Post-partum pituitary insufficiency: diagnostic challenge

2014 ◽  
Author(s):  
Daniela Amzar ◽  
Melania Balas ◽  
Ioana Golu ◽  
Mihaela Vlad ◽  
Ioana Zosin
Keyword(s):  
Post Partum ◽  
Pituitary Insufficiency ◽  
Diagnostic Challenge

scholarly journals Sheehan Syndrome: a Rare Complication of Post-partum Hemorrhage

2014 ◽  
Vol 9 (2) ◽  
pp. 61-63
Author(s):  
M Soni
Keyword(s):  
Post Partum ◽  
Rare Complication ◽  
Developed Countries ◽  
Pituitary Insufficiency ◽  
Post Partum Hemorrhage ◽  
Sheehan Syndrome

Incidence of Sheehan syndrome, also known as post-partum hypopituitarism or post-partum pituitary insufficiency or hypopituitarism syndrome has reduced markedly but it does occur in under-developed countries with a reported incidence of 1:10000 deliveries.1-3 We are reporting the case of a 22 year old female with Sheehan syndrome occurring after massive post-partum hemorrhage. DOI: http://dx.doi.org/10.3126/njog.v9i2.11766 

Slow Developing Sheehan Syndrome with Spontaneous Pregnancies: A Case Report and Literature Review

2020 ◽  
Vol 1 (2) ◽  
pp. 63-66
Author(s):  
Erdinç Gülümsek ◽  
Hilmi Erdem Sümbül ◽  
Zübeyir Arslan ◽  
Burçak Çakır Peköz ◽  
Hasan Koca
Keyword(s):  
Differential Diagnosis ◽  
Post Partum ◽  
Obstetric Care ◽  
Developed Countries ◽  
Clinical Findings ◽  
Hormone Deficiency ◽  
Pituitary Insufficiency ◽  
Sheehan Syndrome ◽  
History Of ◽  
Damage Symptoms

Sheehan's syndrome (SS) is known as pituitary insufficiency that develops after bleeding and hypovolemia at birth or after birth. The pathological and clinical findings of SS were first described by Harold L. Sheehan. Due to improvements in obstetric care, the frequency of the disease has declined worldwide. Sheehan syndrome is a rare cause of hypopituitarism in developed countries.. However, it is more common in underdeveloped and developing countries. Small sella size enlargement of the pituitary gland, autoimmunity also play a role in the pathogenesis of the disease. Depending on the pituitary damage, symptoms may appear immediately or years later. It may be presented as isolated hormone deficiency or pan hypopituitarism. For diagnosis, it is important to have a history of excessive hemorrhage at birth, amenorrhea and inability to breastfeed. Lymphocytic hypophysitis should be remembered in differential diagnosis. In this review, a patient with serious post-partum hemorrhage, followed by a history of 3 pregnancies is presented with a slow developing and pan hypopituitarism-causing SS and current physio pathological data in SS are presented.

TAKATSUBO CARDIOMYOPATHY AFTER CAESEREAN SECTION – A CASE REPORT.

2021 ◽  
pp. 9-10
Author(s):  
Anusha .K ◽  
Sherine Bright. B
Keyword(s):  
Post Partum ◽  
Apical Ballooning ◽  
Vital Role ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Apical Ballooning Syndrome ◽  
Diagnostic Challenge ◽  
Cardiac Enzymes ◽  
Coronary Syndrome ◽  
Peripartum Period

BACKGROUND : Acute cardiac complications in peripartum period provide a diagnostic challenge. Takatsubo cardiomyopathy occurs most frequently in postmenopausal women exposed to emotionalandphysicalstress. We report a case of apical ballooning syndrome, also known as Takotsubo Cardiomyopathy (TCM) or broken-heart syndrome, in a preeclamptic patient post operatively. CASE : 44 year preeclamptic primi presented with dyspnoea three hours after sub arachnoid block for caeserean. On evaluation, trans thoracic echo revealed apical ballooning with global hypokinesia along with raised NT-Pro BNP level. ECG and cardiac enzymes werenormal. She was intubated, ventilated and treated with inotropes and anti failure medications by a multidiciplinary team.She was extubated on Postoperativeday (POD) 3 and discharged on POD 13 with stable vitals. Her echo done on third month was completely normal with adequate left ventricular function. CONCLUSION : Physical, emotional stress and oestrogen deciency in immediate post partum period may be the predisposing risk factors for TCM even if regional anaesthesia is given. Trans thoracic echo plays a vital role in differenciating TCM from other peripartumcardiac complications like pulmonary thrombo embolism, peripartum cardimyopathy or acute coronary syndrome.

scholarly journals Canadian Society of Thoracic Radiology/Canadian Association of Radiologists Best Practice Guidance for Investigation of Acute Pulmonary Embolism, Part 1: Acquisition and Safety Considerations

