Pathomorphology of adenohypophysis in cases of massive obstetric hemorrhages (morphometric and immunohistochemical studies)

摘要

There have been performed morphometric and immunohistochemical examinations of adenohypophysis of 15 females who died of massive post-partum hemorrhages. The revealed changes in the form of hypertrophy of the basophilic cells are the initial stages of Sheehan's syndrome developing as a result of long-term progression of hypopituitarism. Massive obstetric bleeding causes severe complications-posthemorrhagic shock, the pathogenetic mechanism of which includes necrosis of the cells in the anterior part of the hypophysis. Cause-effect relations were shown for the amount of the post-partum blood loss and the revealed pathomorphologic changes in the hypophysis. Hyperproduction of ACTH by the basophilic cells of the adenohypophysis revealed by immunohistochemical analysis is a compensatory mechanism under the conditions of acute adrenal insufficiency inherent in any shock including posthemorrhagic.