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Postpartum pituitary necrosis

Postpartum hemorrhage and hypovolemia can cause infarction of part or

all of the pituitary gland, resulting in postpartum pituitary

necrosis, or Sheehan's syndrome. Depending on the amount of pituitary

tissue that has been destroyed, acute hypopituitarism can occur

immediately, or deficiency can develop slowly over many years. The

acute form is associated with persistent hypotension, tachycardia,

failure to lactate, and hypoglycemia and requires prompt treatment

with glucocorticoids. The slowly developing form often begins as

postpartum amenorrhea and an inability to lactate; after many years,

the classic features of hypothyroidism and adrenal insufficiency may

manifest themselves (2).

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