Nursing action in patients with Sheehan”s syndrome: A literature review
Abstract
The aim was to determine the prevalence and risk factors of Sheehan”s syndrome, as well as to explore therapeutic approaches, identify common complications and evaluate nursing interventions. A review of 50 articles selected for their relevance was carried out. The reported prevalence is 14 million cases of postpartum hemorrhage annually, with an overall incidence of Sheehan”s syndrome of 1 in 100,000 births. Pregnancy and subsequent postpartum hemorrhage are presented as the main precipitating factors. Effective treatment requires permanent hormone replacement. Key complications include agalactia, amenorrhea, and hypopituitarism. Nursing interventions focus on symptom management and implementation of the Nursing Care Process (NCP). Postpartum hemorrhage exceeding 1000 ml of blood loss, with insufficient volume replacement, is a common history in patients with Sheehan”s syndrome.
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Aggarwal, H. K., Deepak, J., Pawar, S., Mittal, A., & Jian, P. (2016). Recurrent Hypoglycemia: an Uncommon Presentation in Sheehan Syndrome. Eur J Gen Med, 13(2), 155-157. http://doi.org/10.15197/ejgm.1457
Ahmad, B., Ramzan, M., Sultan, M., Iqbal, A., & Raiz, A. (2016). Cardiac structural and functional abnormalities in females with untreated hypopituitarism due to Sheehan Syndrome: Response to hormone replacement therapy. Endocrine Practice, 22(9). https://www.endocrinepractice.org/article/S1530891X(20)41692-1/fulltext
Alqersh, D. L. A., Ahmed, A. M. (2023). Effect of teach-back instructional sessions on severity of Sheehan”s syndrome sequelae. International Egypt Journal of Nursing Science and Research, 4(1), 403-419. https://ejnsr.journals.ekb.eg/article_310328_6c32f83574cc2e2f6a5a23ac96ac4c7c.pdf
Barbosa, M., Fernandes, D., Paiva da Costa, T., Sampaio, M., & Guerreiro, C. (2020). Dilated Cardiomyopathy Reversibility in Sheehan”s Syndrome: A Case Report. SBC, 116(2 suppl 1), 17-20. http://doi.org/10.36660/abc.20190547
Barrios Miras, E., & Boal Herranz, G. A. (2019). Un caso poco frecuente de hipogalactia severa materna: Síndrome de Sheehan. Rev Matronas, 2(7). https://acortar.link/MPuH40
Carnicer, M., Villacampa, M., Marcos, P., Carrasco, M., & Cebrián, P. (2020). El papel de la matrona en la hemorragia postparto: a propósito de un caso. Revista Electrónica Portales Médicos, XV(12), 560. https://acortar.link/I6hbHv
Carrillo, R., De la Torres, T., Nava, J., Posada, A., Pérez, A., & De la Torre, M. (2018). Consenso multidisciplinario para el manejo de la hemorragia obstétrica en el perioperatorio. Revista Mexicana de Anestesiología, 41(3). https://www.medigraphic.com/pdfs/rma/cma-2018/cma183b.pdf
Castillo Silva, M., Bravo Morales, F., & Jara, L. (2019). Diagnóstico del Síndrome de Sheehan. Rev. Científica Investig. Actual. del mundo las Ciencias, 3(3). https://reciamuc.com/index.php/RECIAMUC/article/view/305/562
Choudhary, G., Soni, S., & Sadik, M. (2020). Sheehan”s Syndrome: A rare cause of delayed recovery after anesthesia. Journal of Obstetric Anaesthesia and Critical Care, 10(1), 58-60. http://dx.doi.org/10.4103/joacc.JOACC_9_19
de Sá Cavalcante, D., da Silva Castro, M., Quidute, A., Martins, M.R.A., Cid, A.M.P.L., de Barros Silva, P.G., Cadwell Williams Jr, J., Neves, F.S., Ribeiro, T.R., & Costa, F.W.G. (2019). Evaluation of bone texture imaging parameters on panoramic radiographs of patients with Sheehan’s syndrome: a STROBE-compliant case-control study. Osteoporosis International, 30, 2257–2269. https://doi.org/10.1007/s00198-019-05086-4
