Why all placentas should be examined by a pathologist in 1990

Article Abstract:

Placental pathology is the examination of the overall and microscopic structure of the placenta with the idea of finding and identifying possible abnormalities or diseases. Neither pathologists nor obstetricians are usually educated in this field and so cannot appreciate the information that can be derived from placental examinations. However, study of the placenta can clarify the relative contributions of acute events relating to delivery and chronic prenatal problems. It can also lead to improved treatment of subsequent pregnancies by identifying problems which alter the outcome of pregnancy and which may recur or be treatable. Finally, it can identify cases where newborns are at risk for poor development, thus allowing early treatment. This article describes in detail the processes of a placental examination, the information that can be obtained, and the relationship of the information to medical situations. A major problem with which obstetricians currently must contend with is the tendency of parents and others to place the blame for any developmental problem on procedures used during labor and delivery. This is partly because the uterine environment until recently was thought to provide the ideal protected environment for fetal growth, and thus any injury was thought to relate to perinatal or postnatal causes. Research is slowly disproving this notion; only 10 percent of cases of retardation are attributable to problems occurring during labor. However, routine placental examination is even more effective in documenting conditions that can absolutely be attributed to perinatal or prenatal problems. Compared to the price for single settlements for malpractice related to cerebral palsy or other disabilities, the charges for placental pathological examination are minuscule. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Medical examination, Placenta, Obstetrics, Obstetrical diagnosis

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Intrauterine growth restriction in infants of less than thirty-two weeks' gestation: associated placental pathologic features

Article Abstract:

Placental lesions represent placental damage that may stunt fetal growth and cause fetuses to be born prematurely. Researchers studied 420 placentas delivered with preterm infants. Infants were born prematurely because of premature rupture of membranes, preterm labor, maternal preeclampsia, or vaginal bleeding before birth. Preeclampsia is a condition of pregnancy involving high blood pressure and protein in the urine. Preterm infants whose size was appropriate for their gestational age had placentas with fewer lesions and fewer severe lesions. The number and severity of placental lesions, and how early in pregnancy they occur, may determine whether infants are born early or at term, as well as their size. Preeclampsia may cause preterm birth independent of placental lesions, as it may deprive fetuses of nutrition.

Complications and side effects, Fetus, Fetal growth retardation, Preeclampsia, Placental diseases, Placenta diseases

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Does "idiopathic" preterm labor resulting in preterm birth exist?

Article Abstract:

A comprehensive evaluation plan may identify a cause for 'idiopathic' preterm labor. 'Idiopathic' preterm labor is the onset of labor before the ninth month of gestation for no known reason. A comprehensive evaluation plan was used to evaluate the cause of preterm labor in 50 patients who had a preterm delivery. A possible cause of preterm labor was identified for most of the women. Fifty percent of the women had placental abnormalities, 38% had an intrauterine infection and 30% had immunologic factors that may have caused preterm labor. Other possible causes that were identified included cervical incompetence, different uterine factors, trauma and surgery and fetal abnormalities. Fifty-eight percent of the patients had two or more possible causes of preterm labor.

Causes of, Premature labor, Premature birth

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