Hello and welcome to the zero to finals podcast. My name is Tom and this is the final episode of

the obstetrics and gynecology series after which we'll be moving on to a whole new series of the podcast

and in this episode I'm going to be talking to you about Sheehan's

syndrome. And you can find written notes on this topic at zero to finals.com slash she hands

syndrome or in the postnatal care section of the zero to finals of Stetrics and Gynecology

book. So let's get straight into it.

Sheehan's syndrome is a rare complication of postpartum hemorrhage, where the drop in circulating

blood volume leads to avascular necrosis of the pituitary gland.

Low blood pressure and reduced perfusion of the pituitary gland

leads to ischemia in the cells of the pituitary and cell death.

Sheehan's syndrome only affects the anterior pituitary gland, therefore hormones produced by the posterior

pituitary gland are spared.

Let's talk about the blood supply.

The anterior pituitary gets its blood supply from a low-pressure system called the hypothalamo-hypheasial portal system.

This system is susceptible and vulnerable to rapid drops in blood pressure.

The posterior pituitary gets a good blood supply from various arteries

and is therefore not susceptible to ischemia when there's a drop in blood pressure.

Next let's talk about hormones.

The anterior pituitary gland releases thyroid stimulating hormone or T-S-H,

adrenocortico-t or T-S-H, adrenocortocotropic hormone or AC-T-H,

follicle stimulating hormone or F-S-H, loutinizing hormone or LH, growth hormone or GH, and

prolactin. These hormones released by the anterior pituitary are affected by Sheehan

...