SHEEHAN'S SYNDROME

also called postpartum pituitary necrosis insufficiency of pituitary hormones (hypopituitarism) following pregnancy and childbirth, caused by destruction of cells of the anterior pituitary gland by oxygen starvation following childbirth. The condition may also result from septic shock, burn shock, or a massive hemorrhage of any kind. Once the most common cause of hypopituitarism in women, Sheehan's syndrome has become less common with improvements in obstetric practice. In women giving birth, damage to the anterior pituitary may result from a drop in blood pressure caused by blood loss during and after delivery; the hypophyseal arteries, which supply the pituitary gland, go into spasm, temporarily cutting off the blood supply to the gland and killing some of its tissue. As long as at least 30 percent of the gland continues to function, no insufficiency of pituitary hormone will occur. If the damage is more extensive, however, symptoms of hypopituitarismchiefly the loss of secondary sex characteristicsappear shortly after delivery. Clinical manifestations of the syndrome include inability to produce milk, loss of axillary and pubic body hair, and failure to resume menstruation. Supplements of pituitary hormones correct the condition, restoring ovulation and stimulating the secretion of estrogenic hormones.