Spontaneous Pregnancy in Sheehan's Syndrome: A Rare But Possible Occurrence

To the Editor, Sheehan’s syndrome is a rare but serious cause of hypopituitarism resulting from ischemic necrosis of the pituitary gland following postpartum hemorrhage [1]. It is generally responsible for anterior pituitary hormonal deficiencies of varying severity, often associated with infertility due to involvement of the gonadotropic axis [2]. However, spontaneous pregnancy, although rare, remains possible in certain situations [3]. We report the case of a 36-year-old multiparous woman (mother of three children), followed for Sheehan’s syndrome diagnosed four years ago after a delivery complicated by severe hemorrhage requiring blood transfusion and admission to the intensive care unit. Initial hormonal assessment revealed corticotropic and thyrotropic deficiencies, leading to treatment with hydrocortisone (20 mg/day) and levothyroxine (25 µg/day). The gonadotropic axis was preserved despite irregular menstrual cycles. The patient presented with a spontaneous pregnancy occurring two years after her last pregnancy. She is currently at 30 weeks of gestation. The pregnancy has been closely monitored, with adjustment of hormone replacement therapy and regular obstetric follow-up.