Perinatal Pathology

Perinatal pathologists examine the tissues of pregnancy, including the placenta, embryo and fetal tissue. When a neonatal death occurs, a perinatal pathologist is well-equipped to perform the autopsy.

Placentas are sent to pathology for examination based on various indications which include problems in the pregnancy such as hypertension, infection, and diabetes. A perinatal pathologist is typically an expert in diseases of the placenta and works with obstetricians to understand poor pregnancy outcomes in their patients. Placental pathology can also inform neonatal care in specific circumstances such as infection, neurologic injury/encephalopathy or hematologic abnormalities.  

Fetal and embryo tissue is examined by a perinatal pathologist when there has been a pregnancy loss. Perinatal pathologists typically perform a thorough examination of the tissues to potentially determine the cause for the pregnancy loss. Depending on state laws, these examinations may be called surgical pathology examinations or autopsies.

The perinatal pathologist reviews cases of in-utero fetal demise or demise in the neonatal period, or terminations due to fetal abnormality or pregnancy complication. The goal is to establish the specific cause of death or complication, and risk of recurrence in subsequent pregnancies.

Diagnosis is often a collaborative effort, so tissue may be taken for ancillary testing including genetics, microbiology and x-rays; and case discussions with pediatric surgeons, obstetricians, and geneticists are sometimes the most intellectually rewarding part of the job. We are also consultants to our general pathologist colleagues in the community. Because there are so few of us, we have an important role in teaching and quality assurance; a key function of SPP and this committee is to promote standardized diagnostic terminology.