Each of us with trepidation and hope is waiting for the birth of a child. We sincerely believe that the baby and mother will be he althy, and such horrors as Sheehan and Denny-Morfan, 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's syndrome. It affects some women in labor.
Description
Postpartum necrosis of the pituitary gland is also called Sheehan's syndrome. The medical history indicates that this is a rather complex pathology that develops after a difficult and prolonged birth. The cause is profuse bleeding, which, in turn, leads to arterial hypotension. As a result of its development, the pituitary gland, a small gland in the brain, is less supplied with blood, which is responsible for the functioning of the human endocrine system and the production of hormones. Sheehan's syndrome develops in the body, the consequences of which are not the most pleasant - you will not be able to breastfeed the baby, but this is only the smallest part of the problems that await the mother.
Because the pathology can proceed in an erased form, its true frequency is unknown. It has been 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 wake-up call should be the cessation of lactation. Minor symptoms of Sheehan's syndrome usually do not appear until several months later. Often this is secondary amenorrhea - the complete absence of menstruation and a decrease in the secretion of gonadotropins. Then hypothyroidism is diagnosed, when the thyroid gland produces an insufficient amount of hormones. Against this background, myxedema develops - a violation of protein metabolism, which leads to severe swelling of tissues.
Women in their prime - 20 to 40 years old - may also experience hypopituitarism. This is a serious condition of the body, which suffers from a deficiency of various hormones: a woman has severe weakness, sudden 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 form. 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, the person falls into a coma.
- Partial shape. 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 suffer.
- Combined form. When all of the above functions are violated at the same time.
Noticing even mild manifestations of the disease, you should immediately contact a gynecologist or a local therapist who will refer you to the necessary tests and appoint a consultation with other specialists.
Pathogenesis
This is a mechanism from the very beginning 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 the 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 that 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 gland after severe blood loss.
Sheehan's syndrome, the symptoms of which are described above, can also occur after an abortion, as well as against a background of bacterial shock after childbirth. A predisposing factor is preeclampsia - a complication of pregnancy, when a future 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 varies. Usually doctors distinguish such forms:
- Easy. She is characterized by fatigue and frequent headaches. There is a decrease in the functions of the adrenal glands and the thyroid gland.
- Average. The above organs are even more affected. For example, a woman feels very tired, her nails break, she is prone to fainting. The work of the ovaries is disrupted, sometimes up to ovulatory infertility.
- Heavy. The genitals and mammary glands hypertrophy, a person suffers from drowsiness, baldness, skin pigmentation, and memory loss. Body weight falls against 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 amenable to treatment. Doctors need to try to restore the level of iron in the blood.
Diagnosis
During it, it is important to study in detail the characteristic anamnesis, where there is a connection between the disease and bleeding or septic shock during a previous abortion or childbirth. To determine Sheehan's syndrome, the diagnosis begins with an examination of the mammary glands: they do not increase in size, do not thicken, milk is not released even with strong pressure and after a course of massage.
At the same time, a blood test is taken in the laboratory, which determines the hormonal background of the body. Depending on the amount of hormones, the diagnosis is made. Take a sample and urine - it also shows changes in the body. In addition, doctors also conduct differential diagnostics - something that helps to distinguish one disease from another. After all, many of them have very similar symptoms. Therefore, each of them is analyzed in detail, compared and the correct conclusion is drawn.
Treatment
How to get rid of an insidious disease. Usually, when a person is diagnosed with Sheehan's syndrome, treatment begins with hormones: sex and gonadotropic, and therapy for sexual infantilism is also prescribed. Suitable, for example, "Infecundin" or other drugs from a series of synthetic progestins. The Sinestrol course, which lasts at least a month, will also be effective, as well as cyclic therapy for a whole quarter.
Remember that there is no question of any self-treatment! At home, you will only harm, provoke the development of serious complications. Therefore, at the first symptoms, contact a specialist immediately. Only competent diagnostics, professional approach and effective therapy will help cure Sheehan's syndrome and eliminate the consequences that its development in the body has led to.
