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    Point-Counterpoint: Placental examination

     

    A pathology request that provides essential information to the pathologist will likely improve the resulting reports. A template that lists the complications that prompt a placental review allows the obstetric provider to simply circle the indication for the request. These should include maternal complications, fetal complications, and placental findings, as well as basic information on the mother and gestational age at delivery. This also reinforces the indications for pathology review to the obstetrical provider.

    In brief, establishment of institution-based guidelines for triage of placental tissues that include initial submission for pathology and short-term storage in cases not initially felt to meet criteria is necessary to help clinicians utilize the valuable information the placentas may yield. Increased utilization of placental evaluation will maximize our care for obstetric patients and their newborns.

     

    References

    1. Langston C, Kaplan C, Macpherson T, et al. Practice guideline for examination of the placenta: developed by the Placental Pathology Practice Guideline Development Task Force of the College of American Pathologists. Arch Pathol Lab Med. 1997;121(5):449–476.

    2. Badawi N, Kurinczuk JJ, Keogh JM, Chambers HM, Stanley FJ. Why is the placenta being ignored? Aust N Z J Obstet Gynaecol. 2000;40(3):343–346.

    3. Spencer MK, Khong TY. Conformity to guidelines for pathologic examination of the placenta. Arch Pathol Lab Med. 2003;127(2):205–207.

    4. Curtin WM, Krauss S, Metlay LA, Katzman PJ. Pathologic examination of the placenta and observed practice. Obstet Gynecol. 2007;109(1):35–41.

    5. Booth VJ, Nelson KB, Dambrosia JM, Grether JK. What factors influence whether placentas are submitted for pathologic examination? Am J Obstet Gynecol. 1997;176(3):567–571.

    6. Redline, RW. Placental pathology: Is it time to get serious? Contemporary OB/GYN. 2014;59(2):41–48.

     

    NEXT: No. The absence of trained placental pathologists hinders accurate examination. >>

    Sharon T. Phelan, MD
    Dr. Phelan is a Professor in the Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque.

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