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Conformity to guidelines for pathologic examination of the placenta
Michael K Spencer1, T Yee Khong
1Department of Obstetrics and Gynaecology, University of Adelaide, Australia.
Archives of Pathology & Laboratory Medicine
|February 4, 2003
Summary
Placental examination rates at a tertiary hospital were low, with only about one-third of placentas examined when indicated. Medical staff also frequently failed to properly document examination reasons.
Area of Science:
- Pathology
- Obstetrics
- Neonatal Care
Background:
- The College of American Pathologists (CAP) established guidelines for placental examination.
- Adherence to CAP guidelines for placental pathology is not well-documented.
Purpose of the Study:
- To determine placental examination rates at a tertiary hospital.
- To compare documented indications with clinical events for placental pathology.
- To assess adherence to CAP practice guidelines.
Main Methods:
- Retrospective data collection from hospital databases and pathology request forms.
- Analysis of 987 deliveries from April to June 2000.
- Comparison of indicated vs. actual placental examinations.
Main Results:
- Fewer than 20% of placentas were examined, though approximately 50% met examination criteria.
- Maternal fever and suspected neonatal infection had the lowest examination rates.
- Neonatal indications were rarely listed on pathology forms.
Conclusions:
- The hospital examined only about one-third of placentas that warranted examination.
- Incomplete and inaccurate documentation of indications for placental examination was common.
- Improved adherence to CAP guidelines and documentation practices are needed.