We describe an unusual cause of severe hypoglycaemia, secondary to hypopituitarism as a result of antepartum pituitary failure, in a pregnant patient with type 1 diabetes mellitus (T1DM). Antepartum pituitary failure is a very rare condition, which has been reported only in a very small number of pregnant patients with diabetes and presents with an acute onset headache and a sub-arachnoid haemorrhage-like picture. It is a potentially fatal condition to the mother and the child if not recognised and treated. Our case report highlights the importance of thinking about hypopituitarism, as a cause of recurrent hypoglycaemia in pregnant patients with T1DM as missing the diagnosis could be fatal to the mother and child.
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http://dx.doi.org/10.1055/s-2007-967092 | DOI Listing |
Domest Anim Endocrinol
July 2024
Center for Animal Reproduction, Vetmeduni Vienna, Veterinärplatz 1, 1210 Vienna, Austria.
Mares resume ovarian activity rapidly after foaling. Besides follicle-stimulating hormone (FSH) and luteinizing hormone (LH), the pituitary synthesizes prolactin and growth hormone which stimulate insulin-like growth factor (IGF) synthesis in the liver. We tested the hypothesis that follicular growth is initiated already antepartum, mares with early and delayed ovulation differ in IGF-1 release and that there is an additional IGF-1 synthesis in the placenta.
View Article and Find Full Text PDFJ Endocrinol
August 2017
Institute of Nutritional Physiology 'Oskar Kellner'Leibniz Institute for Farm Animal Biology (FBN), Dummerstorf, Germany
During the transition between late gestation and early lactation, dairy cows experience severe metabolic stress due to the high energy and nutrient requirements of the fetus and the mammary gland. Additional thermal stress that occurs with rising temperatures during the ongoing climate change has further adverse implications on energy intake, metabolism and welfare. The thyroid hormone (TH)-mediated cellular signaling has a pivotal role in regulation of body temperature, energy intake and metabolic adaptation to heat.
View Article and Find Full Text PDFArch Womens Ment Health
October 2016
Center for Psychopharmacologic Research and Treatment, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, 01605, USA.
Antepartum depression and anxiety are risk factors for postpartum depression (PPD). Postpartum abnormalities in hypothalamic-pituitary-adrenal (HPA) reactivity are associated with PPD. It is not known if antepartum HPA abnormalities exist in women at risk for PPD (AR-PPD).
View Article and Find Full Text PDFJ Am Psychiatr Nurses Assoc
April 2012
University Hospital Basel, University of Basel, Basel, Switzerland.
Background: Several psychological and obstetric predictors of a negative childbirth experience and traumatic response to delivery have been identified. However, the influence of antepartum physiological stress parameters has not been elucidated.
Objective: The study includes an exploratory analysis of the associations of fear of delivery, antenatal basal and reactive activity of the hypothalamic-pituitary-adrenal axis, and obstetric outcomes, with childbirth experience and posttraumatic avoidance in the postpartum period.
J Clin Anesth
August 2011
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
Sheehan's syndrome is a well described entity that refers to hypopituitarism with pituitary infarction secondary to postpartum shock or hemorrhage. Antepartum pituitary infarction is a very rare condition that has been reported only in patients with longstanding type 1 diabetes mellitus or uncontrolled gestational diabetes. A case of severe, acute hypopituitarism in the setting of hemorrhagic shock from a gunshot wound is presented.
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