Sheehan症候群に関与する産科的要因に関する検討

Aim: To evaluate factors related to the occurrence of Sheehan syndrome. Methods: The obstetrical disseminated intravascular coagulation score, total volume of hemorrhage, shock index, level of consciousness at the time of shock occurrence and pituitary magnetic resonance imaging findings were evaluated in nine women who showed massive hemorrhage during delivery. These clinical outcomes were analyzed in all these patients who were prospectively followed-up to identify any possible occurrence of Sheehan syndrome. Results: Compared to six women with non-Sheehan syndrome, three women who were diagnosed with Sheehan syndrome showed significant elevation of the obstetrical disseminated intravascular coagulation score, decrease in the level of consciousness during shock and remarkable pituitary gland atrophic change with an empty sella turcica detected by pituitary magnetic resonance imaging. The volume of hemorrhage during delivery and shock index were not significantly different between these two groups of women. Conclusion: Careful attention and follow-up should be paid to women with post-partum massive hemorrhage for early detection and management of women with Sheehan syndrome.長崎大学学位論文 学位記番号:博(医歯薬)乙第36号 学位授与年月日:平成26年12月3日Author: Takahiro Matsuwaki, Khaleque Newaz Khan, Tsuneo Inoue, Atsushi Yoshida andHideaki MasuzakiCitation: The Journal of Obstetrics and Gynaecology Research, 40(1), pp.46-52; 201