Artificial Intelligence in Placental Pathology: New Diagnostic Imaging Tools in Evolution and in Perspective

Artificial intelligence (AI) has emerged as a transformative tool in placental pathology, offering novel diagnostic methods that promise to improve accuracy, reduce inter-observer variability, and positively impact pregnancy outcomes. The primary objective of this review is to summarize recent developments in AI applications tailored specifically to placental histopathology. Current AI-driven approaches include advanced digital image analysis, three-dimensional placental reconstruction, and deep learning models such as GestAltNet for precise gestational age estimation and automated identification of histological lesions, including decidual vasculopathy and maternal vascular malperfusion. Despite these advancements, significant challenges remain, notably dataset heterogeneity, interpretative limitations of current AI algorithms, and issues regarding model transparency. We critically address these limitations by proposing targeted solutions, such as augmenting training datasets with annotated artifacts, promoting explainable AI methods, and enhancing cross-institutional collaborations. Finally, we outline future research directions, emphasizing the refinement of AI algorithms for routine clinical integration and fostering interdisciplinary cooperation among pathologists, computational researchers, and clinical specialists.