•To determine if results were being communicated to patients and if any actions taken were consistent with results

 

Design

 A prospective review of histology results as they were received from pathology.

Method

 A total of 45 cases were reviewed.

Indications for histology were compared with the North West Coast

Regional agreed indications for full placental examination.

 Areas of interest included:

 •Communication of results to patients

•Were appropriate management plans made consistent with advice from the Royal College of Pathologists?

 

Results

 Around half of the histology results were communicated to the patient 23/45 (51%).

 Subsequent pregnancy recommendations for the 23 patients who were contacted included:

Glucose tolerance testing in 1/23 (4%).

 

Conclusion

 The most common indication for sending a placenta for histology was fetal growth restriction. This is in keeping with the most common histological finding being maternal vascular malperfusion (MVM). Most of these women were advised to commence aspirin in a future pregnancy.

 NICE guidance does not currently recommend the use of aspirin in a subsequent pregnancy following delivery of a baby <3rd centile. Confirming MVM on placental histology may improve guidance in prescribing aspirin for a previous SGA fetus <3rd centile.

 There was an inconsistency in communication of results and the recommendations made for subsequent pregnancies. It is suspected that this is due to a lack of clear guidelines on reviewing and actioning placental histology. A local guideline for this has been developed but national guidance is still lacking.