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APMIS. 2018 Jul;126(7):638-646. doi: 10.1111/apm.12842.

The structure and utility of the placental pathology report.

Author information

1
Department of Pathology, Paediatric and Pregnancy Related Pathology, Oslo University Hospital, Oslo, Norway.
2
Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
3
Department of Anatomical Pathology, The Children's Hospital, Westmead, NSW, Australia.
4
Department of Obstetrics, Oslo University Hospital, Oslo, Norway.
5
Faculty of Medicine, University of Oslo, Oslo, Norway.
6
Faculty of Biological, Medical and Human Sciences, School of Medical Sciences, Maternal and Fetal Health Research Centre, University of Manchester, Manchester, UK.
7
St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Abstract

The placenta is one of the most exciting organs. It is dynamic; its morphology and function continuously develop and adjust over its brief life span. It mediates the physiology of two distinct yet highly interconnected individuals. The pathology that develops in the placenta, and the adaptations the placenta undergoes to mitigate this pathology, may influence the later life health of the mother and baby (Circ Res, 116, 2015, 715; Hum Reprod Update, 17, 2011, 397; Nutr Rev 71, 2013, S88; Placenta, 36, 2015, S20). Pathological placenta examination may reveal macroscopic and microscopic patterns that provide valuable information to the obstetricians, neonatologists, and pediatricians caring for the family. The placenta often plays a key role in understanding adverse fetal outcomes such as hypoxic brain injury, cerebral palsy, fetal growth restriction, stillbirth, and neonatal death (Placenta, 35, 2014, 552; Placenta, 52, 2017, 58; Placenta, 30, 2009, 700; Obstet Gynecol, 114, 2009, 809; Clin Perinatol, 33, 2006, 503; Pediatr Dev Pathol, 11, 2008, 456; Arch Pathol Lab Med, 124, 2000, 1785). Moreover, it may help to understand the pathophysiology of pregnancy, improve management of subsequent pregnancies, and assist in medicolegal assessment. Placental pathologic examination may even provide evidence of susceptibility to adult-onset diseases such as diabetes (Pediatr Dev Pathol, 6, 2003, 54; Diabetes Metab, 36, 2010, 682; BJOG, 113, 2006, 1126; Int J Gynaecol Obstet, 104, 2009, S25; Zentralbl Gynakol, 97, 1975, 875). Pathologic examination of the placenta may thus be of tremendous value, particularly for those women experiencing an adverse pregnancy outcome. However, this potential utility may be entirely wasted, if the findings are not communicated in an effective manner to the appropriate clinicians. An optimized, readily understandable report of pathological findings is essential for clinical utility.

KEYWORDS:

Clinical relevant diagnosis; histopathology; pathology; placenta; report

PMID:
30129133
DOI:
10.1111/apm.12842
[Indexed for MEDLINE]

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