"The Placenta: To Know Me Is To Love Me. A reference guide for gross placental examination" cuts across medical disciplines bringing together obstetrics and pathology for the common goal of gross placental examination. It was written for all health care professionals who grossly examine the placenta, including Obstetricians, Family Practice Physicians, Pathologists, Resident Physicians, delivery room Nurses, Nurse-Midwives, Physicians Assistants and Pathologists' Assistants. The chapters are succinctly written and quick to read, making it the perfect, daily reference for the busy birthing room and Surgical pathology gross room.

"The Placenta: To Know Me Is To Love Me Companion Atlas CD" compliments the reference guide and features 400 color placental images in a Web Presentation. The CD was created using PowerPoint 2000 (not required to view CD), to run off your Windows based internet browser. Limited copyright permission is extended to the buyer, allowing use of the images in personal educational presentations that will not be sold, widely distributed or placed on the internet. Images are sorted by placental structure, cross indexed by anatomic and pathologic features, and accessed by hyperlinks. Salient placental features are identified and annotated. The images highlight normal characteristics, and common as well as uncommon placental pathology, including rarely seen specimens such as:

  • Breus' mole
  • fetal surface stem vessel thrombosis with avascular villi
  • IUD in extraplacental membranes of term placenta
  • ruptured vasa previa
  • furcate insertion of umbilical cord
  • maternal floor infarction
  • 5-6 week gestation intact amniotic sac with embryo and yolk sac, within chorionic sac
  • amniotic band syndrome with anencephaly
  • hysterectomy specimen with choriocarcinoma
  • extensive entanglement of monoamniotic monochorionic cords in triplet placenta
  • acardiac fetus
  • diamniotic dichorionic twin placenta including complete molar transformation of one placenta
  • spontaneous triamniotic monochorionic triplet placenta

Section I: Clinicopathological Correlation is the "driving force" of the reference guide, supplemented by pathological details in Section II and clinical details in Section III, with a review of the legal impact of the placenta in Section IV. The user friendly table of contents and index provide quick and easy access to desired information, cross referenced through-out all sections of the guide. "The Placenta: To Know Me Is To Love Me" is a reference guide, a "bench companion" to more detailed obstetric and pathology textbooks.

Table of Contents

  • Preface
  • List of Tables (23 clinical and pathological)
  • List of Figures (41 schematics, illustrations and photomicrographs
  • List of common Abbreviations

