The placenta is a fetal organ consisting of the umbilical cord, amniotic and chorionic membranes and parenchyma. Maternal or fetal disorders may have placental effects. Primary placental anomalies can affect both maternal and fetal health. Examination of the placenta can aid in resolving legal issues, diagnosing specific etiologies of adverse outcomes, identifying zygosity/pathology in multiple gestations, and identifying recurrent disorders. For these reasons, examination of the placenta is an important component of the immediate postpartum period.
All placentas should be examined grossly by the delivering physician. At a minimum this exam should include: the number of umbilical cord vessels, the approximate length of the cord (35-70 cm normal range), and the presence of gross anomalies (discoloration, multiple lobes, or focal lesions). Indications for histopathological examination include the following:
•Maternal medical conditions with potential fetal effects (examples: HTN,DM)
•Third trimester bleeding or postpartum hemorrhage
•Severe oligohydramnios or polyhydramnios
•In utero fetal therapy
•Placenta previa or abruption
•Recent history of substance abuse or exposure to toxins
•Umbilical cord anomaly
•Placental anomaly suspected
Histological examination can be omitted with a normal delivery (vaginal or cesarean) of a healthy term neonate from an uncomplicated pregnancy.