Three weeks after a delivery complicated by massive postpartum haemorrhage requiring transfusion, a woman reports she never experienced breast engorgement and could not lactate. She also has persistent fatigue and inability to resume menstruation. Which hormonal abnormality explains her failure of lactation?

• A Prolactin deficiency ✓
• B Growth hormone deficiency
• C ACTH deficiency
• D Oxytocin deficiency

Explanation

Sheehan syndrome is pituitary apoplexy following obstetric haemorrhage. The earliest and most characteristic clue is failure of lactation because prolactin secretion is lost, since suckling-induced prolactin release requires an intact pituitary. ACTH and growth hormone deficiency develop later and cause weakness and hypoglycaemia, while oxytocin is produced mainly by hypothalamic neurons and does not govern milk production.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.