Evaluation and implementation of placental data collection for improved diagnostic accuracy in clinical practice: an observational study

ABSTRACT

Objective. The placenta is a crucial organ in pregnancy, yet its clinical evaluation remains limited. Inadequate data collection can lead to misinterpretations by pathologists, especially in cases of adverse outcomes. This study aimed to assess the feasibility, efficiency, and clinical utility of a standardized Placenta Documentation Form to improve placental evaluation and diagnostic accuracy.

Patients and Methods. This observational study enrolled 209 pregnant women delivering at the University of Pisa between February and June 2024. Inclusion criteria were singleton pregnancies, gestational age ≥37 weeks, physiological labor and delivery. A total of 123 placentas from normal pregnancies were analyzed. The Placenta Documentation Form, completed post-delivery, recorded placental, membrane, and umbilical cord characteristics. The time elapsed during data collection and form completion, and staff’s satisfaction (rated on a 5-point Likert scale) were assessed. Statistical analyses were performed using GraphPad Prism 10.

Results. The mean data collection and completion forms times were 318.7±111.3 and 224.3±99.4 seconds, respectively, with staff maximum satisfaction level reaching 81.3%. Placental clots, often associated with pathological conditions, were detected in 26.02% of cases, yet did not correlate with adverse outcomes. Membrane thickness and meconium staining were noted despite the absence of infection. Umbilical cord insertions varied, with marginal insertion in 30.08% and velamentous in 0.81% women, yet all resulted in normal deliveries.

Conclusions. The Placenta Documentation Form is a practical and well-accepted tool that enhances placental evaluation without disrupting clinical workflow. Its routine implementation could improve diagnostic accuracy and prevent misinterpretations in both normal and pathological pregnancies.