Conformity to Guidelines for Pathologic Examination of the Placenta

Abstract

Abstract Context.—The College of American Pathologists developed a consensual guideline for placental examination that included indications for the submission of placentas for pathologic examination. The adherence to this guideline is not known. Objectives.—To identify the number of placentas that were and that should have been examined by a tertiary-care hospital according to the College of American Pathologists' practice guideline and to compare the indications listed by medical staff on their pathology request forms with the clinical events recorded on the hospital's databases. Design.—Data from the hospital computer databases and from pathology request forms were collected for all 987 deliveries occurring at a tertiary-level maternity hospital from April through June 2000. Results.—Fewer than 20% of placentas were examined, but about 50% should have been. Maternal fever and suspected neonatal infection were the indications with the lowest examination rates. Neonatal indications were infrequently listed. Conclusions.—This hospital examined approximately one third of the placentas that should have been examined. When the placentas were examined, the medical staff often failed to appropriately list the indications on their pathology request forms.