Manifestations of hypopituitarism were looked for in 35 women who had survived postpartum hemorrhage and/or shock. Sheehan's syndrome probably represents one extreme of a spectrum of conditions resulting from damage to the hypophysis during hemorrhage and shock, and the purpose was to identify susceptible patients as the basis for preventive action. Eight case histories illustrate the complexity of the relationships found. Four women proved to have previously undiagnosed pituitary deficiency manifested by mammary and genital atrophy, amenorrhea, and sterility, with other characteristic symptoms and laboratory findings. No correlation was found between the severity of the postpartum hemorrhage and/or shock and the likelihood or degree of subsequent hypopituitarism, but the latter was found more frequently than had been expected. If it is watched for more carefully, more patients can be given the benefits of endocrine substitution therapy.
Schneeberg NG, Perloff WH, Israel SL. INCIDENCE OF UNSUSPECTED "SHEEHAN'S SYNDROME"HYPOPITUITARISM AFTER POSTPARTUM HEMORRHAGE AND/OR SHOCK— CLINICAL AND LABORATORY STUDY. JAMA. 1960;172(1):20–27. doi:10.1001/jama.1960.03020010077007