  • Section I. Clinicopathological Correlation (42 pages). Correlations based upon indications for placental examination. Each Indication section includes: Definition, Clinical Association, Possible Placental Gross Features, Summary of Microscopic Features, Etiology, Significance:
    • Chapter 1: Placental Indications: Abruption Placentae, Accessory Lobe, Bilobed Placenta, Chorioamnionitis, chorioangioma, Circumvallate Placenta, Cyst, Hydatidiform Mole, Infarct, Large Placenta, Maternal Floor Infarction, Meconium, Placenta Creta, Placenta Previa, Placental Insufficiency, Single Umbilical Artery, Small Placenta, Succenturiate Lobe, Thick Placenta, Thin Placenta, Tumors, Twin Placenta/Multifetal Gestations, Umbilical Cord - Amniotic Web, Umbilical Cord - Thick, Thin, Umbilical Cord - Infection, Umbilical Cord - Insertion, Abnormal, Umbilical Cord - Knots, Umbilical Cord - Long, Short, Umbilical Cord - Two Vessel
    • Chapter 2: Maternal Indications: Alcohol, Bleeding, Cocaine, Diabetes Mellitus, Eclampsia, Gestational Diabetes, Group B Streptococcus, HELLP Syndrome, Hemorrhage, Hydramnios, Hypertensive States of Pregnancy, Incompetent Cervix, Infection/Maternal Fever, Marijuana, Maternal Autoimmune Disease, Maternal Heart Disease, Maternal HIV Infection, Oligohydramnios, Polyhydramnios, Pre-eclampsia, Pregnancy Induced Hypertension, Premature Rupture of Membranes, Preterm Labor, Rh Incompatibility, Sickle Cell Anemia, Smoking, Systemic Lupus Erythematosus, Trauma
    • Chapter 3: Fetal Indications: Low Apgar Scores, Congenital Anomalies, Fetal Distress, Fetal Growth Retardation, Hydrops, Intrauterine Growth Retardation, Macrosomia, Meconium, Neonate Fever, Nuchal Cord, Postdates, Prematurity, Prolapsed Umbilical Cord, Small for Gestational Age, Twin to Twin Transfusion Syndrome, Twins and Multifetal Gestations, Vasa Previa, Stillborn/Intrauterine Fetal Demise
    • References, Section I. Clinicopathological Correlation
  • Section II. Placental Pathology (68 pages). Systematic approach to gross placental examination, including review of normal and abnormal gross features:
    • Chapter 4: Development of the Placenta: A Synopsis: Fertilization and Implantation, Prelacunar Stage, Lacunar/Trabecular Stage, Early Villous Stage, Days 22-23, Days 26-29, Days 37-42, Third Month, Fourth Month, Fifth Month, Sixth Month, Seventh Month, Eighth Month, Ninth Month, Tenth Month, Summary
    • Chapter 5: Considerations of Examination: Initial Examination, For Microscopic Exam, "To Fix Or Not To Fix?", Blocks
    • Chapter 6: Gross Examination: Singleton Placenta (Importance, Procedure), Multifetal Placenta, Special Studies (Cultures, Karyotyping), Placental Weight (Variation and Significance, Small Placenta, Large Placenta), Placental Shape (Normal, Trophotropism, Thickness, Bilobed Placenta, Accessory Lobes, Unusual Shapes, Circummarginate and Circumvallate), Placental Implantation (Placenta Creta, Placenta Previa)
    • Chapter 7: Umbilical Cord: Size (Length, Long Cord, Short Cord, Achordia, Thickness), Insertion (Variations, Marginal Insertion, Velamentous Insertion, Theories of Abnormal Cord Insertions, Vasa Previa, Furcate Cord, Interposition, Amniotic Web), Twisting, Structure, Fetal-Placental Circulation, Cysts and Edema, Hematomas/Hemangiomas/Teratomas, Infection/Inflammation (Funisitis, Candidiasis, Necrotizing Funisitis), Knots (False Knots, True Knots), Meconium, Punctures, Prolapsed Umbilical Cord, Single Umbilical Artery, Strictures, Supernumerary Umbilical Vessels, Thrombosis, Other (Allantois Duct/Urachus, Omphalomesenteric Duct/Vitteline Duct, Torsion, Varices and Aneurysms)
    • Chapter 8: Extraplacental Membranes and Fetal Surface: Extraplacental Membranes (Structure, Amnion, Amnionic versus Amniotic, Spongy Layer, Chorion, Decidua), Fetal Surface/Chorionic Plate (Gross Appearance, Structure, Vascular Distribution), Marginal Zone (Structure, Subchorial Closing Ring, Placenta Marginata/Placenta Circumvallate), Point of Rupture, Amnion Nodosum (In Comparison to Other Granular Lesions), Amniotic Bands, Breus' Mole, Brown Discoloration, Chorioamnionitis, Chorioangioma, Cysts, Decidua (Decidua Vasculopathy and Atherosis), Extramembranous Pregnancy, Fetal Surface Vasculature (Thrombi, Superficial Placental Vasculature, Thrombi - Fetal Stem Vessel, Hemorrhagic Endovasculitis, Traumatic Laceration, Aneurysms), Hemorrhage, Infection (Prenatal Infections, Chorioamnionitis, Meconium and Chorioamnionitis), Meconium, Squamous Metaplasia, Subchorionic Fibrin, Yolk Sac, Other (Vernix Caseosa)
    • Chapter 9: Maternal Surface (Basal Plate): Gross and Microscopic Structure (Gross Appearance, Microscopic Appearance, Spiral Arteries), Abruptio Placentae, Calcification, Intactness/Placenta Creta, Maternal Floor Infarction, Retroplacental Blood Clot, Septa/Septal Cysts, Other (Maternal Vasculopathy)