Díaz, V., Abalos, E., & Carroli, G. (2018). Methods for blood loss estimation after vaginal birth. Cochrane Database of Systematic Reviews, 9(9). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513177/
Fahri, B., Halit, D., Funda, E., Dundar, M., & Simsek, Y. (2016). Genetic expressions of thrombophilic factors in patients with Sheehan”s Syndrome. Gynecological Endocrinology, 32(11). https://www.tandfonline.com/doi/abs/10.1080/09513590.2016.1198763
Fariña, T., Castillo, R., & González, Y. (2019). Factores asociados a la hemorragia obstétrica en el postparto inmediato: Hospital Juan Bruno Zayas. Revista Médica Sinergia, 4(10). https://www.medigraphic.com/pdfs/sinergia/rms-2019/rms1910a.pdf
Fein, A., Wen, T., Wright, J., Goffman, D., D”Alton, M., Attenello, F., Mack, W. J., Friedman, A. M. (2019). Postpartum hemorrhage and risk for postpartum readmission. Journal of Maternal and Neonatal Medicine, 34(2), 187-194. https://doi.org/10.1080/14767058.2019.1601697
Fernández, L., Viruez, J., & Vera, O. (2020). Panhipopituitarismo secundario a hemorragia obstétrica profusa. Cuadernos Hospital Clínico, 61(2), 47-50. http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1652-67762020000200006&lang=es
Fong Pantoja, L. (2019). Morbilidad Materna en Unidad de Cuidados Intensivos del Hospital General Docente “Orlando Pantoja Tamayo”, Contramaestre 2014-2019. Rev Inf Científica, 1(1). https://www.redalyc.org/journal/5517/551762954004/551762954004.pdf
García, L., Ramírez-Hernández, M., Moreno, M., Ramírez, E., & Gorbea Chávez, V. (2018). Hemorragia obstétrica posparto: Propuesta de un Manejo Básico Integral, Algoritmo de las 3 «C». Revista Mexicana de Anestesiología, 41(1). http://www.medigraphic.com/rmawww.medigraphic.org.mx
Genetu, A., Anemen, Y., Abay, S., Bante, A., & Mihrete, M. (2021). A 45-year-old female patient with Sheehan”s syndrome presenting with imminent adrenal crisis: a case report. Journal of Medical Case Reports, 15(1). https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-02827-0
Gokalp, D., Gulistan, A., Tuzcu, A., Bahceci, M., & Tuzcu, S. (2016). Decades Without Diagnosis: Sheehan”s Syndrome, a retrospective Analysis. Gynecological Endocrinology, 32(11). https://pubmed.ncbi.nlm.nih.gov/27252045/
González, J. G., Borjas Almaguer, O. D., Salcido Montenegro, A., Rodríguez Guajardo, R., Elizondo Plazas, A. S., Montes-de-Oca-Luna, R., & Rodríguez-Gutiérrez, R. (2018). Sheehan”s syndrome revisited: Underlying autoimmunity or hypoperfusion? International Journal of Endocrinology, 2018(1). https://www.hindawi.com/journals/ije/2018/8415860/
Hajar, A. (2017). Psychosis as a Rare Late Manifestation of Sheehan”s Syndrome. Ec Psychol Psychiatry, 1(1). https://www.ecronicon.com/ecpp/pdf/ECPP-06-00197.pdf
Hernández Morales, M., & García de la Torre, J. (2016). Factores de Riesgo de Hemorragia Obstétrica. Ginecol Obs Mex, 1(1). https://www.medigraphic.com/pdfs/ginobsmex/gom-2016/gom1612d.pdf
Hernández, Y., Ruiz, M., Rodríguez, L., Cepero, A., & Monzón, M. (2017). Alternativas quirúrgicas conservadoras del útero ante la hemorragia postparto. Medisur, 15(5). https://www.medigraphic.com/pdfs/medisur/msu2017/msu175n.pdf
Honegger, J., & Giese, S. (2018). Acute pituitary disease in pregnancy: how to handle hypophysitis and Sheehan”s syndrome. Minerva Endocrinologica, 43(4). https://www.minervamedica.it/en/journals/minervaendocrinology/article.php?cod=R07Y2018N04A0465
Hu, J., Yu, Z., Wang, P., Shi, C., & Yang, H. (2017). Clinical Analysis of Postpartum Hemorrhage Requiring Massive Transfusions at a Tertiary Center. Chinese Medical Journal (English), 130(5). https://europepmc.org/article/MED/28229990
