• Clinical Data:  Record the clinical data and the nature of the specimen according to the surgical pathology request, including all specimens submitted in addition to the placenta.
• Dissection:  Arrange the placenta on the dissecting board with the membranes over the fetal surface similar to their intrauterine position.
• Nature of the Membranes

• Site of attachment:  marginal, circummarginate or circumvallate.
• Color:  meconium staining, transparent or translucent.
• Site of rupture:  the nearest distance to the placental margin; tear into placenta indicates placenta previa.
• Incise the membrane with 2 parallel cuts about 5 cm apart from the site of perforation to the placental margin.
• Make a membrane roll using an instrument such as a closed scissors as the core.
• Tie each end of the rolled membrane with string and place in fixative.
• Umbilical Cord

• Identify the site of insertion as the distance from the nearest placental margin:  central, eccentric, marginal, or velamentous.
• Color, diameter, and length:  (normal 40-80 cm; some remains with the neonate).
• Twists per centimeter.
• Number of blood vessels on the cut section.
• Note abnormalities:  knots, thrombi, edema.
• Placenta disc

• Multiple Births:
• With multiple births, examine each portion of the placenta, whether joined or fuzed, as for a single placenta.
• Identify as A, B, etc. If not labeled by the obstetrician, label arbitrarily.
• Vascularity of fetal surface:  anastomoses between A and B.  If necessary, perfuse vessels with liquid mixture of powdered milk to accentuate cross circulation.  Anastomoses are normal in DiMo, rare in DiDi.

• Umbilical cord:  one block, 3 levels (proximal, middle, distal)
• Membranes:  one block
• Placenta:  three blocks, including fetal and maternal surfaces and site of cord insertion.  Avoid the margins.
• Additional blocks of any abnormalities.
• With multiple births, label the individual segments of the placenta so that the sections can be accurately matched with the portions of the placenta from which they were obtained.  Submit and label the dividing membrane.  Take a block from the fetal surface at the site of the dividing membrane (“T-zone”).

Internal use only

Singleton --

Received unfixed, labeled __ and “placenta”, is a __ x __ x __ cm singleton placenta with attached cord and membranes.  The trimmed placenta disc weighs ___ grams.  One ___ cm long and ___ cm in diameter umbilical cord is ___ (centrally / eccentrically) inserted, ___ cm from the nearest placental edge. There is (no) ___ (true knot / velamentous insertion) . A separate ____-cm segment of umbilical cord is also noted. Three-vessel cross section surface shows no ___ (discoloration / hemorrhage). The membranes are ___ (marginally attached, tan-pink and cloudy).  The point of membrane rupture is ___ cm from the edge of the placental disc / cannot be determined. The fetal surface is __ (purple-gray / smooth) with ____ (unremarkable vasculature / focal white plaque / focal subchorionic fibrin deposition).  The maternal surface is ___ (intact / incomplete) with ___ (a centrally located __ x __ x__ cm hematoma).  Serial sections through the disc show a marron-red spongy parenchyma with ___ (a 1.5 x 1 x 0.8 cm infarct, accounting __ % of the parenchyma).  A __ x __ x __ cm detached blood clot is also found in the container. Representative sections are submitted as follows.

#__ =  a cross section of the umbilical cord 2 cm above cord insertion

#__ = membrane roll with the margin of the disc.

#__ =  a cross section of the umbilical cord at fetal end plus a full thickness section of the placental disc, half-way between cord insertion and disc margin

#__ = full-thickness section of disc close to the cord insertion site

#__ - #__  = abnormal area of placental disc.

__ blocks, __ H&E

Twin placenta--

Received unfixed, labeled ___ and designated as "placenta and cord," is a ____ (diamniotic-dichorionic / diamniotic-monochorionic) twin placenta with attached cords and membranes. The fused placental discs are __ x __ x __ cm and ___ gm (trimmed weight). One cord with a clamp is previously designated as placenta "A", the other with two clamp as "B".  The dividing membranes are ___ (tan-white thick, opaque / semi-translucent)  and divide the disc into two ___  (relatively equal portions). No fetal vessels are seen crossing the dividing membranes.

Placenta "A": The umbilical cord is normally coiled and ___ (centrally / eccentrally / velamentously) inserted.  It is__ cm long and __ cm in diameter with 3 vessels on cross section. There is (no) true knot. The membranes are marginally attached, tan-pink and translucent. The fetal surface is ___ (purple-gray / smooth / with unremarkable fetal vasculature). The maternal surface is ____ (intact / disrupted / with __ x __ cm defect area). A __ x __ x __ cm blood clot is attached to the center of the maternal surface with indentation. Serial sections through the disc show a marron-red spongy parenchyma with ___ (a 1.5 x 1 x 0.8 cm infarct, accounting __ % of the parenchyma). 

Placenta "B" The umbilical cord is hypercoilded ( __ coild per 10 cm) and ___ (centrally / eccentrally / velamentously) inserted on the dividing membranes.  It is__ cm long and __ cm in diameter with 3 vessels on cross section. The membranes are marginally attached, tan-pink and translucent. The fetal surface is ___ (purple-gray / smooth / with unremarkable fetal vasculature). The maternal surface is ____ (intact / disrupted / with __ x __ cm defect area). A __ x __ x __ cm retroplacental hematoma with maternal surface compression is present ____ (centrally / eccentrally from the disc division). Two separate __ x __ x __ cm and __ x __ x __ cm area of infarct are also noted accounting ___ % of the disc valume. The uninvolved parenchyma is ___ (maroon-red and spongy).

Representative sections are submitted as follows:

Placenta A:

#__ =  a cross section of the umbilical cord 2 cm above cord insertion

#__ = membrane roll with the margin of the disc.

#__   =  a cross section of the umbilical cord at fetal end plus a full thickness section of the placental disc, half-way between cord insertion and disc margin

#__ = full-thickness section of disc close to the cord insertion site

#__ - #__  = abnormal area of placental disc.

Placenta B:

#__ =  a cross section of the umbilical cord 2 cm above cord insertion

#__ = a membrane roll with the margin of the disc.

#__  =  cross sections of the hypercoided segment of umbilical cord

#__  =  full thickness section of the placental disc, half-way between cord insertion and disc margin

#__ = full-thickness section of disc close to the cord insertion site

#__ - #__  = abnormal area of placental disc.

__ blocks, __ H&E