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Why is the placenta being ignored?

N Badawi1, J J Kurinczuk, J M Keogh

  • 1TVW Telethon Institute for Child Health Research, Perth, Western Australia, Australia.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|November 7, 2000
PubMed
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Placental examination is recommended for newborns with encephalopathy, but rarely performed. Storing placentas for 72 hours may provide crucial diagnostic information if infants develop neurological issues.

Area of Science:

  • Perinatal pathology
  • Neonatal neurology
  • Obstetrics

Background:

  • Newborn encephalopathy can have placental origins.
  • Established criteria exist for placental examination.

Purpose of the Study:

  • To examine the frequency of placental examination requests versus recommended indications.
  • To assess the diagnostic yield of placental pathology in term newborn encephalopathy.

Main Methods:

  • Population-based study of term newborn encephalopathy cases and controls.
  • Review of placental examination rates and pathological findings.
  • Application of American College of Pathologists criteria.

Main Results:

  • Only 11.2% of case placentas and 0.7% of control placentas were examined.

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  • All cases and 43.3% of controls met criteria for examination.
  • Pathological review of 25 case placentas revealed clinically important findings in 24% (e.g., infection, umbilical vein issues).

    • Conclusions:

    • There is a significant gap between recommended placental examination indications and actual practice.
    • Placental examination can offer vital etiological, diagnostic, and prognostic information for infants with neurological symptoms.
    • Storing all placentas for 72 hours is suggested pending development of Australian guidelines.