Matsuwaki Takahiro, Khan Khaleque Newaz, Inoue Tsuneo, Yoshida Atsushi, Masuzaki Hideaki
Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
J Obstet Gynaecol Res. 2014 Jan;40(1):46-52. doi: 10.1111/jog.12119. Epub 2013 Aug 15.
To evaluate factors related to the occurrence of Sheehan syndrome.
The obstetrical disseminated intravascular coagulation score, total volume of hemorrhage, shock index, level of consciousness at the time of shock occurrence and pituitary magnetic resonance imaging findings were evaluated in nine women who showed massive hemorrhage during delivery. These clinical outcomes were analyzed in all these patients who were prospectively followed-up to identify any possible occurrence of Sheehan syndrome.
Compared to six women with non-Sheehan syndrome, three women who were diagnosed with Sheehan syndrome showed significant elevation of the obstetrical disseminated intravascular coagulation score, decrease in the level of consciousness during shock and remarkable pituitary gland atrophic change with an empty sella turcica detected by pituitary magnetic resonance imaging. The volume of hemorrhage during delivery and shock index were not significantly different between these two groups of women.
Careful attention and follow-up should be paid to women with post-partum massive hemorrhage for early detection and management of women with Sheehan syndrome.
评估与席汉综合征发生相关的因素。
对9例分娩期间出现大量出血的女性,评估其产科弥散性血管内凝血评分、出血总量、休克指数、休克发生时的意识水平以及垂体磁共振成像结果。对所有这些患者进行前瞻性随访,分析这些临床结果,以确定是否可能发生席汉综合征。
与6例非席汉综合征女性相比,3例被诊断为席汉综合征的女性产科弥散性血管内凝血评分显著升高,休克期间意识水平下降,垂体磁共振成像显示垂体明显萎缩性改变伴空蝶鞍。两组女性分娩期间的出血量和休克指数无显著差异。
对于产后大出血的女性应予以密切关注和随访,以便早期发现并管理席汉综合征患者。