Robalo Raquel, Pedroso Célia, Agapito Ana, Borges Augusta
Department of Maternal and Fetal Medicine, Maternidade Alfredo da Costa, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
BMJ Case Rep. 2012 Nov 6;2012:bcr2012007022. doi: 10.1136/bcr-2012-007022.
Sheehan's syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. Improvements in obstetrical care have significantly reduced its incidence in developed countries, but postpartum pituitary infarction remains a common cause of hypopituitarism in developing countries. We report a case of severe postpartum haemorrhage followed by headache, central diabetes insipidus and failure to lactate, which prompted us to investigate and identify both anterior and posterior pituitary deficiency compatible with Sheehan's syndrome. A timely diagnosis allowed us to implement an adequate treatment and follow-up plan, which are known to improve clinical status and patient outcome.
席汉综合征是由于严重产后出血导致垂体缺血性坏死所致。产科护理的改善已显著降低了其在发达国家的发病率,但产后垂体梗死仍是发展中国家垂体功能减退的常见原因。我们报告一例严重产后出血病例,随后出现头痛、中枢性尿崩症和泌乳失败,这促使我们进行调查并确定与席汉综合征相符的垂体前叶和后叶功能减退。及时诊断使我们能够实施适当的治疗和随访计划,已知这些措施可改善临床状况和患者预后。