2021 ◽  
pp. 084653712110007
Author(s):  
Elsie T. Nguyen ◽  
Cameron Hague ◽  
Daria Manos ◽  
Brett Memauri ◽  
Carolina Souza ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Best Practice ◽  
Acute Pulmonary Embolism ◽  
Post Partum ◽  
Circulatory System ◽  
Diagnostic Techniques ◽  
Guidance Document ◽  
Diagnostic Challenge ◽  
Intravenous Contrast ◽  
Canadian Association

Acute pulmonary embolism (APE) is a well-recognized cause of circulatory system compromise and even demise which can frequently present a diagnostic challenge for the physician. The diagnostic challenge is primarily due to the frequency of indeterminate presentations as well as several other conditions which can have a similar clinical presentation. This often obliges the physician to establish a firm diagnosis due to the potentially serious outcomes related to this disease. Computed tomography pulmonary angiography (CTPA) has increasingly cemented its role as the primary investigation tool in this clinical context and is widely accepted as the standard of care due to several desired attributes which include great accuracy, accessibility, rapid turn-around time and the ability to suggest an alternate diagnosis when APE is not the culprit. In Part 1 of this guidance document, a series of up-to-date recommendations are provided to the reader pertaining to CTPA protocol optimization (including scan range, radiation and intravenous contrast dose), safety measures including the departure from breast and gonadal shielding, population-specific scenarios (pregnancy and early post-partum) and consideration of alternate diagnostic techniques when clinically deemed appropriate.

scholarly journals The primary empty Sella: An endocrine study on 36 cases

2021 ◽  
Vol 11 (2) ◽  
pp. 124-129
Author(s):  
Marwa Chiboub ◽  
Fatma Mnif ◽  
Boubaker Ben Miloud ◽  
Dhouha Ben Salah ◽  
Nabila Rekik ◽  
...  
Keyword(s):  
Post Partum ◽  
Sella Turcica ◽  
Empty Sella ◽  
Pituitary Insufficiency ◽  
Multiparous Women ◽  
Anterior Pituitary Function ◽  
History Of ◽  
Visual Disturbances ◽  
Primary Empty Sella

Introduction: The term primary empty sella (PES) makes reference to the herniation of the subarachnoid space within the sella turcica in patients with no history of pituitary tumor, surgery or radiotherapy. Materials and Methods: We studied 36 patients; 27 females and 9 males. The mean age at diagnosis was 50, 4 years [21-80 years]. Most diagnoses were made by magnetic resonance imaging (n = 32). The anterior pituitary function was evaluated by basal hormonal measurements. Then, we had compared two groups of patients: G1(n=17), who had a pituitary disorder, and G2 (n=10), patients without hormonal disease, in order to determine risk factors for endocrine dysregulation in PES. Results: The reasons for ordering pituitary scans were: headaches (65%), visual disturbances (32%) and neurological symptoms in 8% of cases. Sixty-six point five per cent of women were multiparous. Diabetes, obesity and hypertension were found in 19.45 %, 11 % and 19.45 % of the studied population respectively. Hyperprolactinemia was present in 17.24 % of patients. Fifty-five percent of our patients had some degree of hypopituitarism. We didn’t find any correlation in our study, between pituitary insufficiency and age, gender, weight, parity nor post-partum hemorrhage. Failure of lactation was significantly associated with a hormonal disorder. On the other hand, headache was negatively correlated with hormonal effects in PES. Conclusion: PES was most commonly found in middle-aged multiparous women. In most patients, PES is a heterogeneous condition that ranges from hypopituitarism to various degrees of isolated GH deficiency, and which needs careful endocrine assessment, treatment and follow-up.

scholarly journals Disseminated Tuberculosis in a Postpartum Young Women Presenting as Isolated Optic Neuritis

2018 ◽  
Vol 1 (1) ◽  
pp. 46-48
Author(s):  
Priya Sivakumar
Keyword(s):  
Optic Neuritis ◽  
Post Partum ◽  
World Health ◽  
Diagnostic Challenge ◽  
Extra Pulmonary Tuberculosis ◽  
Disseminated Tuberculosis ◽  
Competent Person ◽  
The World ◽  
Health Organization ◽  
Hiv 1

Tuberculosis (TB) is the first infectious disease declared by the World Health Organization as a global health mergency. It remains the leading cause of death among infectious diseases causing more deaths worldwide than uman immune deficiency virus (HIV) [1]. The following case report highlights the occult and non specific  resentations of the disease which makes it a diagnostic challenge. We report a case of extensively disseminated tuberculosis in an immune competent post partum young woman presenting as isolated optic neuritis. Extra pulmonary tuberculosis is commoner among immune compromised patients. Co-existence of military and intracranial tuberculosis in an immune competent person is extremely rare.

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