    • Chapter 10: Parenchyma: Structure (Villous Tree, Hofbauer Cells, Intervillous Space and Placentone, Non-villous Structures, Vasculosyncytial Membranes, Placental Barrier), Chorioangioma, Color, Cysts, Edema, Fibrin/Fibrinoid,Gitterinfarct (Fibrin Versus Fibrinoid, Intervillous Fibrin and Intravillous Fibrinoid, Gitterinfarct), Holes, Infarcts, Infection - Bacterial (Bacterial vaginosis, Chlamydia trachomatis, Fusobacterium, Group B Streptococcus, Leprosy, Listeriosis, Mycoplasma hominis and Ureaplasma urealyticum ("T" strain of Mycoplasma), Neisseria gonorrhoeae, Syphilis, Tuberculosis (TB), Other Bacteria), Infection - Fungal (Candida, Torulopsis, Coccidioides immitis, Cryptococcosis), Infection - Viral/Villitides (Cytomegalovirus, Epstein-Barr Virus, Hepatitis, Herpes simplex Virus, Human Immunodeficiency Virus, Mumps, Parvovirus B19, Rabies, Rubella, TORCH Group, Varicella), Infection - Other (American Trypanosomiasis/Chagas' Disease, Malaria, Toxoplasmosis), Low Uteroplacental Blood Flow, Pale Areas, Thrombi, Tumors - Metastatic, Villitis, Other (Organization, Calcification, Microscopic Lesions).
    • Chapter 11: Multifetal Gestations: Twinning Overview, Zygosity (Placenta of Dizygous/Fraternal Twins, Placenta of Monozygous/Identical Twins), Determination of Chorionicity, Determination of Zygosity, Features Unique to Twin and Multifetal Placentas (Common Membrane, Vascular Equator, Vascular Anastomoses, Umbilical Cords, Parenchyma and Membranes, Cerebral Palsy), Features of Diamniotic Dichorionic Placentas, Features of Diamniotic Monochorionic Placentas (Vascular Anastomoses, Twin to Twin Transfusion Syndrome), Features of Monoamniotic Monochorionic Placentas, Higher order Multifetal Gestations, In Vitro Fertilization and Embryo Transfer, Vanished Twin, Fetus Papyraceous/Fetus Compressus, Acardiac Twin/Twin Reversed Arterial Perfusion
    • Chapter 12: Gestational Trophoblastic Disease: Overview, Review of the Trophoblast, Hydatidiform Mole (Genetics, Gross and Microscopic Characteristics, Clinical Course), Invasive Mole, Chorioadenoma Destruens, Trophoblastic Pseudotumor/Placental Site Trophoblastic Tumor/Syncytial Endometritis, Choriocarcinoma (Gross Appearance, Microscopic Features, Clinical Course)
    • References, Section II. Placental Pathology
  • Section III. Clinical Definitions (41 pages). Brief description of over 125 commonly encountered clinical terms and procedures:
    • Chapter 13: Clinical Definitions: Abortion, Ablatio Placentae, Abruptio Placentae, Accoucheur, Alpha-Fetoprotein, Amnioinfusion, Amniotic Fluid Index, Apgar Score, Artificial Insemination, Uterine Atony, Battledore Placenta, Betamethasone, Biophysical Profile, Braxton-Hick's Contractions, Breech, Brethine, Cervical Cerclage, Cesarean Section, Chorioangioma, Choriocarcinoma, Clomid, Contraction Stress Test, Couvelaire Uterus, Deceleration, Dystocia, Eclampsia, Ectopic Pregnancy, Cervical Effacement, Embryo, Engagement, Erythroblastosis Fetalis, Estimated Date of Confinement - Nagele's Rule, Eutocia, Failure to Progress, Fetal Development, Fetal Distress, Fetal Dysmaturity, Fetal Growth Retardation, Periodic Fetal Heart Rate, Fetal Lie, Fetal Lung Maturity, Fetal Position, Fetal Presentation, Fetal Well Being Assessment, Fetus, Fullterm, Gestational Age, Gestational Age - Clinical Parameters, Gestational Diabetes, Gestational Trophoblastic Disease, Gestational Trophoblastic Tumors, Gamete Intrafallopian Tube Transfer, Grading of Placental Maturity, Hemangioma, Third Trimester Hemorrhage, Hydatidiform Mole, Hydramnios, Hypertensive States of Pregnancy, In Vitro Fertilization, Incompetent Cervix, Indications for Induction of Labor: Conditions/Fetal/Maternal, Extremely Low Birth Weight Infant, Low Birth Weight Infant, Very Low Birth Weight Infant, Infertility, Artificial Insemination, Intrauterine Death, Intrauterine Growth Retardation, Isoimmunization, Labor, Large for Gestational Age, Latent Period, Lecithin-Sphingomyelin, Low Lying Placenta, L/S Ratio, Macrosomia, Magnesium Sulfate, Marginal Cord Insertion, Meconium, Miscarriage, Molar Pregnancy, Invasive Mole, Multigravida, Multipara, Multiparity, Nagele's Rule, Neonate, Newborn Assessment, Nidation, Nonstress Test, Nullipara, Oligohydramnios, Oxytocin, Parturition, Pergonal, Perinatal Period, Pitocin, Placenta Creta, Placenta Maturity Grading, Placenta Previa, Placental Aging, Placental Site Trophoblastic tumor, Polyhydramnios, Postdates/Postterm, Postpartum Hemorrhage, Pre-Eclampsia, Premature Placental Aging, Premature Rupture of Membranes, Premature Separation of the Placenta, Preterm, Preterm Labor, Primigravida, Primipara, Puerpera, Quickening, Rh/Rhesus Incompatibility, RhoGam, Secundigravida, Small for Gestational Age, Sphingomyelin, Terbutaline Sulfate, Term, Tocolysis, TORCH Infection, Toxemia, Trendelenburg Position, Trimesters, Twin To Twin Transfusion Syndrome, Twins, Umbilical Cord Clamping, Umbilical Cord Prolapse, Uterine Atony, Uterine Inversion, Uterine Rupture, Uteroplacental Apoplexy, Valsalva Maneuver, Vasa Previa, Velamentous Cord Insertion, Vernix Caseosa, Version, Vertex, Zygote Intrafallopian Tube Transfer
    • References, Section III. Clinical Definitions
  • Section IV. Legal Implications (6 pages). Review of importance of placental examination, in the litigation process for neurologically impaired children:
    • Chapter 14: Legal Implications: Birth Injury, Cerebral Palsy, Fetal Growth Retardation, Meconium, Multifetal Placenta, Postdates, Prematurity, Placental Examination
    • References, Section IV. Legal Implications
  • Index (11 pages)