SHEEHAN'S SYNDROME CLINICAL CASE

Sheehan’s syndrome (SS) is an ischemic necrosis of the pituitary gland due to severe postpartum hemorrhage, characterized by varying degrees of impaired pituitary hormone synthesis. As recently as 50 years ago, SS occurred in 10–20 cases per 100,000 women. It is believed that due to improved obstetric care, the prevalence of the disease has decreased, especially in developed countries. According to various estimates, the prevalence of SS in India is 2.7–3.9% among women over 20 years of age who have given birth. The prevalence of SS among the population of Iceland in 2009 was 5.1 per 100,000 women [1, 2]. It is known that during pregnancy, the pituitary gland increases in volume (up to 36%) due to hypertrophy of prolactin-secreting lactotrophs, which leads to vulnerability of the pituitary gland to ischemia - this explains the absence of SS in non-pregnant women [3]. The enlarged pituitary gland compresses the branches of the superior pituitary artery (SPA), which feed the adenohypophysis, but during the physiological course of pregnancy and childbirth this causes a minimal decrease in blood supply.