As a L&D RN studying to be a IBCLC, I have not personally observed a
relationship between the drug Cytotec and lactation failure, nor heard of any
research relating the two. From my studies the known relationship is between
the PPH and lactation failure. According to Marie Biancuzzo's "Breastfeeding
the Newborn", Sheehan's syndrome can occur after severe PPH. As she explains
in her textbook...severe PPH causes necrosis of the pituitary from decreased
vascular flow to this gland. Lactation hormones plummet and result in mammary
involution and lactation failure. To quote "Taber's Cyclopedic Medical
Dictionary", Sheehan's syndrome is "(h)ypopituitarism resulting from an
infarct of the pituitary following postpartum shock or hemorrhage. Damage to
the anterior pituitary gland causes partial to complete loss of thyroid,
adrenocortical, and gonadal function."  As noted in "Williams Obstetrics,
20th edition", pituitary and hypothalamic functions may be tested by
measuring function of thyroid TSH and adrenal ACTH levels or by CT scan. This
textbook states that on CT the appearance of pituitary is abnormal in that
the sella turcica was either totally or partially empty. Other symptoms of
pituitary insufficiency are loss of pubic/axillary hair and failure to resume
menses postpartum, yet some symptoms may not occur for years later. The
incidence of Sheehan's syndrome is 1 in 10,000.
(Forgive amateur me if this info was already known to all professional LC
already! If not, I'm happy to participate for my first time on LACTNET!)
Kathleen Williams, RN, BSN, and IBCLC-to-be!

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