{"id":12987,"date":"2024-08-23T07:07:09","date_gmt":"2024-08-23T05:07:09","guid":{"rendered":"https:\/\/valintermed.com\/?p=12987"},"modified":"2024-08-23T07:07:09","modified_gmt":"2024-08-23T05:07:09","slug":"sindrom-shihana","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/","title":{"rendered":"Sheehan&#039;s syndrome"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p>Sheehan&#039;s syndrome (or postpartum hypopituitarism) is a rare but serious complication that occurs due to massive blood loss and shock, which can occur during or after childbirth. The condition is associated with necrosis of the pituitary gland, a gland responsible for many endocrine functions in the body, such as regulating metabolism and reproductive function. Sheehan&#039;s syndrome most often occurs in developing countries where health care is less available, leading to an increased risk of complications during childbirth. The main clinical manifestations include fatigue, weight loss, decreased libido, hypotension, and, in women, menstrual irregularities. Since the disease can have serious consequences if not diagnosed in time, knowledge of it is important for physicians.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" 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href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\" >History of the disease and interesting historical facts<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\" >Epidemiology<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\" >Genetic predisposition to this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Risk factors for the development of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Diagnosis of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Treatment<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >List of medications used to treat this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Disease monitoring<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Age-related features of the disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/shihana-syndrome\/#%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\" >Questions and Answers<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\"><\/span>History of the disease and interesting historical facts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Sheehan&#039;s syndrome was first described by Japanese obstetrician and gynecologist Dr. Shigeru Shihan in 1930. This condition became known after the analyses and observations conducted in his practice, where he recorded cases of hypopituitarism in women after difficult childbirth, accompanied by massive blood loss. Interestingly, in the past, this condition often remained undiagnosed, being mistaken for a number of other diseases that women suffered from for many years. In 1946, A. I. Grigoriev summarized the information about Sheehan&#039;s syndrome, pointing out the importance of medical services and monitoring of pregnant and laboring women. Historically, this disease emphasizes the importance of skilled obstetric care.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\"><\/span>Epidemiology<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Sheehan&#039;s syndrome is relatively rare, but its prevalence varies depending on the level of health care in the country. According to various studies, in developing countries, where the risk of complications during childbirth is high, the incidence rate can reach 10% among women who have had difficult childbirth with massive blood loss. In developed countries, cases of Sheehan&#039;s syndrome are registered much less frequently, which is associated with improved medical care and preventive work in obstetrics. Observed statistics also show that in women who have experienced severe postpartum trauma and shock, the risk of developing the syndrome increases by 2-5 times.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\"><\/span>Genetic predisposition to this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Currently, information on genetic predisposition to Sheehan syndrome remains limited. However, research suggests that factors influencing the condition are primarily related to preexisting medical complications rather than genetic mutations. Although certain genetic traits may influence the body&#039;s susceptibility to severe blood loss and shock, specific genes responsible for Sheehan syndrome have not been identified. Research in this area is ongoing, and it may be possible to identify specific genetic markers or interventions that can predict or prevent the condition.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Risk factors for the development of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>There are several risk factors that contribute to the development of Sheehan syndrome:<\/p>\n<ul>\n<li>Severe blood loss during childbirth (more than 1 liter);<\/li>\n<li>Lack of qualified medical care during childbirth;<\/li>\n<li>Pregnancy complications such as placenta previa;<\/li>\n<li>Multiple pregnancy;<\/li>\n<li>Conducting operations related to childbirth (caesarean section, for example).<\/li>\n<\/ul>\n<p>These factors indicate that prevention and organization of the medical process during pregnancy and childbirth can significantly reduce the risk of developing Sheehan syndrome. <\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Diagnosis of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Several approaches are used to diagnose Sheehan syndrome:<\/p>\n<ul>\n<li><strong>Main symptoms:<\/strong> These include chronic fatigue, weight loss, hypotension, changes in the menstrual cycle, cold intolerance and decreased libido.<\/li>\n<li><strong>Laboratory tests:<\/strong> Studies of the level of key hormones, such as cortisol, thyroid hormones, hormones of the anterior pituitary gland (growth hormone, adrenocorticotropic hormone).