Development of an Orff music-based intervention program based on the PERMA model for children with cochlear implants: a Delphi study.

Hypopituitarism is an uncommon endocrine disorder (incidence of 4.2 cases per 100,000 per year and prevalence of 45.5 cases per 100,000) characterized by partial or complete deficiency of pituitary hormones due to a variety of etiologies, including congenital factors, trauma, brain hemorrhage, tumors, systemic hemorrhage during labor and infection []. Panhypopituitarism, a more severe form of the condition in which all pituitary hormones are affected, is even less common. Women with hypopituitarism frequently experience difficulties achieving pregnancy due to deficiencies in gonadotropins and other pituitary hormones. Conception often requires assisted reproductive technologies, ranging from ovulation induction with gonadotropins to in vitro fertilization, along with close endocrinologic follow-up []. Owing to the low prevalence of hypopituitarism, reports on peripartum outcomes in women with this condition are limited [–]. Furthermore, the topic of lactation in women with panhypopituitarism is virtually absent from the scientific literature, with only brief mentions of a small number of patients, mostly stating that lactation was not initiated and that prolactin levels were low [, , , –]. This is not surprising given that the anterior pituitary hormone prolactin and the posterior pituitary hormone oxytocin, which are essential for breast milk production [] and letdown [, ] respectively, are often deficient in these women, hindering the onset of lactation. We present a case of a 34-year-old parturient woman with panhypopituitarism after treatment for craniopharyngioma who successfully achieved partial breastfeeding. We conducted a comprehensive literature search for reports on breastfeeding status in parturient women with partial or complete hypopituitarism and used a multivariable logistic regression model to examine the effects of different variables on breastfeeding. Recognizing the need for practical support, we conclude with a suggestion for a structured management checklist to guide clinicians in facilitating breastfeeding for pregnant women with panhypopituitarism to optimize care and outcomes.