Pituitary apoplexy may lead to a deficiency of one, several, or all of the pituitary trophic hormones. Failure of growth hormone secretion is the most common and usually the earliest manifestation to appear in patients with pituitary insufficiency.1 Recently we had the opportunity to study a young woman with postpartum pituitary necrosis (Sheehan Syndrome) and deficiencies of luteinizing hormone, thyroid-stimulating hormone, and adrenocorticotrophic (ACTH) hormone, although her pituitary gland retained the ability to secrete growth hormone. In spite of the multiple trophic hormone deficiencies, the patient became pregnant.
A 21-year-old white woman entered the hospital with a chief complaint of lethargy of nine months' duration. She had been well until five days before the delivery of her first child at which time the membranes ruptured. During the night before delivery, she became febrile (39.4 C) and remained so throughout the course of her labor. After labor was