Criteria for placental examination for obstetrical and neonatal providers
Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved..
Pathologic examination of the placenta can provide insight into likely (and unlikely) causes of antepartum and intrapartum events, diagnoses with urgent clinical relevance, prognostic information for mother and infant, support for practice evaluation and improvement, and insight into advancing the sciences of obstetrics and neonatology. Although it is true that not all placentas require pathologic examination (although alternative opinions have been expressed), prioritization of placentas for pathologic examination should be based on vetted indications such as maternal comorbidities or pregnancy complications in which placental pathology is thought to be useful for maternal or infant care, understanding pathophysiology, or practice modifications. Herein we provide placental triage criteria for the obstetrical and neonatal provider based on publications and expert opinion of 16 placental pathologists and a pathologists' assistant, formulated using a modified Delphi approach. These criteria include indications in which placental pathology has clinical relevance, such as pregnancy loss, maternal infection, suspected abruption, fetal growth restriction, preterm birth, nonreassuring fetal heart testing requiring urgent delivery, preeclampsia with severe features, or neonates with early evidence of multiorgan system failure including neurologic compromise. We encourage a focused gross examination by the provider or an attendant at delivery for all placentas and provide guidance for this examination. We recommend that any placenta that is abnormal on gross examination undergo a complete pathology examination. In addition, we suggest practice criteria for placental pathology services, including a list of critical values to be used by the relevant provider. We hope that these sets of triage indications, criteria, and practice suggestions will facilitate appropriate submission of placentas for pathologic examination and improve its relevance to clinical care.
| Errataetall: |
CommentIn: Am J Obstet Gynecol. 2023 Jun;228(6):762-763. - PMID 36731816 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:228 |
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| Enthalten in: |
American journal of obstetrics and gynecology - 228(2023), 5 vom: 01. Mai, Seite 497-508.e4 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Roberts, Drucilla J [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 01.05.2023 Date Revised 07.06.2023 published: Print-Electronic CommentIn: Am J Obstet Gynecol. 2023 Jun;228(6):762-763. - PMID 36731816 Citation Status MEDLINE |
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| doi: |
10.1016/j.ajog.2022.12.017 |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Pathologic examination of the placenta can provide insight into likely (and unlikely) causes of antepartum and intrapartum events, diagnoses with urgent clinical relevance, prognostic information for mother and infant, support for practice evaluation and improvement, and insight into advancing the sciences of obstetrics and neonatology. Although it is true that not all placentas require pathologic examination (although alternative opinions have been expressed), prioritization of placentas for pathologic examination should be based on vetted indications such as maternal comorbidities or pregnancy complications in which placental pathology is thought to be useful for maternal or infant care, understanding pathophysiology, or practice modifications. Herein we provide placental triage criteria for the obstetrical and neonatal provider based on publications and expert opinion of 16 placental pathologists and a pathologists' assistant, formulated using a modified Delphi approach. These criteria include indications in which placental pathology has clinical relevance, such as pregnancy loss, maternal infection, suspected abruption, fetal growth restriction, preterm birth, nonreassuring fetal heart testing requiring urgent delivery, preeclampsia with severe features, or neonates with early evidence of multiorgan system failure including neurologic compromise. We encourage a focused gross examination by the provider or an attendant at delivery for all placentas and provide guidance for this examination. We recommend that any placenta that is abnormal on gross examination undergo a complete pathology examination. In addition, we suggest practice criteria for placental pathology services, including a list of critical values to be used by the relevant provider. We hope that these sets of triage indications, criteria, and practice suggestions will facilitate appropriate submission of placentas for pathologic examination and improve its relevance to clinical care | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a critical values in placental pathology | |
| 650 | 4 | |a guidelines for placental pathologic examination | |
| 650 | 4 | |a indications for placental examination | |
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| 700 | 1 | |a Baergen, Rebecca N |e verfasserin |4 aut | |
| 700 | 1 | |a Boyd, Theonia K |e verfasserin |4 aut | |
| 700 | 1 | |a Carreon, Chrystalle Katte |e verfasserin |4 aut | |
| 700 | 1 | |a Duncan, Virginia E |e verfasserin |4 aut | |
| 700 | 1 | |a Ernst, Linda M |e verfasserin |4 aut | |
| 700 | 1 | |a Faye-Petersen, Ona M |e verfasserin |4 aut | |
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| 700 | 1 | |a Hecht, Jonathon L |e verfasserin |4 aut | |
| 700 | 1 | |a Heerema-McKenney, Amy |e verfasserin |4 aut | |
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| 700 | 1 | |a Linn, Rebecca L |e verfasserin |4 aut | |
| 700 | 1 | |a Polizzano, Carolyn |e verfasserin |4 aut | |
| 700 | 1 | |a Ravishankar, Sanjita |e verfasserin |4 aut | |
| 700 | 1 | |a Redline, Raymond W |e verfasserin |4 aut | |
| 700 | 1 | |a Salafia, Carolyn M |e verfasserin |4 aut | |
| 700 | 1 | |a Torous, Vanda F |e verfasserin |4 aut | |
| 700 | 1 | |a Castro, Eumenia C |e verfasserin |4 aut | |
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