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Obstetric Complications

Question
73 out of 80
 

Woman with placenta praevia - bleeds - what is most likely to occur after delivery? (AIIMS MAY 10)



A Lack of menstrual cycles
B Galactorrhea

C Diabetes insipidus
D Cushing disease

Ans. A

Lack of menstrual cycles

Sheehan syndrome, also known as postpartum hypopituitarism or postpartum pituitary necrosis, is hypopituitarism, caused by necrosis due to blood loss and hypovolemic shock during and after childbirth.

Causes

It is a rare complication of pregnancy, usually occurring after excessive blood loss or due to DIC

Symptoms

a. Most common initial symptoms of Sheehan's syndrome are absence of lactation and/or difficulties with lactation.

b. Amenorrhea or oligomenorrhea after delivery.

c. In some cases, a woman with Sheehan syndrome might be relatively asymptomatic, and the diagnosis is not made until years later, with features of hypopituitarism.

d. Such features include secondary hypothyroidism with tiredness, intolerance to cold, constipation, weight gain, hair loss and slowed thinking, as well as a slowed heart rate and low blood pressure.

e. Another such feature is secondary adrenal insufficiency, which, in the rather chronic case is similar to Addison's disease with symptoms including fatigue, weight loss, hypoglycemia (low blood sugar levels), anemia and hyponatremia (low sodium levels).

f. Gonadotropin deficiency will often cause amenorrhea, oligomenorrhea, hot flashes, or decreased libido. Growth hormone deficiency causes many vague symptoms including fatigue and decreased muscle mass.

Obstetric Complications Flashcard List

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