Rare Case of Secondary Infertility
Abstract
35 year old patient reported with irregular periods and secondary infertility evaluation. Since her last delivery she used to get periods once in only 3 to 6 months. On tracing through her obstetric history, she had a full term normal delivery about 10 years back elsewhere. Soon after delivery she suffered from severe atonic post partum haemorrhage and about 3 to 5 units of blood was transfused then. Since then she had to face unfortunate events. She could not breast feed her baby. She was suffering from amenorrhea, dryness of vagina, dyspareunia etc. Meanwhile she was detected to have hyperglycemia and was put on oral hypoglycemic agents.
Sheehan’s Syndrome, also known as Postpartum Hypopituitarism or Postpartum Pituitary Necrosis, is a condition in which hypopituitarism develops after severe bleeding (‘postpartum hemorrhage’) during or immediately after childbirth. Sheehan’s Syndrome is mainly diagnosed by low levels of TSH, ACTH, FSH, and LH with low levels of T4, cortisol, and estradiol in the blood.
Treatment is essentially by replacing the hormones that the pituitary gland fails to produce. Hormones like corticosteroids, thyroid hormones and estrogens and medicines to control diabetes become necessary to maintain normal functioning of the body. Any minor illnesses like influenza or even a common cold can cause a crisis and may require adjustment of these hormones.
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