Spontaneous Pregnancy and Delivery in a Patient with Sheehan's Syndrome

Young Kwang Choo; Won Sang Yoo; Do Hee Kim; Hyun-Kyung Chung; Hee Jin Kim

doi:10.3803/jkes.2009.24.2.121

Journal List > J Korean Endocr Soc > v.24(2) > 1003485

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Choo, Yoo, Kim, Chung, and Kim: Spontaneous Pregnancy and Delivery in a Patient with Sheehan's Syndrome

Case Report

Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2009; 24(2): 121-125.

Published online: 30 June 2009

DOI: https://doi.org/10.3803/jkes.2009.24.2.121

Spontaneous Pregnancy and Delivery in a Patient with Sheehan's Syndrome

Young Kwang Choo, Won Sang Yoo, Do Hee Kim, Hyun-Kyung Chung, Hee Jin Kim

Department of Internal Medicine, College of Medicine, Dankook University, Korea.

Received 22 October 2008 Accepted 8 March 2009

Abstract

Sheehan's syndrome is postpartum hypopituitarism due to the necrosis of the pituitary gland. It is usually the result of severe hypotension or shock caused by massive hemorrhage during or after delivery. Patients with Sheehan's syndrome have varying degrees of anterior pituitary hormone deficiency. They are accompanied with amenorrhea and ovulation dysfunction, and so they rarely get pregnant naturally. Ovulation induction is necessary if these patients desire to become pregnant. However, spontaneous pregnancy may be possible in some patients who have a preserved gonadotrophin reserve. We experienced a case of 29-year-old woman who was diagnosed Sheehan's syndrome 20 months after delivery and we medicated her with prednisolone and thyroxine. She got pregnant spontaneously after 18 months of hormone replacement therapy although she had amenorrhea and irregular menstrual cycles. She successfully delivered a baby by cesarean section. Here we report on this case with a review of the relevant literature concerned with pregnancy and Sheehan's syndrome.

Keywords: postpartum hypopituitarism, pregnancy, Sheehan's syndrome

Figures and Tables

Fig. 1

Magnetic resonance imaging (MRI) of the hypothalamopituitary region reveals the normal size of the sella turcica and the almost absence of the pituitary gland. Coronal (A) and sagittal (B) images show CSF filling the sella turcica and pituitary stalk extending up to the floor of the sella turcica.

Table 1

Combined pituitary stimulation test

T3: 82.2 ng/dL, free T4: 0.68 ng/dL, E2: 20.1 pg/mL

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