Department of Internal Medicine, Landspitali University Hospital, Fossvogur, 108 Reykjavik, Iceland.
Eur J Endocrinol. 2011 Mar;164(3):349-54. doi: 10.1530/EJE-10-1004. Epub 2010 Dec 23.
Half a century ago the prevalence of Sheehan's syndrome (SS) was 10-20 per 100,000 women. With better obstetric help the prevalence is assumed to have decreased, especially in developed countries. The aim of this study is to estimate the prevalence of SS in modern times in Iceland.
We studied the prevalence of SS in 2009 in a nationwide retrospective population-based study.
All patients with diagnosed SS were identified, and information regarding obstetric care, clinical presentation and hormonal assays was collected. Correlation was calculated with Kendall's tau-b. Significance level: P<0.05.
Eight women were identified with SS; thus, the prevalence of SS in 2009 was 5.1 per 100,000 women. The mean age at delivery and diagnosis was 33.0 and 36.6 respectively, resulting in a diagnostic delay (DD) of 1-240 months. Four women had low blood pressure during delivery, and five had massive blood loss (>1000 ml). Six had complicated deliveries. The most common clinical presentation was failure to lactate and failure to resume menstruation. The patients had three to five failing pituitary axis. There was no correlation between bleeding at delivery or the number of hormonal axes affected and DD.
The prevalence of SS in Iceland was higher than we expected in a country with modern obstetric care. Long DD and incidental diagnosis indicate that women might be lacking correct diagnosis and treatment, and thus the prevalence of SS is even higher. As SS is easily diagnosed and treatable, but can be life-threatening if unrecognised, doctors need to be aware of the disease.
半个世纪前，席汉氏综合征（SS）的患病率为每 10 万女性中有 10-20 例。随着产科医疗水平的提高，该患病率预计已经下降，尤其是在发达国家。本研究旨在评估现代冰岛 SS 的患病率。
我们进行了一项全国性的回顾性基于人群的研究，以评估 2009 年 SS 的患病率。
所有确诊 SS 的患者均被识别，并收集了有关产科护理、临床表现和激素检测的信息。使用 Kendall's tau-b 进行相关性计算。显著性水平：P<0.05。
共发现 8 例 SS 患者，因此 2009 年 SS 的患病率为每 10 万女性中有 5.1 例。分娩和诊断的平均年龄分别为 33.0 岁和 36.6 岁，导致诊断延迟（DD）为 1-240 个月。4 例患者在分娩时出现低血压，5 例患者发生大量失血（>1000ml）。6 例患者分娩过程复杂。最常见的临床表现为无乳和无月经恢复。患者有 3-5 个垂体轴功能衰竭。分娩时出血或受影响的激素轴数量与 DD 之间无相关性。
在产科医疗水平现代的冰岛，SS 的患病率高于预期。较长的 DD 和偶然诊断表明，女性可能缺乏正确的诊断和治疗，因此 SS 的患病率甚至更高。由于 SS 易于诊断和治疗，但如果未被识别则可能危及生命，因此医生需要了解该疾病。
