Clinical value of placental examination for paediatricians (original) (raw)

Clinical value of placental examination for paediatricians

http://orcid.org/0000-0002-9814-8841Daniel Cromb1,2,
Megan Hall1,3,
Lisa Story1,3,
http://orcid.org/0000-0003-2750-8405Panicos Shangaris3,4,5,
Mudher Al-Adnani6,
Mary A Rutherford1,3,
http://orcid.org/0000-0001-7966-3779Grenville F Fox2,
Neelam Gupta2,7
1 Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
2 Neonatal Unit, Evelina London Children's Hospital, St Thomas' Hospital, London, UK
3 Department of Women's Children and Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
4 Fetal Medicine Research Institute, King's College Hospital, London, UK
5 Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
6 Department of Cellular Pathology, St Thomas' Hospital, London, UK
7 GKT School of Medical Education, King's College London, London, UK
Correspondence to Dr Daniel Cromb, Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London Faculty of Life Sciences & Medicine, London, UK; daniel.cromb{at}kcl.ac.uk

Abstract

The placenta contains valuable clinical information that is linked to fetal development, neonatal morbidity and mortality, and future health outcomes. Both gross inspection and histopathological examination of the placenta may identify intrinsic or secondary placental lesions, which can contribute directly to adverse neonatal outcomes or indicate the presence of an unfavourable intrauterine environment. Placental examination therefore forms an essential component of the care of high-risk neonates and at perinatal post-mortem examination. In this article, we describe the clinical value of placental examination for paediatricians and perinatal clinicians. We discuss common pathological findings on general inspection of the placenta with photographic examples and provide an overview of the placental pathological examination, including how to interpret key findings. We also address the medico-legal and financial implications of placental examinations and describe current and future clinical considerations for clinicians in regard to placental examination.

Neonatology
Paediatrics
Pathology
Growth
Intensive Care Units, Neonatal

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