Difference between revisions of "Products of conception"

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*Look for '''fetal tissue''' (fetus, fetal membranes or chorionic villi). If chorionic villi are found, no lengthy search is needed for other kinds of fetal tissue, just a quick look for obvious ones. Membranous material is less reliable, and may still indicate further sampling. Inspect any found fetal tissue for gross anomalies. If found, submit one piece of the fetus and one piece of the placenta.<ref name=Chicago>{{cite web|url=https://voices.uchicago.edu/grosspathology/peds-perinatal/products-of-conception/|title=Gross Pathology Manual, By The University of Chicago Department of Pathology - Products of Conception|accessdate=2020-08-13}}</ref>
 
*Look for '''fetal tissue''' (fetus, fetal membranes or chorionic villi). If chorionic villi are found, no lengthy search is needed for other kinds of fetal tissue, just a quick look for obvious ones. Membranous material is less reliable, and may still indicate further sampling. Inspect any found fetal tissue for gross anomalies. If found, submit one piece of the fetus and one piece of the placenta.<ref name=Chicago>{{cite web|url=https://voices.uchicago.edu/grosspathology/peds-perinatal/products-of-conception/|title=Gross Pathology Manual, By The University of Chicago Department of Pathology - Products of Conception|accessdate=2020-08-13}}</ref>
 
<gallery mode=packed heights=180>
 
<gallery mode=packed heights=180>
 +
File:Gross pathology of chorionic villi at 10 weeks.jpg|Fresh '''chorionic villi''' (arrows), surrounded by decidua, at 10 weeks of gestational age.
 
File:Gross pathology of fixed chorionic villi.jpg|'''Chorionic villi''' (here fixed) are more apparent in fluid.
 
File:Gross pathology of fixed chorionic villi.jpg|'''Chorionic villi''' (here fixed) are more apparent in fluid.
 
File:Gross pathology of fresh chorionic villi.jpg|Fresh '''chorionic villi'''
 
File:Gross pathology of fresh chorionic villi.jpg|Fresh '''chorionic villi'''
File:Gross pathology of partially fixed placental parenchyma.jpg|Fresh '''chorionic villi''' in a placenta for comparison.
+
File:Gross pathology of partially fixed placental parenchyma.jpg|Fresh '''chorionic villi''' in a term placenta for comparison.
 
File:Gross pathology of fetal membranes versus decidua.jpg|'''Fetal membranes''' versus decidua.
 
File:Gross pathology of fetal membranes versus decidua.jpg|'''Fetal membranes''' versus decidua.
 
</gallery>
 
</gallery>

Revision as of 20:30, 5 February 2021

Author: Mikael Häggström [note 1]

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Gross processing

  • Look for fetal tissue (fetus, fetal membranes or chorionic villi). If chorionic villi are found, no lengthy search is needed for other kinds of fetal tissue, just a quick look for obvious ones. Membranous material is less reliable, and may still indicate further sampling. Inspect any found fetal tissue for gross anomalies. If found, submit one piece of the fetus and one piece of the placenta.[1]
  • If fetal parts are not visually found, search for diagnostic placental tissue, which is soft and shaggy or spongy (as opposed to membranous, which is likely to be decidua or blood clots).[1]
  • If no fetal or placental tissue is found, all presented tissue generally needs to be submitted.

Gross report

(Labeled - products of conception.) The specimen (is received <<fresh / in formalin>>) and consists of multiple fragments of soft tan-pink decidua, blood clots and amniotic sac measuring about 5 cc in aggregate. The intact amniotic sac measures 2.3 cm in greatest dimension. Fetal tissue is identified within the amniotic sac, measuring 1.0 cm in crown-rump length. Representative sections are submitted for microscopic examination (in 1 cassette).

Microscopy

The most important is to detect the presence of chorionic villi.

In the absence of chorionic villi, look for implantation site intermediate trophoblasts (ISITs):

Microscopy report

Examples:

Histopathology of chorionic villi at gestational age of 9 weeks.jpg

((Products of conception/fetal tissue:)) Products of conception, including immature chorionic villi, and fetal tissue corresponding to first trimester pregnancy. ((Spontaneous abortion, clinically.))

Histology of implantation site intermediate trophoblasts.jpg

((Products of conception/fetal tissue:)) Fragments of focally necrotic decidua and implantation site, consistent with intrauterine products of conception. Negative for chorionic villi.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

Image sources