<\/li>\n<li><strong>Radiological examinations:<\/strong> Magnetic resonance imaging (MRI) to visualize the statics of the pituitary gland and identify signs of its necrosis.<\/li>\n<li><strong>Other types of diagnostics:<\/strong> Assessment of the clinical history, including history of childbirth and development of postpartum complications.<\/li>\n<li><strong>Differential diagnosis:<\/strong> It is important to exclude other endocrine disorders such as adrenogenital syndrome and thyroid changes.<\/li>\n<\/ul>\n<p>Diagnosis of Sheehan syndrome requires a comprehensive approach and consideration of many factors.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment of Sheehan&#039;s syndrome is usually complex and multimodal:<\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<ul>\n<li><strong>General treatment:<\/strong> The main goal is to manage symptoms and replace missing hormones.<\/li>\n<li><strong>Pharmacological treatment:<\/strong> Replacement therapy with corticosteroids, thyroid hormones and sex hormones depending on the specific needs of the patient.<\/li>\n<li><strong>Surgical treatment:<\/strong> In some cases, surgery may be needed to remove tumors or other growths that are affecting the function of the pituitary gland.<\/li>\n<li><strong>Other types of treatment:<\/strong> Psychological support and therapy aimed at improving the general condition of the patient.<\/li>\n<\/ul>\n<p>An important aspect is the individualization of treatment for each patient, taking into account his unique condition and medical history.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>List of medications used to treat this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The main medications used to treat Sheehan syndrome include:<\/p>\n<ul>\n<li>Hydrocortisone;<\/li>\n<li>Prednisone;<\/li>\n<li>Thyroxine (levothyroxine);<\/li>\n<li>Estrogens and progesterone (if necessary);<\/li>\n<li>Growth hormone (if indicated).<\/li>\n<\/ul>\n<p>When starting treatment, it is important to monitor hormone levels to avoid excesses and optimize therapy.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Disease monitoring<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Monitoring the condition of a patient with Sheehan syndrome is important to manage the disease and minimize complications. Key monitoring steps include:<\/p>\n<ul>\n<li>Regular laboratory tests of hormone levels;<\/li>\n<li>Follow-up observation of clinical symptoms;<\/li>\n<li>Correction of the course of treatment depending on the dynamics of the condition.<\/li>\n<\/ul>\n<p>The prognosis with timely diagnosis and treatment is usually favorable, but without treatment, serious complications such as cardiovascular disease, reproductive problems, and other serious conditions can develop.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Age-related features of the disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Sheehan syndrome can present differently depending on the age group:<\/p>\n<ul>\n<li>In young women: symptoms often become noticeable immediately after childbirth and may be associated with physical and psycho-emotional state;<\/li>\n<li>In older women: the clinical picture may be more vague, which requires longer diagnostics;<\/li>\n<li>In older women: often associated with concomitant diseases, making diagnosis difficult.<\/li>\n<\/ul>\n<p>The nature of the course of the disease depends on the individual characteristics of the body and the presence of concomitant diseases.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\"><\/span>Questions and Answers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><strong>What is Sheehan syndrome?<\/strong> This is a rare condition that occurs after massive blood loss during or after childbirth, resulting in necrosis of the pituitary gland and hormone deficiency.<\/li>\n<li><strong>What are the main symptoms of Sheehan syndrome?<\/strong> Chronic fatigue, weight loss, hypotension, menstrual irregularities and cold intolerance.<\/li>\n<li><strong>How is Sheehan syndrome diagnosed?<\/strong> Diagnosis includes assessment of clinical symptoms, laboratory tests, and radiological examinations (eg, MRI).<\/li>\n<li><strong>What is the treatment for Sheehan&#039;s syndrome?<\/strong> Treatment includes hormone replacement therapy, as well as the possibility of surgery if necessary.<\/li>\n<li><strong>What is the prognosis for Sheehan syndrome?<\/strong> The prognosis with properly selected therapy is usually favorable, but without treatment, serious complications can develop.<\/li>\n<\/ul>\n<p>Sheehan&#039;s syndrome is a topical issue in medicine that requires careful attention from both healthcare professionals and patients to minimize the risk of its development and provide adequate treatment.<\/p>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sheehan&#039;s syndrome (or postpartum hypopituitarism) is a rare but serious complication that occurs due to massive blood loss and the shock that can occur<\/p>","protected":false},"author":1,"featured_media":23002,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[298],"tags":[],"class_list":["post-12987","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medlibrary"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12987","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=12987"}],"version-history":[{"count":1,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12987\/revisions"}],"predecessor-version":[{"id":13934,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12987\/revisions\/13934"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media\/23002"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=12987"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=12987"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=12987"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}