Placental pathology reports: A qualitative study in a US university hospital setting on perceived clinical utility and areas for improvement.

To explore how placental pathology is currently used by clinicians and what placental information would be most useful in the immediate hours after delivery. We used a qualitative study design to conduct in-depth, semi-structured interviews with obstetric and neonatal clinicians who provide delivery or postpartum care at an academic medical center in the US (n = 19). Interviews were transcribed and analyzed using descriptive content analysis. Clinicians valued placental pathology information yet cited multiple barriers that prevent the consistent use of pathology. Four main themes were identified. First, the placenta is sent to pathology for consistent reasons, however, the pathology report is accessed by clinicians inconsistently due to key barriers: difficult to find in the electronic medical record, understand, and get quickly. Second, clinicians value placental pathology for explanatory capability as well as for contributions to current and future care, particularly when there is fetal growth restriction, stillbirth, or antibiotic use. Third, a rapid placental exam (specifically including placental weight, infection, infarction, and overall assessment) would be helpful in providing clinical care. Fourth, placental pathology reports that connect clinically relevant findings (similar to radiology) and that are written with plain, standardized language and that non-pathologists can more readily understand are preferred. Placental pathology is important to clinicians that care for mothers and newborns (particularly those that are critically ill) after birth, yet many problems stand in the way of its usefulness. Hospital administrators, perinatal pathologists, and clinicians should work together to improve access to and contents of reports. Support for new methods to provide quick placenta information is warranted.

Informations de copyright

Copyright: © 2023 Gallagher et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The details for competing interests for each author are as follows: KG: Co-I R01 (R01EB030130) Development of Software to Rapidly Assess Placenta Images at Birth. Patent application: Systems and Methods Incorporating One or More Modalities to Automatic Placental Analysis. PSU Ref 2022-5452. JA: The author has declared that no competing interests exist. CO-M: The author has declared that no competing interests exist. JP: Reports funding from Pfizer for an RSV vaccine study. WC: Funded by Penn State College of Medicine for research in fetal growth restriction and placental pathology. This work had no bearing on study design, collection, analysis, interpretation of data, and/or decision to submit current work for publication. JG: MPI R01 (R01EB030130) Development of Software to Rapidly Assess Placenta Images at Birth, K08EB030120, Walder Foundation Fund to Retain Clinician Scientists (unnumbered). Patent: Systems and Methods Utilizing Artificial Intelligence for Placental Assessment and Examination. Reference 2019-4905. Patent Application: Systems and Methods Incorporating One or More Modalities to Automatic Placental Analysis. PSU Ref 2022-5452. HS: The author has declared that no competing interests exist. AG: MPI R01 (R01EB030130) Development of Software to Rapidly Assess Placenta Images at Birth. Patent: Systems and Methods Utilizing Artificial Intelligence for Placental Assessment and Examination. Reference 2019-4905. Patent Application: Systems and Methods Incorporating One or More Modalities to Automatic Placental Analysis. PSU Ref 2022-5452.