Sheehan syndrome: a narrative review

Abstract

This study aimed to investigate the epidemiological, pathophysiological and therapeutic aspects of Sheehan Syndrome, an obstetric complication resulting from postpartum pituitary necrosis. For this purpose, articles published between 2019 and 2024, in English and Portuguese, in the PubMed and Google Scholar databases, were analyzed using specific terms related to the condition. This condition occurs due to anterior pituitary ischemia, triggered by severe obstetric hemorrhage and hypovolemic shock. The resulting pituitary failure can lead to variable clinical manifestations, including amenorrhea, hypoglycemia, hypotension and adrenal insufficiency. Diagnosis is often late, being based on clinical signs, hormone dosages and pituitary imaging exams. Management involves hormone replacement according to the affected axis, highlighting the need for glucocorticoid replacement to avoid potentially fatal adrenal crises. Early identification of risk factors and appropriate management of postpartum hemorrhage are essential to prevent Sheehan Syndrome and reduce maternal morbidity and mortality.