A female undergoes an uneventful full term normal vaginal delivery. After few hours, she staed complaining of severe headache & visual changes. She is found unresponsive after 4 hours. She is intubated & O/E her BP- 64/30 mmHg, HR- 160/min. Lab studies show RBS- 45 mg/dl, with normal haemoglobin, WBC & platelets. Which of the following you will use to manage this patient?
The give scenario suggests diagnosis of Sheehan syndrome. Pituitary haemorrhage/infarction- bilateral visual changes, headache, meningeal signs & ophthalmoplegia. In severe cases, cardiovascular collapse and altered levels of consciousness. Pan hypopituitarism is seen. Hypotension & hypoglycemia- due to decreased ACTH Most immediate concern is replacement of glucocoicoid- Hydrocoisone is given Activated drotrecogin alfa & Piperacillin/tazobactam- not indicated as there is no evidence of sepsis Transfusion of packed red blood cells- not useful as haematocrit is normal
Activated drotrecogin alfa
Hydrocoisone
Piperacillin/tazobactam
Transfusion of packed red blood cells
Disorders of pituitary gland