Pathology at vcu.edu

de:Sheehan-Syndrom es:Síndrome de Sheehan fr:Syndrome de Sheehan hr:Sheehanov sindrom it:Sindrome di Sheehan ja:??????? pl:Zespó? Sheehana pt:Síndrome de Sheehan ru:??????? ??????