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Spontaneous Pregnancy and Delivery in a Patient with Sheehan¡¯s Syndrome

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Ãß¿µ±¤ ( Choo Young-Kwang ) - ´Ü±¹´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç

À¯¿ø»ó ( Yoo Won-Sang ) - ´Ü±¹´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
±èµµÈñ ( Kim Do-Hee ) - ´Ü±¹´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
Á¤Çö°æ ( Chung Hyun-Kyung ) - ´Ü±¹´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
±èÈñÁø ( Kim Hee-Jin ) - ´Ü±¹´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç

Abstract

½¬ÇÑÁõÈıºÀº »êÈÄ ³úÇϼöü±â´ÉÀúÇÏÁõÀ¸·Î ´Ù¾çÇÑ Á¤µµÀÇ ³úÇϼöü Àü¿±ÀÇ ±â´ÉÀå¾Ö¸¦ ³ªÅ¸³»¸ç, ¹«¿ù°æ°ú ¹è¶õÀå¾Ö°¡ µ¿¹ÝµÇ¹Ç·Î ÀÚ¿¬ÀûÀ¸·Î ÀÓ½ÅÀ» ÇÏ´Â °æ¿ì´Â µå¹°´Ù. ȯÀÚ°¡ ÀÓ½ÅÀ» ¿øÇÏ´Â °æ¿ì¿¡´Â ¹è¶õ À¯µµ°¡ ÇÊ¿äÇϳª ¼º¼±ÀÚ ±ØÈ£¸£¸óÀÇ ±â´ÉÀÌ ºÎºÐÀûÀ¸·Î ³²¾ÆÀÖ´Â °æ¿ì¿¡´Â µå¹°°Ô ÀÚ¿¬ÀûÀÎ ÀÓ½ÅÀÌ °¡´ÉÇϱ⵵ ÇÏ´Ù. ÀúÀÚµéÀº Ãâ»ê 20°³¿ù ÈÄÀÎ 29¼¼ ¶§ ½¬ÇÑÁõÈıºÀ» Áø´Ü¹Þ°í ´çÁúÄÚ¸£Æ¼ÄÚÀ̵å¿Í °©»ó¼±È£¸£¸óÀ¸·Î Ä¡·á¸¦ ¹Þ´ø Áß, 18°³¿ù µ¿¾È °£ÇæÀûÀ¸·Î »ý¸®¸¦ Çϰųª ¹«¿ù°æ »óÅ¿´À½¿¡µµ ºÒ±¸Çϰí ÀÚ¿¬ÀûÀ¸·Î ÀÓ½ÅÀ» ÇÑ ÈÄ Á¦¿ÕÀý°³·Î Á¤»ó¾Æ¸¦ ºÐ¸¸ÇÑ È¯ÀÚ¸¦ °æÇèÇÏ¿´±â¿¡ ¹®Çå°íÂû°ú ÇÔ²² º¸°íÇÏ´Â ¹ÙÀÌ´Ù.

Sheehan¡¯s syndrome is postpartum hypopituitarism due to the necrosis of the pituitary gland. It is usually the result of severe hypotension or shock caused by massive hemorrhage during or after delivery. Patients with Sheehan¡¯s syndrome have varying degrees of anterior pituitary hormone deficiency. They are accompanied with amenorrhea and ovulation dysfunction, and so they rarely get pregnant naturally. Ovulation induction is necessary if these patients desire to become pregnant. However, spontaneous pregnancy may be possible in some patients who have a preserved gonadotrophin reserve. We experienced a case of 29-year-old woman who was diagnosed Sheehan¡¯s syndrome 20 months after delivery and we medicated her with prednisolone and thyroxine. She got pregnant spontaneously after 18 months of hormone replacement therapy although she had amenorrhea and irregular menstrual cycles. She successfully delivered a baby by cesarean section. Here we report on this case with a review of the relevant literature concerned with pregnancy and Sheehan¡¯s syndrome.

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postpartum hypopituitarism;pregnancy;Sheehan¡¯s syndrome
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