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Placenta and Umbilical Cord Abnormalities Seen With Stillbirth

PINAR, HALIT MD*; CARPENTER, MARSHALL MD

Clinical Obstetrics & Gynecology: September 2010 - Volume 53 - Issue 3 - pp 656-672
doi: 10.1097/GRF.0b013e3181eb68fe
Stillbirth

Placental lesions identified in cases of stillbirth are of clinical interest and are frequently invoked as having a causal role. However, most of the placental changes found in stillbirth are also seen in liveborn pregnancies, and are of uncertain pathogenetic significance. Much of the literature addressing placental lesions found in stillbirth is descriptive, listing cases of interest without adequate controls. Further, lesions are described qualitatively, often with inadequate description of examination and sampling protocols. In this manuscript we describe the placental characteristics that are most frequently listed in stillbirth case series, including entities associated with maternal diseases. First, we describe how macroscopic placental, cord, and membrane findings can provide answers to midwives and physicians at the time of delivery and how the placenta should be handled in the delivery room to optimize the histopathological examination. Second, we provide a brief organization of histological findings of the pathogenesis of conditions associated with fetal death.

*Division of Perinatal and Pediatric Pathology, Brown University, Providence, Rhode Island

Maternal and Fetal Medicine, Tufts Medical School, Boston, Massachusetts

Correspondence: Halit Pinar, MD, Division of Perinatal and Pediatric Pathology, Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905. E-mail: hpinar@wihri.org

© 2010 Lippincott Williams & Wilkins, Inc.