Placental assessment: Simple techniques to enhance best practice

Abstract

Valuable information on a pregnancy can be provided by ensuring histopathological examination of appropriate placentas with the simple introduction of placental information sheets, updated midwifery policy, education sessions and a colourful reminder poster.

Chronic chorioamnionitis is the most common placental lesion in late preterm birth

“…The human placenta is considered as a diary of fetal life as it shows changes of an adaptive nature to the intrauterine environment [1,2]. Therefore, pathologic examination of the placentas can often provide important clues for the pathogenesis of pregnancy complications [1,2].…”

“…Therefore, pathologic examination of the placentas can often provide important clues for the pathogenesis of pregnancy complications [1,2]. Recent efforts by the Perinatal Section of the Society of Pediatric Pathology have provided useful and systematic diagnostic schema defining pathological changes of the placenta associated with different pathogenetic alterations: amniotic fluid infection, maternal vascular underperfusion, and fetal vascular obstruction [3e6].…”

Histopathological examination of the placenta: key issues for pathologists and obstetricians

“…Uniformly presented relevant medical and obstetric history provides clarity and use of a standard format for this is helpful. 1 The presented data should include maternal age, gravidity, parity, fetal losses, vascular disease, uterine abnormalities, systemic diseases such as hypertension, infections, caesarean(s), and also relevant family history regarding congenital anomalies and systemic diseases. Secondly, information on the current pregnancy should include: gestational age, medication, smoking and drug or alcohol use, bleeding or infection, abnormalities discovered at ultrasonographic examination, diseases in pregnancy such as infections, trauma or antepartum haemorrhages, pregnancy related diseases such as preeclampsia or gestational diabetes.…”

“…[1][2][3] The College of American Pathologists (CAP) published guidelines in 1997 for pathological assessment of the placenta. 4 Despite this, Badawi et al found only 11.2% of placentas were examined, although according to the guidelines developed by CAP 43.3% had an indication for examination.…”

Uncertainty over implications of placental histopathological findings: A survey of Australian and New Zealand neonatologists

“…Other adverse pregnancy outcomes include growth restriction (6.4% of live births), prematurity (8% of live births) and neurodevelopmental disorders such as cerebral palsy (1.7/1000 births) . Histopathological analysis of the placenta can provide useful information following an adverse pregnancy outcome or suboptimal delivery conditions in many cases …”