Instituto Nacional de Estadísticas y Censos. (2021). Boletín Técnico Registro Estadístico de Defunciones Generales. https://acortar.link/Groa1S
Khan, N. A., Ekram, R., Mallick, P. K., Islam, M. R., & Amin, M. R. (2017). Partial Sheehan” Syndrome with Primary Hypothyroidism A Delayed Diagnosis. J Med, 18(2), 115-118. https://www.banglajol.info/index.php/JOM/article/view/33692
Kluczyński, L., Gilis, A., Rogoziński, A., Pantofliński, J., & Hubalewska, A. (2019). Hypophysitis: new insights into diagnosis and treatment. Endokrynologia Polska, 70(3). https://journals.viamedica.pl/endokrynologia_polska/article/view/EP.a2019.0015/48699
Laway, B. A., & Baba, M. S. (2023). Sheehan syndrome: Cardiovascular and metabolic comorbidities. Frontiers in Endocrinology, 14, 1086731. https://doi.org/10.3389/fendo.2023.1086731
Liu, C. N., Yu, F. B., Xu, Y. Z. H., Li, J. S. H., Guan, Z. H., Sun, M., Liu, C. A., He, F., & Chen, D. J. (2021). Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study. BMC Pregnancy Childbirth, 21(1). https://europepmc.org/articles/PMC8077797
Mandal, S., Mukhopadhyay, P., & Ghosh, S. (2022). Quality of life in Sheehan Syndrome. Indian Journal of Endocrinology and Metabolism, 26(3), 282. https://10.4103/ijem.ijem_100_22
Merin, J., Amir, S., & Desai, R. (2019). Chronic Sheehan”s Syndrome–A Differential to be considered in clinical Practice in Women with a History of Postpartum Hemorrhage. Cureus. https://assets.cureus.com/uploads/case_report/pdf/24517/1612429364-161242935520210204-18203-urmg35.pdf
Ministerio de Salud Pública. (2013). Prevención, diagnóstico y tratamiento de la hemorragia posparto. https://www.salud.gob.ec/wp-content/uploads/2016/09/Guía-de-hemorragiapostparto.pdf
Mir, S. A., Shah, T., Singh, H., Shabir, I., & Laway, B. A. (2018). Serum Lipid and Leptin Concentrations in Patients with Sheehan Syndrome. Indian Journal of Endocrinology and Metabolism, 22(4). https://europepmc.org/articles/PMC6085965
Narváez, H., Flores, M., Apolo, M., & Ramos, R. (2019). Aplicación del proceso de Atención de Enfermería en pacientes con hemorragia de posparto inmediato, mediato, tardío. Ocronos-Editorial Científico-Técnica, 1(1). https://revistamedica.com/proceso-de-atencion-de-enfermeria-hemorragiapostparto/#google_vignette
Ontano Moreno, M. A., Mejía Velasteguí, A., & Avilés Arroyo, M. (2019). Uso del ácido tranexámico en hemorragia obstétrica. Revista Científica Mundo de la Investigación y el Conocimiento, 3(4). https://dialnet.unirioja.es/servlet/articulo?codigo=7402137
Organización Mundial de la Salud. (2014). Recomendaciones de la OMS para la prevención y el tratamiento de la hemorragia posparto. http://apps.who.int/iris/bitstream/handle/10665/141472/9789243548500_spa.pdf?sequence=1
Organización Mundial de la Salud. (2018). Tendencia en la mortalidad materna de 2000 a 2017. https://www.who.int/es/publications/i/item/9789241516488
Parikh, R., Bucch, V., Makwana, M., & Buch, H. (2016). The Price of a 15-Year Delay in Diagnosis of Sheehan”s Syndrome. Baylor University Medical Center Proceedings, 29(2). https://www.tandfonline.com/doi/pdf/10.1080/08998280.2016.11929422?needAccess=true
Paulino, E. R., & Monteiro, C. (2018). Spontaneous Pregnancy in a Patient with Suspected Sheehan”s Syndrome: Case Report. Revista de Medicina da UFC, 1(1). http://periodicos.ufc.br/revistademedicinadaufc/article/view/31231/95645
Pooja, P., Dixit, N., Kilapadi, K., Sebastian, A., & Gopal, S. (2017). Sheehan”s syndrome in a dengue parturient. Lankan Journal of Anaesthesiology, 26(1). https://slja.sljol.info/articles/abstract/10.4038/slja.v26i1.8286/
