An approach to placental examination

Abstract

The placenta is fundamentally a foetal organ with a limited life span. By virtue of its structure, maturational features, and interface with maternal circulation and inner uterus, it can provide valuable diagnostic information about the existence of adverse intrauterine conditions, facing the foetus, and evidence of underlying maternal disorders. Examination of the placenta can reveal pathological features that have significant implications for the newborn, risks for recurrence of pathology affecting outcomes of future pregnancies, and/or explain the cause of intrauterine foetal death. Also, there is mounting evidence that low infant birthweight, due to prematurity and/or intrauterine growth restriction, both of which may be related to utero-placental insufficiency and adverse intrauterine conditions, may contribute to the risks for developing chronic diseases in childhood and adulthood, including cardiovascular disease and hypertension. The placenta may exhibit pathology that may become important in identifying which individuals may later be at risk for developing such complications. This presentation will focus on (1) practical techniques of how to examine and sample the placenta, (2) diagnostic terminology and criteria for common and uncommon placental pathologies, and (3) information concerning the implications of placental inflammation, meconium staining, and chorionic villous ischaemic, thrombotic, and involutional changes.