ABSTRACT
The placentas from all deliveries should be examined grossly in the clinical setting. Gross abnormalities such as incompleteness of the maternal surface, retro-placental hemorrhage, premature separation, abnormal adherence, cord hematoma, rupture of vasa previa (exposed fetal vessels from membranous cord insertion when coursing over the cervical os, meconium staining, etc.) should be noted and recorded. The length of the cord should be measured, as the full cord is often not sent to the pathology laboratory. Sampling of the fresh placenta for cytogenetics, placental cultures in cases of suspected infection or premature labor, and freezing of placental tissue in cases of possible metabolic disease may also be performed in this setting. In special cases of concern, the pathologist can assist in these preparations if informed and in receipt of the specimen promptly. Placentas meeting the indications (see below) for full examination by the pathologist, which will include further gross and microscopic evaluation, can then be sent to the laboratory. Institutional policy varies as to whether all placentas are sent or selected placentas are sent to pathology. Ideally, they should be sent to the pathology laboratory fresh; however, in some institutions, this is not feasible, and placentas are received in 10% formalin. Fresh placentas may be stored at 4°C for a week, allowing time to determine whether a neonatal issue dictates a laboratory placental examination10.
