Pathologic findings of the placenta and clinical implications – recommendations for placental examination (original) (raw)

Review article: Medical guidelines

Vol. 154 No. 10 (2024)

• Elisabeth Bruder+−
• Irene Hösli+−
• Olav Lapaire+−
• Luigi Raio+−
• Henning Schneider+−
• Sylvia Höller+−
• Roland Hentschel+−
• Simone Brandt+−
• Peter Bode+−
• Sven Schultzke+−
• Gero Drack+−

Summary

The placenta is a unique and complex organ that combines the circulatory systems of two or more individuals within a single dynamic organ with a set, short lifespan. A diverse spectrum of disorders, including infections as well as metabolic, genetic, circulatory, and maturation defects, may affect its function. Pathology investigation of the placenta is key for identifying several pathogenic processes in both the mother and the foetus. Aberrant placentation, maternal and foetal vascular compromise, infection, inflammatory immunologic conditions, and disorders of maturation are elements of newly proposed classification schemes.

The clinical impact of placental examination consists of diagnosing maternal and foetal disease, identifying the potential for recurrence, correlating clinical pathological findings with distinct morphologic features, and identifying the aetiology responsible for growth restriction or foetal death.

Gestational trophoblastic disease occurs more frequently in the first trimester; however, in very rare cases, it can affect the term or third-trimester placenta.

The application of reproducible nomenclature is expected to facilitate progress in the diagnosis and treatment of obstetric and foetal disorders with placental manifestation.

Therefore, this review aims to facilitate communication between obstetricians, neonatologists, and pathologists involved in this diagnostic process.

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• Adalgisa Condoluci, Marie Théaudin, Rahel Schwotzer, Aju P. Pazhenkottil, Paolo Arosio, Manuela Averaimo, Ulrike Bacher, Peter Bode, Andrea Cavalli, Stefan Dirnhofer, Nadia Djerbi, Stephan Dobner, Thomas Fehr, Maura Garofalo, Ariana Gaspert, Sabine Gerull, Raphael Heimgartner, Annemarie Hübers, Hans H. Jung, Chiara Kessler, Raphael Knöpfel, Natallia Laptseva, Giulia Magini, Robert Manka, Luca Mazzucchelli, Martin Meyer, Violeta Mihaylova, Pierre Monney, Alessio Mylonas, René Nkoulou, Thomas Pabst, Otmar Pfister, Axel Rüfer, Adrian Schmidt, Harald Seeger, Simon F. Stämpfli, Guido Stirnimann, Thomas Suter, Giorgio Treglia, Alexandar Tzankov, Friederike Vetter, Markus Zweier, Andreas J. Flammer, Bernhard Gerber, Management of transthyretin amyloidosis, Swiss Medical Weekly: Vol. 151 No. 4142 (2021)
• Rahel Schwotzer, Andreas J. Flammer, Sabine Gerull, Thomas Pabst, Paolo Arosio, Manuela Averaimo, Ulrike Bacher, Peter Bode, Andrea Cavalli, Adalgisa Condoluci, Stefan Dirnhofer, Nadia Djerbi, Stephan W. Dobner, Thomas Fehr, Maura Garofalo, Ariana Gaspert, Raphael Heimgartner, Annemarie Hübers, Hans H. Jung, Chiara Kessler, Raphael Knöpfel, Natallia Laptseva, Robert Manka, Luca Mazzucchelli, Martin Meyer, Violeta Mihaylova, Pierre Monney, Alessio Mylonas, René Nkoulou, Aju P. Pazhenkottil, Otmar Pfister, Axel Rüfer, Adrian Schmidt, Harald Seeger, Simon F. Stämpfli, Guido Stirnimann, Thomas Suter, Marie Théaudin, Giorgio Treglia, Alexandar Tzankov, Friederike Vetter, Markus Zweier, Bernhard Gerber, Expert recommendation from the Swiss Amyloidosis Network (SAN) for systemic AL-amyloidosis, Swiss Medical Weekly: Vol. 150 No. 4950 (2020)
• Patricia Christoph, Pauline Challande, Luigi Raio, Daniel Surbek, High prevalence of severe vitamin D deficiency during the first trimester in pregnant women in Switzerland and its potential contributions to adverse outcomes in the pregnancy, Swiss Medical Weekly: Vol. 150 No. 2122 (2020)
• Anda-Petronela Radan, Sofia Amylidi-Mohr, Beatrix Mosimann, Cedric Simillion, Luigi Raio, Martin Mueller, Daniel Surbek, Safety and effectiveness of labour induction after caesarean section using balloon catheter or oxytocin, Swiss Medical Weekly: Vol. 147 No. 4546 (2017)
• Beatrice Mosimann, Chantal Pfiffner, Sofia Amylidi-Mohr, Lorenz Risch, Daniel Surbek, Luigi Raio, First trimester combined screening for preeclampsia and small for gestational age – a single centre experience and validation of the FMF screening algorithm, Swiss Medical Weekly: Vol. 147 No. 3334 (2017)
• Francesca Compagno, Klaudia Naegele, Christian R. Kahlert, Irene Hösli, Karoline Aebi-Popp, Begona Martinez de Tejada, Paolo Paioni, Sabine Yerly, Jürg Böni, Manuel Battegay, Christoph Rudin, Hans H. Hirsch, the Swiss HIV Cohort Study, The rate of mother-to-child transmission of antiretroviral drug-resistant HIV strains is low in the Swiss Mother and Child HIV Cohort Study, Swiss Medical Weekly: Vol. 149 No. 1314 (2019)
• Jarmila A. Zdanowicz, Eliane Sommer, Luigi Raio, Mathias Nelle, Roland Gerull, Do late preterm twins face an increased neonatal morbidity compared with singletons?, Swiss Medical Weekly: Vol. 148 No. 0102 (2018)
• Christian De Geyter, Oliver Sterthaus, Peter Miny, Friedel Wenzel, Olav Lapaire, Maria De Geyter, Gideon Sartorius, First successful pregnancy in Switzerland after prospective sex determination of the embryo through the separation of X-chromosome bearing spermatozoa, Swiss Medical Weekly: Vol. 143 No. 0708 (2013)
• Irene Hösli, Ursula von Mandach, Valproate in pregnancy: comment from the SAPP, Swiss Medical Weekly: Vol. 151 No. 0708 (2021)