Virginia Via Research Day Book 2026

Medical Student Research Case Reports

16 CONCEALED PLACENTAL ABRUPTION LEADING TO SHEEHAN'S SYNDROME: A CASE REPORT

Hannah Duraiswamy, OMS III; Ahan Hunter, MD Corresponding author: hduraiswamy@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

Matsuda et al.). Unlike many published descriptions in which abruption is identified rapidly based on classic symptoms or acute deterioration, this patient underwent several days of inpatient monitoring with persistent DIC-panel abnormalities prior to cesarean delivery, emphasizing that concealed abruption may declare itself primarily through laboratory trends rather than textbook symptoms (Ananth et al.; Tikkanen et al.). Diagnosis: Concealed placental abruption complicated by severe postpartum hemorrhage and Sheehan’s syndrome Certainty: high, based on intraoperative hemorrhage, abnormal coagulation studies, and subsequent pituitary insufficiency

Intraoperatively, the patient experienced severe hemorrhage consistent with placental abruption. Postoperatively, she developed pituitary insufficiency consistent with Sheehan’s syndrome, requiring endocrine evaluation and long-term hormonal replacement. Methods: A literature search was conducted using NCBI, PubMed, and Google Scholar with the terms “concealed placental abruption,” “disseminated intravascular coagulation,” and “Sheehan’s syndrome.” Concealed placental abruption can present without vaginal bleeding or significant abdominal pain, which may delay recognition and increase maternal risk, particularly when fetal status is initially reassuring (Ananth et al.; Tikkanen et al.). Coagulopathy is a recognized complication of placental abruption, and abnormal coagulation parameters may represent an early indicator of an evolving consumptive process even before overt clinical decompensation (Ananth et al.;

Context: Placental abruption is a life-threatening obstetric emergency that can lead to massive hemorrhage, disseminated intravascular coagulation (DIC), and postpartum pituitary necrosis, such as Sheehan’s syndrome. When the abruption is concealed, however, classic symptoms such as vaginal bleeding and abdominal pain may be absent, delaying recognition and intervention. Report of Case: A 40-year-old G2P1001 with a history of gestational diabetes and preeclampsia presented with preterm premature rupture of membranes. Although she lacked significant vaginal bleeding or abdominal pain, laboratory evaluation demonstrated abnormalities on a disseminated intravascular coagulation (DIC) panel, raising concern for evolving coagulopathy. She was closely monitored, and after several days of persistent laboratory abnormalities and concern for concealed placental abruption, a cesarean delivery was performed.

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