Postpartum syndrome; It shows itself with both physical and psychological effects in women. The first of these; It is a rare condition that occurs with excessive bleeding after birth, defined as postpartum pituitary, postpartum hypopituitarism, Sheehan syndrome in medicine, and known as postpartum syndrome among the public. The other; It is caused by the changes in the mother's mood due to the stressful and difficult phase she goes through after birth. These effects usually improve within 7-10 days. However, in some cases, effects such as depression and psychosis that start in the first 6 weeks affect the mother for 1-2 years.
Postpartum syndromes
Sheehan syndrome: Excessive bleeding after birth will reduce blood flow to the pituitary gland in the brain, which causes tissue loss here and causes the pituitary gland to function less. This causes the hormones secreted from here to decrease. Postpartum syndrome, which is one of the causes of empty sella syndrome, which is pituitary insufficiency at different levels, usually occurs due to excessive bleeding due to placenta previa or placental failure to separate, and hypovolemia due to pituitary and adrenaline insufficiency. The basic mechanism is the development of necrosis in the anterior pituitary due to decreased blood volume. The factor that causes this is the increased sensitivity to bleeding and volume loss as a result of the growth of the pituitary gland due to the effect of estrogen, which increases during pregnancy. Clinical symptoms are not observed until the necrosis rate in the pituitary gland reaches 70%. When the necrosis rate reaches 90%, complete hypopituitarism occurs.
What are the clinical manifestations of Sheehan syndrome?
In order for a person to be psychologically and physically healthy, the pituitary gland must be able to function regularly. Sheehan syndrome is the result of symptoms such as weakness and fatigue continuing for a long time with the loss of blood flow after birth. Hormone deficiency occurs due to excessive blood loss during birth and the malfunctioning of the pituitary gland, and growth hormone production stops. These expectant mothers cannot breastfeed their children. The reason for this is the inability to secrete the prolactin hormone. The most important hormone that ensures milk secretion is the prolactin hormone. The FSH and LH hormones called gonadotropins, which prevent women from menstruating, are also not secreted. The hair in the armpits and genital area disappears. Adrenocorticotropic and thyrotropic hormone secretions also decrease. Weakness, loss of resistance to cold, slowing of the heartbeat, thinning of the skin, sparse and thinning of hair, loss of sexual desire and numbness are added to the symptoms, and the disease begins to show itself. In postpartum syndrome, which can develop quite a lot of clinical courses, some patients experience coma as a result of sudden panhypopituitarism symptoms; while some patients may develop nonspecific symptoms such as long-lasting weakness, anemia, and fatigue. The hormones secreted from the pituitary gland have various functions. Their low secretion causes some symptoms to occur in the body.
How is Sheehan syndrome diagnosed?
After birth, symptoms such as no milk coming from the breasts, hair loss in the armpits, and menstrual bleeding not starting may occur. Since the condition has a slow course, it may be difficult to diagnose. Primary hypothyroidism may be diagnosed incorrectly. The condition is diagnosed with hormone deficiencies associated with the symptoms, radiological findings, and obstetric history. The first symptoms after birth manifest themselves with fatigue. Then menstruation stops and the woman experiences a loss of sexual desire. In this case, women should consult an endocrinologist and metabolism specialist and have the condition diagnosed. The diagnosis of postpartum syndrome is made by following the development of the complaints together with diagnostic methods such as detecting low levels of pituitary hormones in the blood and monitoring the pituitary gland with brain tomography.
How is Sheehan syndrome treated?
When people with the above symptoms go to the doctor, the treatment to be applied is carried out with medications. In this way, the treatment of the patients is completed and the complaints are resolved. Not having a period for a certain period after birth is considered normal among the public. However, if there are symptoms such as feeling weak and tired in addition to not having a period, this should not be considered normal. The hormone deficiency caused by the under-functioning pituitary gland in the body is completed with externally administered medications. The under-functioning pituitary gland, which stimulates the thyroid gland and adrenal gland, may have also caused a deficiency in the hormones released there. After these are detected, drug treatment is also applied for this. It is normal for the baby to lose blood during birth. The effects of this will be eliminated with the medications and nutrition program recommended by the doctor. These should be used without neglect. In women, the effects of blood loss such as weakness and fatigue are eliminated in this way. If the expectant mother, who has come out of a pregnancy process of approximately 40 weeks, still feels weak after a tiring birth and sufficient rest, she should share this problem and go to the doctor and get treatment. In order to be more vigorous and healthy, women need to monitor the changes in themselves after giving birth and take appropriate precautions.
Postpartum depression: The causes of depression affecting women after birth are examined in two different ways. The sudden drop in estrogen and progesterone levels during pregnancy with birth, thyroid disorders, and folate deficiency are seen as biological factors in depression. In addition to hormonal changes, psychiatric changes in women are among the reasons that push women to postpartum depression.
What are the symptoms of depression?
In women, intense feelings of sadness, emptiness, and insensitivity
Feeling of extreme physical fatigue and lack of energy
Tendency to stay away from friends and family
Increased anxiety about their babies
Having difficulty concentrating and poor memory
Experiencing situations such as panic attacks, distress, anxiety, irritability, spontaneous crying
Increased psychomotor mobility and restlessness
Weight loss, loss of appetite and sleep disturbances
They should feel happy, but they feel guilty and depressed.
How is postpartum depression treated?
Although the exact causes of these emotional changes are not known, they are successfully treated. It may be beneficial for women to rest and get help from their loved ones. In severe depressive cases, treatment can be provided by using medication.
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