Sellar size in women with Sheehan syndrome- A case control study

Abstract

Purpose Sheehan syndrome is a common cause of hypopituitarism in developing countries. Among risk factors, in addition to postpartum haemorrhage, a smaller sellar volume is also believed to predispose to pituitary necrosis. Some of the previous studies have reported smaller sellar volume in these patients but these studies either are limited with less number of patients or were lacking matched controls for comparison. The present work was aimed to study the sellar volume in a large cohort of patients with Sheehan syndrome and comparing it with age, gender and parity matched controls.

Methods Study comprising of 50 patients with Sheehan syndrome and a same number of age, gender and parity matched controls. In addition to baseline investigations and hormonal assay, both patients and controls were subjected to MRI pituitary and sellar volume was calculated.

Results Sellar volume was significantly lower in patients with Sheehan syndrome (331.50±129.08 mm³ in patients as against 456.64±169.25 mm³ in controls, p = 0.000). 40% of women with Sheehan syndrome had decreased sellar volume as against 12% of matched healthy women.

Conclusion Patients with Sheehan syndrome have a smaller sellar volume that may be a non-modifiable risk factor for the development of postpartum pituitary necrosis.

Key words:   Sheehan syndrome. PPH .  Hypopituitarism . MRI .  Sellar size