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Related Experiment Video

Updated: Oct 29, 2025

Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye
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Interobserver Reliability for Identifying Specific Patterns of Placental Injury as Defined by the Amsterdam

Raymond W Redline1, Torstein Vik2, Amy Heerema-McKenney3

  • 1From the Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Redline, Ravishankar).

Archives of Pathology & Laboratory Medicine
|July 12, 2021
PubMed
Summary

Pathologists showed good reliability diagnosing placental inflammatory lesions using the Amsterdam consensus criteria. However, reliability was lower for vascular lesions, indicating a need for clearer definitions.

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Area of Science:

  • Pathology
  • Obstetrics
  • Neonatology

Background:

  • Placental pathology is crucial for understanding neonatal illness.
  • The Amsterdam international consensus standardized criteria for placental pathology.
  • Standardized criteria aid research and clinical care.

Purpose of the Study:

  • Evaluate interobserver reliability of Amsterdam consensus criteria.
  • Assess reliability among pathologists with varying experience levels.
  • Utilize digitally scanned placental slides from a general birth population.

Main Methods:

  • Secondary analysis of placentas from a neonatal encephalopathy case-control study.
  • Digital scanning and blinded evaluation of 80 placental histologic slides by 6 pathologists.
  • Interobserver reliability assessed using agreement metrics and correlation coefficients.

Main Results:

  • Moderate to good agreement for acute chorioamnionitis and villitis of unknown etiology.
  • Good to excellent agreement for inflammatory lesions among 4 observers.
  • Poor to fair agreement for fetal vascular malperfusion and accelerated villous maturation.

Conclusions:

  • Amsterdam consensus criteria show good reliability for inflammatory placental lesions.
  • Lower reliability for vascular lesions highlights the need for more precise diagnostic definitions.
  • Enhanced clarity on histologic features is required for vascular and maturation patterns.