Powers, P., Jan, K., & Bommisetty, D. (2023). Adrenal Crisis in a Delayed Diagnosis of Sheehan Syndrome. Cureus, 15(8). https://doi.org/10.7759/cureus.44225
Rabee”, H., Braik, T., Alnatour, R., Shamlawi, A., & Rashed, A. (2023). Sheehan”s syndrome unveiled after decades without a diagnosis: A case report. SAGE Open Medical Case Reports, 11, 2050313X231209685. https://doi.org/10.1177/2050313X231209685
Rahim, A., Baird, G. J., Ashton, D. E., Angstmann, T., & Lahoria, R. (2018). Acute Sheehan Syndrome Manifesting as Unremitting Headache. The Neurohospitalist, 8(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022896/
Rivera, S., Chacón, C., & González, A. (2020). Hemorragia posparto primaria: diagnóstico y manejo oportuno. Revista Médica Sinergia, 5(6). https://revistamedicasinergia.com/index.php/rms/article/view/512/86
Rodriguez Piña, M. D., Piña Vidal, N., Sosa Garcia, B. C., Lagos Robles, P., & Mendieta Zerón, H. (2022). Sheehan”s syndrome expected prevalence in five years in Mexico. Angol Journal of Health Sciences, 3(1), 10-16. https://doi.org/10.54283/RACSaude.v3i1.2022.p10-16
Rodríguez, G., Vieitez Ruano, B., & Pita Gutiérrez, F. (2017). Síndrome de Sheehan agudo. Obs Ginecol, 60(1). https://acortar.link/XXlZTT
Rojas, L., Rojas, L., Villagómez, M., Rojas, E., & Rojas, A. (2019). Hemorragia posparto: nuevas evidencias. La Ciencia al Servicio de la Salud y la Nutrición, 10(1). http://revistas.espoch.edu.ec/index.php/cssn/article/view/182/197
Sadiq, S., & Chowdhury, A. (2021). A Case of Sheehan Syndrome 7 Years Postpartum with Transaminitis and Hyperlipidemia. American Journal of Case Reports, 22(1). https://europepmc.org/article/PMC/8112285
Schury, M. P., & Adigun, R. (2017). Sheehan Syndrome. StatPearls Publishing Treasure Island. http://europepmc.org/books/NBK459166
Sethuram, V., Viswanathan, S., & Rajeswari Aghoeram. (2018). Refractory Hypoglycemia and Seizures as the Initial Presenting Manifestation of Empty Sella Syndrome. Cureus, 10(6). https://europepmc.org/articles/PMC6089698
Shinde, S., Sabnis, G., Lanjewar, C., & Kerkar, P. (2017). A rare endocrine cause of electrical storm: a case report. European Heart Journal–Case Reports, 1(2). https://academic.oup.com/ehjcr/article/1/2/ytx008/4600568
Suntaxi, I. (2017). Atención Prehospitalaria de la Hemorragia Posparto Inmediato. Rev Inv. Acad Educ, 1(2). https://www.revistaacademicaistcre.edu.ec/admin/postPDF/Atenciónprehospitalariadelahemorragiapospartoinmediat o.pdf
Taniguchi, J., Sugawara, H., Yamada, H., Yoshida, K., Kurihara, I., Yoshida, M., ... (2020). Adrenal crisis precipitated by influenza A led to the diagnosis of Sheehan”s syndrome 18 years after postpartum hemorrhage. Wiley Online Library, 8(1). https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.3355
Tzvi, I., Olhowski, J., Mrav, F., Bashiri, A., & Barski, L. (2019). A rare cause of postpartum acute hyponatremia. Endocrinology Diabetes Metabolism Case Reports, (1). https://edm.bioscientifica.com/view/journals/edm/2019/1/EDM18-0124.xml
Zain, A., Sivakumar, A., Akah, O., Shiza, S. T., Mahadevaiah, A., & Khan, A. (2022). A Rare Case of Sheehan Syndrome With Cardiac Tamponade. Cureus, 14(4), e24329. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123339/
Zhan, Y., Xu, T., & Wang, X. (2021). Perinatal Management and Outcomes of Pregnancy Following Sheehan Syndrome: A Case Report and Literature Review. Maternal Medicine, 3(3), 213-220. http://creativecommons.org/licenses/by-nc-nd/4.0
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