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Routine Placental Histopathological Examination: Provides Answers in Neonatal Management

Received: 19 November 2021     Accepted: 14 December 2021     Published: 17 January 2022
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Abstract

Placental abnormality may affect the fetus adversely. The purpose of this study was to identify the prevalence of placental histopathological examination in a private hospital setting and analyse the placental histopathology findings for high-risk pregnancies. A retrospective cross-sectional study was conducted at the Mater Hospital in Sydney from January 2018 to June 2020. The placental histopathology was classified as per the 2014 Amsterdam Placental Workshop Group criteria, enabling uniformity for analysis. There were 5594 live births during the study period. Of these, 5% (256/5594) were low birth weight (LBW). Placental histopathology was conducted for 8% (443/5594) of the live births and 59% (152/256) of LBW births. The LBW group was subclassified into small for gestation (SGA) (n=66) and non-SGA (n=86) to analyse differences in placental abnormalities between the two groups. Of SGA, 82% (54/66) had placental abnormality compared to 76% (65/86) for non-SGA. Intervillous fibrin deposits (p=0.013) and smaller placental weight (p=0.008) were more common in the SGA; whereas the placental inflammatory-immune process was more common in the non-SGA. Original placental histopathology reports did not employ the objective Amsterdam classification system, thereby risking subjective or variable interpretation by clinicians. In conclusion, placental histopathology plays an important role in neonatal management. A quality improvement project may improve the prevalence of placental histopathological examination.

Published in American Journal of Pediatrics (Volume 8, Issue 1)
DOI 10.11648/j.ajp.20220801.13
Page(s) 10-13
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Low Birth Weight (LBW), Placental Histopathology, Placental Vascular Malperfusion

References
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[2] Jaiman S, Romero R, Pacora P, et al. Disorders of placental villous maturation are present in one-third of cases with spontaneous preterm labor. Journal of Perinatal Medicine. May 26 2021; 49 (4): 412-430. doi: https://dx.doi.org/10.1515/jpm-2020-0138.
[3] Spinillo A, Gardella B, Muscettola G, Cesari S, Fiandrino G, Tzialla C. The impact of placental massive perivillous fibrin deposition on neonatal outcome in pregnancies complicated by fetal growth restriction. Placenta. 11 2019; 87: 46-52. doi: https://dx.doi.org/10.1016/j.placenta.2019.09.007.
[4] Shannon P, Hum C, Parks T, et al. Brain and Placental Pathology in Fetal COL4A1 Related Disease. Case Reports. Pediatr Dev Pathol. May-Jun 2021; 24 (3): 175-186. doi: https://dx.doi.org/10.1177/1093526620984083.
[5] Chalak L, Redline RW, Goodman AM, et al. Acute and Chronic Placental Abnormalities in a Multicenter Cohort of Newborn Infants with Hypoxic-Ischemic Encephalopathy. Clinical Trial, Phase III Multicenter Study Randomized Controlled Trial. J Pediatr. Oct 2021; 237: 190-196. doi: https://dx.doi.org/10.1016/j.jpeds.2021.06.023.
[6] Han X, Du H, Cao Y, et al. Association of histological and clinical chorioamnionitis with perinatal and neonatal outcome. J Matern Fetal Neonatal Med. Mar 2021; 34 (5): 794-802. doi: https://dx.doi.org/10.1080/14767058.2019.1618824.
[7] Mittal N, Byard RW, Dahlstrom JE. A practical guide to placental examination for forensic pathologists. Review. Forensic Sci Med Pathol. 06 2020; 16 (2): 295-312. doi: https://dx.doi.org/10.1007/s12024-019-00214-2.
[8] Khong TY, Mooney EE, Ariel I, et al. Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement. Arch Pathol Lab Med. Jul 2016; 140 (7): 698-713. doi: https://dx.doi.org/10.5858/arpa.2015-0225-CC.
[9] Nkwabong E, Kamgnia Nounemi N, Sando Z, Mbu RE, Mbede J. Risk factors and placental histopathological findings of term born low birth weight neonates. Placenta. Feb 2015; 36 (2): 138-41. doi: https://dx.doi.org/10.1016/j.placenta.2014.12.005.
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[12] Redline RW. Classification of placental lesions. Review. Am J Obstet Gynecol. Oct 2015; 213 (4 Suppl): S21-8. doi: https://dx.doi.org/10.1016/j.ajog.2015.05.056.
[13] Ravishankar S, Redline RW. What Obstetricians Need to Know About Placental Pathology. Review. Obstet Gynecol Clin North Am. Mar 2020; 47 (1): 29-48. doi: https://dx.doi.org/10.1016/j.ogc.2019.10.007.
[14] Fouks Y, Many A, Shulman Y, Bak S, Shinar S. The Contribution of an Infectious Workup in Understanding Stillbirth. Am J Perinatol. 03 2021; 38 (4): 377-382. doi: https://dx.doi.org/10.1055/s-0039-1697668.
[15] Tachibana M, Nakayama M, Ida S, et al. Pathological examination of the placenta in small for gestational age (SGA) children with or without postnatal catch-up growth. J Matern Fetal Neonatal Med. Mar 2016; 29 (6): 982-6. doi: https://dx.doi.org/10.3109/14767058.2015.1029911.
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Cite This Article
  • APA Style

