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Revista Matronas

Revista Matronas

SEPTIEMBRE 2019 N° 2 Volumen 7

A rare case of severe hypogalactia: Sheehan syndrome

Section: Caso Clínico

How to quote

Barrios Miras E, Boal Herranz GA. Un caso poco frecuente de hipogalactia severa materna: síndrome de Sheehan. Matronas hoy. 2019; 7(2):21-6.

Authors

1 Ester Barrios Miras, 2 Gloria Aurora Boal Herranz

Position

1, Pediatra. Centro de Salud San Fernando. Comunidad de Madrid.2 Matrona. Centro de Salud San Fernando. Comunidad de Madrid.

Contact email: gloriaboal@hotmail.com

Abstract

Introduction: Sheehan syndrome is panhypopituitarism caused by ischemic necrosis of the pituitary gland due to hypovolemic shock, typically during childbirth1. It appears initially as lactotrope insufficiency or inability to breastfeed. Afterwards it can be associated with gonadotropic, corticotrophin and thyrotrophic insufficiency, with their subsequent clinical manifestations and mammary atrophy, and disappearance of secondary sexual characteristics, asthenia, anorexia, and cold intolerance. Treatment consists in the replacement of the deficient hormones2.
Objective: to describe a case record of Sheehan Syndrome detected by the Primary Care Pediatrician.
Materials and Method: design: Case record. Place: Pediatrician Unit, Primary Care, Community of Madrid, 2019.
Clinical data: a 5-day-old newborn attends the Pediatric Unit with her mother for a first examination. While completing the clinical record, the mother refers that the newborn latched on naturally to her breast since her first hours of life, and after this she received 60ml of artificial milk. For the past two days, additionally to breastfeeding, she has been using an electric device for milk extraction, without producing any milk. The main characteristic was the total inability to breastfeed, there was no other sign or symptom. The lack of milk production was confirmed in subsequent consultations.
Discussion: inability to breastfeed is the early sign in the majority of cases described. Such an early diagnosis contributed to preventing the characteristics of Sheehan Syndrome, avoiding a poor prognosis in the patient4.
Conclusion: when faced with a woman who wants to breastfeed and is not able to, it is essential to prepare a complete and comprehensive clinical record together with the examination of the breast and the baby, in order to detect any diseases that can interfere with breastfeeding and, as in this Sheehan Syndrome case presented, also to avoid any potential risk for the life of the woman.

Keywords:

Sheehan syndrome; hypopituitarism; postpartum hemorrhage

Versión en Español

Título:

Un caso poco frecuente de hipogalactia severa materna: síndrome de Sheehan

Artículo completo no disponible en este idioma / Full article is not available in this language

Bibliography

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