Each of us with awe and hope awaits the birth of a child. We sincerely believe that the baby and mother will be healthy, and such horrors as Sheehan and Denny-Morphan, Down or Simmonds syndromes will not be diagnosed in them. All of these diseases are terrible and difficult to treat. In this article, we will describe in detail the first of them - Sheehan syndrome. Some women giving birth are exposed to it.
Description
Postpartum pituitary necrosis is also called Sheehan's syndrome. The medical history suggests that this is a rather complex pathology that develops after a difficult and prolonged birth. The cause is heavy bleeding, which, in turn, leads to arterial hypotension. Due to its development, the pituitary gland is less supplied with blood - a small gland in the brain that is responsible for the work of the human endocrine system and the production of hormones. Shihan's syndrome develops in the body, the consequences of which are not the most pleasant - you cannot breastfeed your baby, but this is only the smallest part of the problems that expect a mother.
Since pathology can occur in an erased form, its true frequency is unknown. It is established that after birth bleeding, the risk of its development reaches 40%. The disease is diagnosed in every fourth woman if she has lost about 800 ml of blood, in 50% of those giving birth - with the loss of a liter of vital fluid.
Symptoms
They are quite specific. For example, the first alarm bell should be the cessation of lactation. Secondary symptoms of Sheehan's syndrome usually appear only after a few months. Often this is secondary amenorrhea - a complete absence of menstruation and a decrease in the secretion of gonadotropins. Then they diagnose hypothyroidism when the thyroid gland produces insufficient hormones. Against this background, myxedema develops - a violation of protein metabolism, which leads to severe swelling of the tissues.
Women in their prime - from 20 to 40 years old - may also experience hypopituitarism. This is a serious condition of the body that suffers from a deficiency of various hormones: a woman has severe weakness, sharp weight loss, lack of libido. In advanced cases, a person may suffer from neuropsychiatric disorders and even fall into a coma.
Classification
Lack of hormones in the body can be different - from mild to deficient forms. Depending on this, the following types of Sheehan's syndrome are distinguished:
- Global form. With it, there is an extreme insufficiency of top hormones, as a result of which severe mental disorders develop, the neurological system malfunctions, a person falls into a coma.
- Partial form. Hormone deficiency is not very pronounced, therefore, only insufficiency of adrenocorticotropic, gonadotropic or thyrotropic functions is diagnosed. The genitals, the work of the kidneys and other organs are affected.
- Combined form. When all of the above functions are violated at the same time.
If you notice even mild manifestations of the disease, you should immediately contact a gynecologist or a local therapist, who will direct you to the necessary tests and schedule a consultation with other specialists.
Pathogenesis
This is a mechanism from the very onset of the disease to the vivid manifestations of symptoms. Experienced doctors consider it at various levels: from molecular pathologies to disruption of the body as a whole. It is necessary to study it, since it is pathogenesis that gives the answer to the question of how and why the disease develops. As for Sheehan's syndrome, it has long been established: its main manifestation is necrotic changes in the pituitary gland. They occur against the background of blood coagulation, when there is a spasm of the vessels of the anterior pituitary after severe blood loss.
Sheehan's syndrome, the symptoms of which are described above, can occur after an abortion, as well as against a background of bacterial shock after childbirth. A predisposing factor is gestosis - a complication of pregnancy, when the expectant mother is diagnosed with severe swelling, loss of protein in the urine, high blood pressure and so on. It is these women who become prone to blood clots.
Clinical picture
The degree of manifestation of Sheehan's syndrome is different. Usually, doctors distinguish such forms:
- Easy. It is characterized by rapid fatigue and frequent headaches. There is a decrease in adrenal and thyroid function.
- Medium . The above organs are even more affected. For example, a woman feels very tired, she breaks her nails, she is prone to fainting. The work of the ovaries is disturbed, sometimes up to ovulatory infertility.
- Heavy . The genitals and mammary glands hypertrophy, a person suffers from drowsiness, baldness, skin pigmentation, memory loss. Body weight falls on the background of severe swelling.
The syndrome is characterized by severe anemia, which manifests itself in all forms of the disease. It is very resistant to therapy, so it is practically not treatable. Doctors need to try to restore the level of iron in the blood.
Diagnostics
During it, it is important to study in detail the characteristic anamnesis, where the relationship between the disease and bleeding or septic shock during a previous abortion or childbirth is traced. To determine Sheehan’s syndrome, diagnosis begins with an examination of the mammary glands: they do not increase in size, do not condense, milk does not stand out even with strong pressure and after a course of massage.
At the same time, a blood test is taken in the laboratory, according to which the
hormonal background of the body is determined. Depending on the amount of hormones, a diagnosis is made. They take urine for a test - changes in the body are also visible on it. In addition, doctors also conduct differential diagnostics - something that helps to distinguish one disease from another. Indeed, many of them have very similar symptoms. Therefore, each of them is analyzed in detail, compared and the correct conclusion is made.
Treatment
How to get rid of an insidious disease. Usually, when a person is diagnosed with Sheehan’s syndrome, treatment begins with hormones: sexual and gonadotropic, and therapy of sexual infantilism is prescribed. Suitable, for example, "Infecundin" or other drugs from a series of synthetic progestins. The Sinestrol course, which lasts at least a month, as well as cyclic therapy throughout the whole quarter, will be effective.
Remember that there is no question of any self-medication! At home, you only harm, provoke the development of serious complications. Therefore, at the first symptoms, immediately contact a specialist. Only competent diagnosis, a professional approach and effective therapy will help cure Sheehan's syndrome and eliminate the consequences that its development in the body led to.