WISSP - Protocol for Placental and Cord Evaluation

Protocol for Placental and Cord Evaluation

GROSS ASSESSMENT

Weight (trimmed) ________g.

Placental weight:Fetal weight ratio ________

Contour

Size ________cm x ________cm

Presence of Accessory Lobes Y N

Insertion of Cord Central

Eccentric
Marginal
Velamentous

Membranes

Membranes ruptured ________cm from the margin.

Membrane insertion

Normal

Marginal
Circum-marginate
Circumvallate

Membrane character

Normal

Abnormal 
Meconium stained
Blood stained
Other ______________________

Placental disc

Color

Red
Brown
Green
Pale
Other___________________________

Odor

Normal
Foul

Features

Blood clot of maternal surface _________________________
Thrombi of fetal surface ______________________________
Fibrin(oid) deposition ________________________________
estimated percentage of surface involved ____%
Infarction _________________________________________
estimated percentage of volume involved _____%
Other_____________________________________________

Cord

Length _______cm Diameter_______cm
Number of vessels _______

Features

True knot(s) ________________________________________
False knot(s) ________________________________________
Torsion/twisting _____________________________________
Engorgement ________________________________________
Narrowing/constriction ________________________________
location ______________________________________
Abnormal Wharton's jelly ______________________________
_____________________________________________

If Twins:

Membrane Configuration

Monochorionic-Monoamniotic
Monochorionic-Diamniotic
Dichorionic-Diamniotic

Placental Vessels

Anastomotic vessels evident by gross inspection
Anastomotic vessels demonstrated by injection/perfusion

HISTOLOGIC ASSESSMENT

Sections should be obtained as follows:

1. Cross section of umbilical cord
1b. Cross section just proximal to and just distal to any apparent cord constriction or cord stricture
2. Amniochorionic membrane roll
3. Fetal side placenta
4. Basal placenta
5. Sampling of any apparent abnormalities.

Reporting should include general description of each section and description (including severity and extent) of

Inflammation

Chorioamnionitis ______________________________________________

Cord Vasculitis _______________________________________________

Funisitis ____________________________________________________

Villitis ______________________________________________________

Infarction __________________________________________________________

Calcification(s) ______________________________________________________

Fibrin Deposition ____________________________________________________

Other _____________________________________________________________

____________________________________________________________