Techniques

Abstract

fetal, and placental. Each of these indicators consisted of 3 or 4 conditions (e.g., fetal indicators: fetal compromise, fetal phenotype abnormality, or multiple gestations). We determined the level of concordance between clinical indicator condition and placental pathologic diagnosis. Results: Of submitted placentas with clinical indicators (81%), 49% were maternal indicators, 31% fetal, and 19% placental. In 64% of placentas, the pathologic diagnosis correlated with the clinical indicator. The highest concordance (100%) was with the suspected condition of chorioamnionitis/infection and the lowest level of concordance (33%) was with suspected placental conditions (e.g., previa, retained products, etc.). In 19% of specimens, an appropriate clinical indicator was not provided and the majority was from women who had a Cesarean section with bilateral tubal ligation and no maternal, fetal or placental indications of disease. None of these placental specimens had signifi cant pathologic fi ndings. Extrapolated to the entire year, our laboratory performed a placental examination without appropriate clinical indication in 114 cases. Conclusions: We hypothesize that a standard clinical indicator checklist may be used to triage placentas for pathologic examination. Providing clinicians with correlation of clinical indicator-pathologic fi ndings also may be used to evaluate the utility of the clinical indicator assessment. Improved lab effi ciency may be achieved by limiting unnecessary placental examinations without compromising safety.