Uterine artery pseudoaneurysm (UAP) is a rare cause of secondary postpartum haemorrhage (PPH). Ultrasound may suggest this condition and pelvic arteriography is done to confirm the diagnosis and to institute treatment via uterine artery embolization. Herein, we describe a case who experienced recurrent episodes of secondary PPH with inconclusive findings on ultrasound and pelvic arteriography. Foley catheter balloon was used several times to arrest acute bleeding episodes. Exploratory laparotomy revealed pseudoaneurysm of the branch of right uterine artery. Transection and ligation of the involved artery followed by ligation of bilateral internal iliac arteries were performed. Post operation, patient made a full recovery. This case highlights uterine artery pseudoaneurysm as a rare but important cause for secondary PPH. We recommend a simple measure to provide intrauterine tamponade by using Foley catheter balloon. Diagnosis of UAP may not be straightforward and this condition may only be discovered during surgery.
Key words: secondary PPH, pseudoaneurysm, pelvic angiography, intrauterine tamponade, Foley catheter balloon
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