Placental diagnostic criteria and clinical correlation--a workshop report

Placental pathology is a valuable link explaining how underlying pregnancy risk factors result in adverse pregnancy outcome. This potentially useful information is currently underutilized due to a general lack of rigor in placental diagnosis. This lack of rigor is in large part due to a failure to appreciate the importance of the information provided and hence to demand accurate and clinically responsive reporting. This workshop reviewed the results of a recent initiative by the Perinatal Section of the Society for Pediatric Pathology to systematize and validate diagnostic schema for the description of lesions related to three important pathologic processes: amniotic fluid infection, maternal vascular underperfusion, and fetal vascular obstruction. This was followed by presentation of three studies correlating these pathologic processes with the following clinical outcomes: complications of prematurity, fetal growth restriction, and neurodisability following term delivery.