Unveiling postpartum pituitary apoplexy through atypical presentation: A case report and review of literature

Abstract

Our case details the atypical presentation of postpartum pituitary apoplexy in a 20-year-old female, who exhibited general weakness, dizziness, and brief loss of consciousness following an uncomplicated vaginal delivery. Despite normal vital signs except for bradycardia, imaging revealed a pituitary hemorrhage, leading to the diagnosis of pituitary apoplexy. Managed conservatively with IV hydrocortisone and intensive care, the patient experienced persistent bradycardia and severe abdominal pain, requiring transfer to another ICU. This case highlights the diagnostic challenges posed by the rarity and complexity of pituitary apoplexy during pregnancy and the postpartum period, emphasizing the importance of early diagnosis and tailored treatment strategies. The discussion further contrasts this case with existing literature, particularly in the context of postpartum pituitary apoplexy, and explores the broader implications for managing such rare cases, reinforcing the viability of conservative management in the absence of visual field disturbances.

Keywords

• Pituitary apoplexy
• Postpartum
• Conservative therapy