A 21-year-old pregnant woman experiences abruptio placentae at 37 weeks of gestation and develops severe vaginal bleeding that is difficult to control. Five months later, the patient presents with profound lethargy, pallor, muscle weakness, failure of lactation, and amenorrhea. Which of the following best explains the pathogenesis of pituitary insufficiency in this patient?
High-Yield Explanation
Hypotension caused by post-partum bleeding can, in rare cases, lead to infarction of the pituitary. The pituitary is particularly susceptible at this time because its enlargement during pregnancy renders it vulnerable to a reduction in blood flow. None of the other choices cause clinical features of pan-hypopituitarism.Diagnosis: Sheehan syndrome, pituitary infarction