Pathologic examination of the placenta: recommended versus observed practice in a university hospital
Amber Sills,1 Carmen Steigman,2 Songthip T Ounpraseuth,3 Imelda Odibo,1 Adam T Sandlin,1 Everett F Magann1
1Departments of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, AR, USA; 2Department of Pathology, University of Arkansas for the Medical Sciences, Little Rock, AR, USA; 3Department of Biostatistics, University of Arkansas for the Medical Sciences, Little Rock, AR, USA
Introduction: The purpose of this study was to determine the frequency of appropriate placental examinations in a university hospital.
Methods: A retrospective review of all deliveries and all placentas submitted for pathologic examination from live births. Placentas were reviewed by a perinatal pathologist to determine whether they met the College of American Pathologists (CAP)-recommended guidelines for examination.
Results: We used 1346 deliveries between July 1, 2010 and December 31, 2010 as the basis of this review. According to CAP guidelines, 703 placentas (52.2%) should have been sent for pathologic examination; 575/703 (81.8%; 95% confidence interval [CI] = 78.9–84.7) were actually sent for examination. Of the 643 placentas that did not need to be examined per CAP guidelines, 568 (88.3%; 95% CI = 85.9–90.8) were appropriately not sent. In comparing the three categories of indications for examination (maternal, fetal/neonatal, placental), the only significant association was that women with fetal/neonatal indications were more likely to have their placenta sent than women with maternal indications (odds ratio, 2.63; 95% CI = 1.81–3.80).
Conclusion: In this university hospital, more than 80% of the time, placentas were appropriately sent to pathology, and more than 85% of the time, placentas that should not have been sent for evaluation were not sent.
Keywords: placenta, pathologic examination, clinical guidelines, birth
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]