    Roy Bithi, Gonzalez Jeannette, Kwok Adrian, Walker Karen, Morgan Catherine, et al. (2022). Routine Placental Histopathological Examination: Provides Answers in Neonatal Management. American Journal of Pediatrics, 8(1), 10-13. https://doi.org/10.11648/j.ajp.20220801.13

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    ACS Style

    Roy Bithi; Gonzalez Jeannette; Kwok Adrian; Walker Karen; Morgan Catherine, et al. Routine Placental Histopathological Examination: Provides Answers in Neonatal Management. Am. J. Pediatr. 2022, 8(1), 10-13. doi: 10.11648/j.ajp.20220801.13

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    AMA Style

    Roy Bithi, Gonzalez Jeannette, Kwok Adrian, Walker Karen, Morgan Catherine, et al. Routine Placental Histopathological Examination: Provides Answers in Neonatal Management. Am J Pediatr. 2022;8(1):10-13. doi: 10.11648/j.ajp.20220801.13

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  • @article{10.11648/j.ajp.20220801.13,
      author = {Roy Bithi and Gonzalez Jeannette and Kwok Adrian and Walker Karen and Morgan Catherine and Webb Annabel and Badawi Nadia and Novak Iona},
      title = {Routine Placental Histopathological Examination: Provides Answers in Neonatal Management},
      journal = {American Journal of Pediatrics},
      volume = {8},
      number = {1},
      pages = {10-13},
      doi = {10.11648/j.ajp.20220801.13},
      url = {https://doi.org/10.11648/j.ajp.20220801.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220801.13},
      abstract = {Placental abnormality may affect the fetus adversely. The purpose of this study was to identify the prevalence of placental histopathological examination in a private hospital setting and analyse the placental histopathology findings for high-risk pregnancies. A retrospective cross-sectional study was conducted at the Mater Hospital in Sydney from January 2018 to June 2020. The placental histopathology was classified as per the 2014 Amsterdam Placental Workshop Group criteria, enabling uniformity for analysis. There were 5594 live births during the study period. Of these, 5% (256/5594) were low birth weight (LBW). Placental histopathology was conducted for 8% (443/5594) of the live births and 59% (152/256) of LBW births. The LBW group was subclassified into small for gestation (SGA) (n=66) and non-SGA (n=86) to analyse differences in placental abnormalities between the two groups. Of SGA, 82% (54/66) had placental abnormality compared to 76% (65/86) for non-SGA. Intervillous fibrin deposits (p=0.013) and smaller placental weight (p=0.008) were more common in the SGA; whereas the placental inflammatory-immune process was more common in the non-SGA. Original placental histopathology reports did not employ the objective Amsterdam classification system, thereby risking subjective or variable interpretation by clinicians. In conclusion, placental histopathology plays an important role in neonatal management. A quality improvement project may improve the prevalence of placental histopathological examination.},
     year = {2022}
    }
    

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    AB  - Placental abnormality may affect the fetus adversely. The purpose of this study was to identify the prevalence of placental histopathological examination in a private hospital setting and analyse the placental histopathology findings for high-risk pregnancies. A retrospective cross-sectional study was conducted at the Mater Hospital in Sydney from January 2018 to June 2020. The placental histopathology was classified as per the 2014 Amsterdam Placental Workshop Group criteria, enabling uniformity for analysis. There were 5594 live births during the study period. Of these, 5% (256/5594) were low birth weight (LBW). Placental histopathology was conducted for 8% (443/5594) of the live births and 59% (152/256) of LBW births. The LBW group was subclassified into small for gestation (SGA) (n=66) and non-SGA (n=86) to analyse differences in placental abnormalities between the two groups. Of SGA, 82% (54/66) had placental abnormality compared to 76% (65/86) for non-SGA. Intervillous fibrin deposits (p=0.013) and smaller placental weight (p=0.008) were more common in the SGA; whereas the placental inflammatory-immune process was more common in the non-SGA. Original placental histopathology reports did not employ the objective Amsterdam classification system, thereby risking subjective or variable interpretation by clinicians. In conclusion, placental histopathology plays an important role in neonatal management. A quality improvement project may improve the prevalence of placental histopathological examination.
    VL  - 8
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Author Information
  • School of Health Sciences, The University of Sydney, Sydney, Australia

  • The Mater Hospital, North Sydney, Australia

  • School of Medicine, University of Notre Dame, Sydney, Australia

  • Royal Prince Alfred Hospital Newborn Care, Sydney Local Health District, Sydney, Australia

  • Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia

  • Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia

  • Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia

  • Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia

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